Bill To:


Arkansas Farm Bureau
P.O. Box 31
Little Rock, AR 72203

Services Rendered To:


Fonda Miller
101 Jackson 120
Newport, AR 72112
Phone# 870-217-3964

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AR-34-008-22-28 05/20/2022 09/22/2023 On Receipt Erwin VFD

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

    $500.00
    3
    $1,500.00
  2. 104 Tanker Response (Per Hour)

    $400.00
    3
    $1,200.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    3
    $600.00
  4. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  5. 304 SCBA Cylinder (# Used)

    $25.00
    3
    $75.00
  6. 404 Scene Lighting (Per Hour)

    $75.00
    3
    $225.00
  7. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  8. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 101 Jackson 120 Newport, AR 72112

Subtotal $3,800.00
Total Due $3,800.00


Updated
September 22, 2023 @ 11:10 am

Invoice updated by Geoffrey.

Status Update
September 22, 2023 @ 11:10 am

Status changed: Draft to Pending.