Bill To:


Rodney Ford
300 S 600 Rd
Quapaw, OK 74363

Services Rendered To:


Rodney Ford
300 S 600 Rd
Quapah, OK 74363
Vin # 3AKJGHDV465HD3225
POLICY # ISAH2554158A


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

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

    $300.00
    4
    $1,200.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    4
    $400.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 221 SB IH 45 Angus, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $1,600.00
Total Due $1,600.00


Updated
September 19, 2022 @ 6:12 pm

Invoice updated by Geoffrey.

Updated
September 19, 2022 @ 6:12 pm

Invoice updated by Geoffrey.

Status Update
September 19, 2022 @ 6:12 pm

Status changed: Draft to Pending.

Status Update
September 19, 2022 @ 6:12 pm

Status changed: Draft to Pending.

Updated
March 28, 2023 @ 11:28 am

Invoice updated by Geoffrey.