Bill To:


Rose Yeager
2922 E. Highway H
Stoutland, MO 65567

Services Rendered To:


Rose Yeager
2922 E. Highway H
Stoutland, Missouri 65567

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
MO-05-307-22-413 04/13/2022 04/14/2022 On Receipt Eldridge V.F.D.

*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

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

    $150.00
    1.25
    $187.50
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Pawnee Drive - Eldridge, Missouri

Subtotal $640.00
Total Due $640.00


Updated
April 14, 2022 @ 3:51 pm

Invoice updated by Geoffrey.

Status Update
April 14, 2022 @ 3:51 pm

Status changed: Draft to Pending.