Bill To:


WilsonArt LLC
2501 Wilsonart Drive P.O. Box 6110
Temple, TX 76503

Services Rendered To:


Wilson Art LLC
VIN# 3AKJHHDR0LSMC3337
POLICY# AS2631510797012

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-01-717-22-1209-E 12/09/2022 12/21/2022 On Receipt Tri Community VFD / Millerville VFD

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

Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient

    Kerry Morgan

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 68875 Hwy 9- Goodwater, AL

Subtotal $1,500.00
Total Due $1,500.00


Updated
December 21, 2022 @ 1:41 pm

Invoice updated by Geoffrey.

Updated
May 18, 2023 @ 2:52 pm

Invoice updated by Geoffrey.

Updated
May 24, 2023 @ 2:34 pm

Invoice updated by Geoffrey.