Bill To:


Joshua Wood
PO Box 801649
Dallas, TX 75380-1649

Services Rendered To:


Joshua Wood
PO Box 801649
Dallas, TX 75380-1649
Policy # BAS 59604153


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $350.00
    1.25
    $437.50
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50
  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 204 Flate (# Used)

    $8.00
    4
    $32.00
  7. 319 Generator (Per Generator/Per Hour)

    $50.00
    1.25
    $62.50
  8. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  9. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  10. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  11. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  12. 201 Oil Absorbent Material (# Used)

    $35.00
    3
    $105.00
  13. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  14. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  15. 327 Windshield Kit (# Used)

    $25.00
    1
    $25.00
  16. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  17. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US Highway 62 - Lawton, OK

Subtotal $2,102.50
Total Due $2,102.50

Final Notice

06/11/2022


Updated
July 18, 2021 @ 4:16 pm

Invoice updated by Geoffrey.

Updated
July 26, 2021 @ 1:29 pm

Invoice updated by Geoffrey.

Updated
July 26, 2021 @ 1:29 pm

Invoice updated by Geoffrey.

Updated
July 26, 2021 @ 1:33 pm

Invoice updated by Geoffrey.

Updated
June 11, 2022 @ 4:54 pm

Invoice updated by Karen Smith.

Updated
June 11, 2022 @ 4:56 pm

Invoice updated by Karen Smith.

Updated
June 11, 2022 @ 4:56 pm

Invoice updated by Karen Smith.