Bill To:


Terry Ebert
815 Wernsing Road
Jasper, IN 47546

Services Rendered To:


Terry Eber
815 Wernsing Road
Jasper, Indiana 47546

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-016-2021-21 06/17/2020 05/17/2021 On Receipt Paradise Point Fire Department

*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $250.00
    4
    $1,000.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    4
    $1,000.00
  3. 410 Fire Department Response Fee – Lvl 1

    $200.00
    1
    $200.00

  4. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: Lotawatah & I-40 - Checotah, OK

Subtotal $2,200.00
Total Due $2,200.00


Updated
May 16, 2021 @ 7:25 pm

Invoice updated by Geoffrey.

Status Update
May 16, 2021 @ 7:25 pm

Status changed: Draft to Pending.

Updated
May 16, 2021 @ 7:25 pm

Invoice updated by Geoffrey.

Viewed
May 16, 2021 @ 7:25 pm

Invoice viewed by 63.88.73.4 for the first time.

Updated
May 16, 2021 @ 7:28 pm

Invoice updated by Geoffrey.

Updated
May 16, 2021 @ 7:29 pm

Invoice updated by Geoffrey.

Updated
May 16, 2021 @ 7:30 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 10:29 pm

Invoice viewed by 64.124.8.27 for the first time.