Bill To:


ALFA INSURANCE
207 Hwy 78 W
Jasper, AL 35501

Services Rendered To:


Kathlyn Tripplet
190 Lime Rock Rd
Tuscumbia, AL 35674
POLICY# A1817229

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-02-006-23-177 06/02/2023 06/05/2023 On Receipt Littleville VFD

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

    $350.00
    1
    $350.00
  2. 331 Air Bags (# Used)

    $150.00
    6
    $900.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 209 Extinguisher (# Used)

    $50.00
    1
    $50.00
  6. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  7. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  8. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  9. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  10. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  11. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  12. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  13. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  14. 327 Windshield Kit (# Used)

    $25.00
    1
    $25.00
  15. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  16. 419 Environmental Spill

    $250.00
    1
    $250.00

  17. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1369 George Wallace Hwy- Russellville, AL

    Ordinance Info: Littleville Volunteer Fire Dept. Resolution

Subtotal $2,585.50
Total Due $2,585.50


Updated
June 5, 2023 @ 11:36 am

Invoice updated by Geoffrey.

Status Update
June 5, 2023 @ 11:36 am

Status changed: Draft to Pending.