Bill To:


ALFA INSURANCE
207 Hwy 78 W
Jasper, AL 35501

Services Rendered To:


Regina Scott
250 Mobley Xing
Vina, AL 35593
POLICY# 19001271793


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

    $350.00
    1
    $350.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 331 Air Bags (# Used)

    $150.00
    1
    $150.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US Hwy 43 & Lake Jackson Ln- Russellville, AL

Subtotal $885.00
Total Due $885.00


Updated
January 11, 2023 @ 10:17 am

Invoice updated by Geoffrey.

Status Update
January 11, 2023 @ 10:17 am

Status changed: Draft to Pending.