Bill To:


Acord Insurance
1 Blue Hill Plaza PO Box 1529
Pearl River, NY 10965

Services Rendered To:


MP Global 6 Inc
11 S 315 Madison St Floor 2
Burr Ridge, IL 60527
POLICY# GL2207476-90034


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

    $350.00
    2
    $700.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    2
    $600.00
  3. 331 Air Bags (# Used)

    $150.00
    4
    $600.00
  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  6. 402 Fire/Police Services (Per Hour)    

    $100.00
    2
    $200.00
  7. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  8. 206 Latex Gloves (Pairs Used)

    $2.00
    5
    $10.00
  9. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  10. 203 Oil Boom (# Used)

    $20.00
    2
    $40.00
  11. 404 Scene Lighting (Per Hour)

    $75.00
    2
    $150.00
  12. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  13. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  14. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  15. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  16. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 43 & Colburn Mills Rd- Russellville, AL

Subtotal $3,715.00
Total Due $3,715.00


Updated
December 7, 2022 @ 10:09 am

Invoice updated by Geoffrey.

Status Update
December 7, 2022 @ 10:09 am

Status changed: Draft to Pending.

Viewed
March 30, 2024 @ 12:07 am

Invoice viewed by 66.249.72.5 for the first time.