Bill To:


Kaemon Richmer
9801 N.W. Madische Road
Elgin, OK 73538

Services Rendered To:


Kaemon Richmer
9801 NW Madische Road
Elgin, Oklahoma 73538
Policy # 948736722

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-16-016-2021-225 09/17/2021 10/08/2021 On Receipt Wichita Mountain Estates V.F.D.

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

    $500.00
    1
    $500.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US 62 - Lawton, Oklahoma

Subtotal $1,493.00
Total Due $1,493.00


Updated
October 7, 2021 @ 10:06 pm

Invoice updated by Geoffrey.

Status Update
October 7, 2021 @ 10:07 pm

Status changed: Draft to Pending.

Updated
October 8, 2021 @ 1:50 pm

Invoice updated by Geoffrey.

Updated
October 8, 2021 @ 1:50 pm

Invoice updated by Geoffrey.

Updated
February 4, 2022 @ 5:42 pm

Invoice updated by Geoffrey.

Updated
February 4, 2022 @ 5:42 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 8:11 pm

Invoice viewed by 64.124.8.32 for the first time.

Viewed
July 22, 2024 @ 5:45 am

Invoice viewed by 69.171.249.14 for the first time.