Bill To:


Buford Fox
20185 S.E. 43rd
Harrah, OK 73045

Services Rendered To:


Buford Fox
20185 S.E. 43rd
Harrah, OK 73045

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-55-024-22-002 01/03/2022 01/25/2022 On Receipt Newalla Fire Department

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

    $300.00
    1
    $300.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  3. 216 Oxygen (# Used)

    $25.00
    1
    $25.00
  4. 232 N95 Mask (Per Unit/Per Use)

    $10.00
    3
    $30.00
  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: 20185 S.E. 43rd - Harrah, OK 73045

Subtotal $621.00
Total Due $621.00


Updated
January 24, 2022 @ 5:05 pm

Invoice updated by Geoffrey.

Status Update
January 24, 2022 @ 5:05 pm

Status changed: Draft to Pending.

Updated
January 24, 2022 @ 5:06 pm

Invoice updated by Geoffrey.

Updated
January 24, 2022 @ 5:06 pm

Invoice updated by Geoffrey.