Bill To:


Canal Insurance
P.O Box 7
Greenville, SC 29602

Services Rendered To:


Hotshot Freight System LLC
3930 Buena Vista Cir
Granbury, TX 76409
POLICY# CT2158125349

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-01-403-24-224 03/07/2024 03/14/2024 On Receipt Jemison FD

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

    $500.00
    1.75
    $875.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1.75
    $700.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  4. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  6. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 218 I-65 NB- Jemison, AL

Subtotal $2,116.00
Total Due $2,116.00


Updated
March 14, 2024 @ 3:39 pm

Invoice updated by Geoffrey.

Status Update
March 14, 2024 @ 3:39 pm

Status changed: Draft to Pending.