Bill To:


Zachary Wood
7720 East Eagle Drive
Bixby, OK 74008

Services Rendered To:


Zachary Wood
7720 E. Eagle Drive, Apt.101
Bixby, OK 74008
Policy # 1391985B05365

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-007-2020-82201-A 08/22/2020 12/26/2020 On Receipt F.A.I.C. V.F.D.

*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $500.00
    3
    $1,500.00
  2. 103 Rescue Response (Per Hour)

    $500.00
    3
    $1,500.00
  3. 102 Engine Response (Per Hour)

    $500.00
    3
    $1,500.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    3
    $300.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 MM 259 Just West of Checotah, OK

Subtotal $4,800.00
Total Due $4,800.00


Updated
December 26, 2020 @ 7:10 pm

Invoice updated by Geoffrey.

Status Update
December 26, 2020 @ 7:10 pm

Status changed: Draft to Pending.

Updated
December 26, 2020 @ 7:12 pm

Invoice updated by Geoffrey.

Updated
October 4, 2021 @ 12:42 pm

Invoice updated by Geoffrey.

Updated
October 4, 2021 @ 12:42 pm

Invoice updated by Geoffrey.

Viewed
October 25, 2022 @ 2:53 pm

Invoice viewed by 64.124.8.25 for the first time.

Viewed
November 19, 2023 @ 10:16 am

Invoice viewed by 102.113.204.248 for the first time.