Bill To:


Wichita Area Team Comm. Help, Inc.
840 North Wabash
Wichita, TX 67214

Services Rendered To:


Natalie Feagin
Ph# 440-566-5242
2014 Freightliner
VIN.# 3AKJGLD65ESFV1109
Policy # 026712380
Claim # 213410132
Adjuster: Marcus Jones


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $150.00
    1
    $150.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    16
    $32.00
  6. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  7. 403 Traffic Control / Road Closure (Per Hour)

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

    4 patients Extricated 

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 226 Southbound Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $1,397.00
Total Due $1,397.00


Updated
February 22, 2021 @ 4:03 pm

Invoice updated by Geoffrey.

Status Update
February 22, 2021 @ 4:03 pm

Status changed: Draft to Pending.

Updated
May 28, 2021 @ 7:25 pm

Invoice updated by Geoffrey.

Updated
May 29, 2021 @ 4:23 pm

Invoice updated by Geoffrey.

Updated
July 15, 2021 @ 2:37 pm

Invoice updated by Geoffrey.

Updated
August 31, 2021 @ 4:31 pm

Invoice updated by Geoffrey.

Updated
August 31, 2021 @ 4:34 pm

Invoice updated by Geoffrey.