Bill To:


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

Services Rendered To:


Steven Kerr
1703 N 168th E Ave
Tulsa, Oklahoma 74116
POLICY# MCP69307A


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

    $150.00
    1.5
    $225.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  3. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 377 N of Sandusky Rd- Whitesboro, TX

Subtotal $630.00
Total Due $630.00


Updated
February 2, 2023 @ 12:39 pm

Invoice updated by Geoffrey.

Status Update
February 2, 2023 @ 12:39 pm

Status changed: Draft to Pending.

Updated
February 7, 2023 @ 3:33 pm

Invoice updated by Geoffrey.

Updated
February 7, 2023 @ 3:34 pm

Invoice updated by Geoffrey.