Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Gloria Williams
22848 Gulfwinds Ln
Lebanon, MO 65536
POLICY# 6428983-E1425


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

    $350.00
    1.75
    $612.50

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: N Hwy 5 & Kansas Rd- Lebanon, MO

Subtotal $612.50
Total Due $612.50


Updated
May 8, 2023 @ 11:02 am

Invoice updated by Geoffrey.

Status Update
May 8, 2023 @ 11:02 am

Status changed: Draft to Pending.