Bill To:


Hertz
8501 Williams Road
Estero, FL 33928

Services Rendered To:


Tammy Morgan
49723 Kettle Mills Rd
Hampshire, TN 38461
Vin# 3N1CN8EV7ML924447
LICENSE PLATE# BHN-X05

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-015-22-8231-E 12/23/2022 12/26/2022 On Receipt Tiger Mtn FD

Product
Price
Qty
Amount
  1. 405 Medical Extrication – Lvl 1

    Patient

    Tammy Morgan
    49723 Kettle Mills Rd
    Hampshire, TN 38461
    Vin# 3N1CN8EV7ML924447
    LICENSE PLATE# BHN-X05

    $500.00
    1
    $500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 E Bound MM 250- Henryetta, OK

    Ordinance Info: Tiger Mountain - McIntosh County Resolution 72021

Subtotal $500.00
Total Due $500.00


Updated
December 26, 2022 @ 2:32 pm

Invoice updated by Geoffrey.

Updated
December 26, 2022 @ 2:32 pm

Invoice updated by Geoffrey.

Viewed
December 28, 2022 @ 7:39 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.