Bill To:


FEDERATED MUTUAL INSURANCE
121 EAST PARK SQUARE
OWATONNA, MN 55060-3046

Services Rendered To:


Rosscom LLC
Policy# 9186648


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

    $350.00
    1.75
    $612.50
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  4. 324 Traffic Cone (# Used)

    $5.00
    20
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 MM 254 WB- Checotah, OK

Subtotal $1,150.00
Total Due $1,150.00


Updated
May 10, 2023 @ 1:10 pm

Invoice updated by Geoffrey.

Status Update
May 10, 2023 @ 1:10 pm

Status changed: Draft to Pending.