Bill To:


Falcon Insurance Company
P.O. Box 3577
Oak Brook, IL 60522

Services Rendered To:


Joshua Jackson
6998 NW Shoyer Rd
Lawton, OK 73507
POLICY# 0400010530-6


Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  2. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  4. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  6. 324 Traffic Cone (# Used)

    $5.00
    8
    $40.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 23336 OK 58- Lawton, OK

Subtotal $1,071.25
Total Due $1,071.25


Updated
April 18, 2023 @ 3:10 pm

Invoice updated by Geoffrey.

Status Update
April 18, 2023 @ 3:10 pm

Status changed: Draft to Pending.