Bill To:


FARM BUREAU INSURANCE
5400 UNIVERSITY AVENUE
WEST DES MOINES, IA 50266-5997

Services Rendered To:


Stuart Burns
1844 Rogers Avenue
Stoutland, MO 65567
Ph # 417-322-2761
Policy # Not Available on Scene


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

    $350.00
    1.75
    $612.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  6. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: West Highway H - Stoutland, MO

Subtotal $1,840.00
Total Due $1,840.00


Updated
August 26, 2021 @ 8:24 pm

Invoice updated by Geoffrey.

Status Update
August 26, 2021 @ 8:24 pm

Status changed: Draft to Pending.