Bill To:


SHELTER INSURANCE
1817 WEST BROADWAY
COLUMBIA, MO 65203-1107

Services Rendered To:


Linda Liska
4619 Ulan Road
Indianola, OK 74442
POLICY # 35-1-7256576-9


Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    2
    $600.00
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  5. 324 Traffic Cone (# Used)

    $5.00
    3
    $15.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Indian Nation Turnpike - 1113092 South 3980 Road, OK

    Ordinance Info: SALEM-RYAL FIRE DEPT. RESOLUTION NO. 72821

Subtotal $1,085.00
Total Due $1,085.00


Updated
August 12, 2022 @ 3:07 pm

Invoice updated by Geoffrey.

Status Update
August 12, 2022 @ 3:07 pm

Status changed: Draft to Pending.