Bill To:


Ace American Insurance
436 Walnut Street
Philadelphia, PA 19106-3703

Services Rendered To:


Autozone Parts Inc
130 Green Springs Hwy
Birmingham, AL 35209
POLICY# ISAH2555923A


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

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  7. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  8. 216 Oxygen (# Used)

    $25.00
    1
    $25.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 4800 Block AL Hwy 155- Montevallo, AL

Subtotal $1,173.00
Total Due $1,173.00


Updated
January 27, 2023 @ 11:34 am

Invoice updated by Geoffrey.

Status Update
January 27, 2023 @ 11:34 am

Status changed: Draft to Pending.