Bill To:


R.D. Stephenson
21770 Old Oak Drive
Newalla, OK 74857

Services Rendered To:


R.D. Stephenson
21770 Old Oak Drive
Newalla, OK 74857

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-55-024-22-90 04/09/2022 04/23/2022 On Receipt Newalla Fire Department

*** Please Submit this to your PROPERTY/HOMEOWNER Insurance Company for processing and payment OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 410 Fire Department Response Fee – Lvl 1

    $200.00
    1
    $200.00

  2. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: 21770 Old Oak Drive Newalla, OK 74857

Subtotal $200.00
Total Due $200.00


Updated
April 22, 2022 @ 7:37 pm

Invoice updated by Geoffrey.

Status Update
April 22, 2022 @ 7:37 pm

Status changed: Draft to Pending.

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