Bill To:


Equity Insurance Company
616 S. Boston Avenue #500
Tulsa, OK 74119

Services Rendered To:


Kyle Barrett Standley
103252 S. 4080 Road
Henryetta, OK 74437
CLAIM # 2104-244103-88
Adjuster: Monic Carpenter
918-582-7700 ext. # 4619

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-016-2021-03-02 04/24/2021 05/18/2021 On Receipt Paradise Point Fire Department

*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 266 & 1050 Road - Council Hill, OK

    Ordinance Info: Paradise Point Cost Recovery Resolution 1621

Subtotal $1,000.00
Total Due $1,000.00


Updated
May 17, 2021 @ 4:11 pm

Invoice updated by Geoffrey.

Updated
October 19, 2021 @ 5:58 pm

Invoice updated by Geoffrey.