Bill To:


GREAT WEST CASUALTY
1100 WEST 29th STREET
SOUTH SOUIX CITY, NE 68776-3130

Services Rendered To:


Heniff TTL, LLC
1655 Rich Road
Richmond, IN 47674

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
MO-07-714-22-12 02/03/2022 02/04/2022 On Receipt Timber Knob V.F.D.

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 5 South - South of West Highway - Gainesville, MO

Subtotal $700.00
Total Due $700.00


Updated
February 4, 2022 @ 3:47 pm

Invoice updated by Geoffrey.

Status Update
February 4, 2022 @ 3:47 pm

Status changed: Draft to Pending.

Viewed
October 22, 2022 @ 7:50 am

Invoice viewed by 64.124.8.27 for the first time.