Bill To:


Farmer's Insurance
PO Box 0991
Carol Stream, IL 60132-0991

Services Rendered To:


Raeann Crank
2082 S Hwy 48
Terlton, OK 74081
POLICY# A7997748060

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-59-007-23-51 04/21/2023 07/14/2023 On Receipt North 48 Fire Department

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

    $500.00
    6
    $3,000.00
  2. 104 Tanker Response (Per Hour)

    $400.00
    6
    $2,400.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    6
    $1,200.00
  4. 103 Rescue Response (Per Hour)

    $400.00
    6
    $2,400.00
  5. 105 Utility Vehicle Response (Per Hour)

    $250.00
    6
    $1,500.00
  6. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  7. 205 Foam (Per Gallon)

    $65.00
    30
    $1,950.00
  8. 319 Generator (Per Generator/Per Hour)

    $50.00
    6
    $300.00
  9. 310 Hydraulic Tool (# Used)

    $200.00
    4
    $800.00
  10. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  11. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  12. 202 Oil Absorbent Sheet (# Used)

    $2.50
    4
    $10.00
  13. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00
  14. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    6
    $300.00
  15. 304 SCBA Cylinder (# Used)

    $25.00
    6
    $150.00
  16. 404 Scene Lighting (Per Hour)

    $75.00
    6
    $450.00
  17. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    6
    $600.00
  18. 306 Hose Per 50′ (Amt Used)

    $25.00
    9
    $225.00

  19. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 370468 E 5605 Rd- Terlton, OK

Subtotal $15,786.00
Total Due $15,786.00


Updated
July 14, 2023 @ 12:36 pm

Invoice updated by Geoffrey.

Status Update
July 14, 2023 @ 12:36 pm

Status changed: Draft to Pending.

Viewed
July 22, 2024 @ 6:20 am

Invoice viewed by 173.252.83.29 for the first time.