Bill To:


Certus Thomas
13695 SSR-E
Eldridge, MO 65463

Services Rendered To:


Certus Thomas
13695 Highway e
Eldridge, MO 65463

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
MO-05-307-22-132 10/04/2022 03/27/2023 On Receipt Eldridge V.F.D.

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Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 13695 Highway E- Eldridge, MO

Subtotal $400.00
Total Due $400.00


Updated
March 27, 2023 @ 3:58 pm

Invoice updated by Geoffrey.

Status Update
March 27, 2023 @ 3:58 pm

Status changed: Draft to Pending.

Updated
May 8, 2023 @ 4:30 pm

Invoice updated by Geoffrey.