Bill To:


Analise Westbrook
3601 Granddaughter LN, Lot 16
Harrah, OK 73045

Services Rendered To:


Analise Westbrook
3601 Granddaughter LN, Lot 16
Harrah, Oklahoma 73045

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-55-024-22-007 01/14/2022 01/25/2022 On Receipt Newalla Fire Department

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Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  3. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  4. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: 3601 Granddaughter LN, Lot 16 Harrah, Oklahoma 73045

Subtotal $558.00
Total Due $558.00


Updated
January 24, 2022 @ 7:52 pm

Invoice updated by Geoffrey.

Status Update
January 24, 2022 @ 7:52 pm

Status changed: Draft to Pending.

Updated
January 24, 2022 @ 7:52 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 11:45 pm

Invoice viewed by 64.124.8.28 for the first time.