Bill To:


Joseph Bryant
339 Melton Road
Burkesville, KY 42717

Services Rendered To:


Joseph Bryant
339 Melton Road
Burkesville, KY 42717
Policy # AKY0012392

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
KY-00-921-21-107 11/10/2021 11/23/2021 On Receipt Breeding Area 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)

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 301 Hand Tool (# Used)

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

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 61 - Breeding, Kentucky

Subtotal $915.00
Total Due $915.00


Updated
November 22, 2021 @ 4:38 pm

Invoice updated by Geoffrey.

Status Update
November 22, 2021 @ 4:38 pm

Status changed: Draft to Pending.

Updated
November 22, 2021 @ 4:38 pm

Invoice updated by Geoffrey.

Updated
August 31, 2022 @ 4:57 pm

Invoice updated by Geoffrey.

Updated
August 31, 2022 @ 4:57 pm

Invoice updated by Geoffrey.