Bill To:


Arkansas Farm Bureau
P.O. Box 31
Little Rock, AR 72203

Services Rendered To:


Mary Kay Hardin
11589 Hwy 17
Tupelo, AR 72169
Phone# 870-512-9264

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AR-34-008-23-11 03/30/2023 09/22/2023 On Receipt Erwin VFD

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

    $500.00
    1.25
    $625.00
  2. 104 Tanker Response (Per Hour)

    $400.00
    1.25
    $500.00
  3. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 11589 Hwy 17 Tupelo, AR 72169

Subtotal $1,475.00
Total Due $1,475.00


Updated
September 22, 2023 @ 11:19 am

Invoice updated by Geoffrey.

Status Update
September 22, 2023 @ 11:19 am

Status changed: Draft to Pending.