Bill To:


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

Services Rendered To:


Peggy Moore
2090 Kirkland Ave
Russellville, AL 35654
POLICY# 4159252C1901B


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

    $500.00
    1.25
    $625.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.25
    $312.50
  3. 331 Air Bags (# Used)

    $150.00
    2
    $300.00
  4. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  6. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00
  7. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  8. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  9. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75
  10. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  12. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  13. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: George Wallace Hwy & Lynwood Ave- Russellville, AL

    Ordinance Info: Littleville FD Billing Resolution

Subtotal $2,354.25
Total Due $2,354.25


Updated
February 8, 2024 @ 10:12 am

Invoice updated by Geoffrey.

Status Update
February 8, 2024 @ 10:12 am

Status changed: Draft to Pending.