Bill To:


ALFA INSURANCE
207 Hwy 78 W
Jasper, AL 35501

Services Rendered To:


Daniel Spratling
727 Minter Rd
Camp Hill, AL 36850
POLICY# 19000025717

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-06-203-22-1208 12/28/2022 02/01/2023 On Receipt Camp Hill VFD

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

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 301 Hand Tool (# Used)

    $15.00
    5
    $75.00
  4. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    3
    $150.00
  5. 304 SCBA Cylinder (# Used)

    $25.00
    3
    $75.00

  6. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 727 Minter Rd- Camp Hill,AL

Subtotal $800.00
Total Due $800.00


Updated
February 1, 2023 @ 12:34 am

Invoice updated by Geoffrey.

Status Update
February 1, 2023 @ 12:34 am

Status changed: Draft to Pending.