Bill To:


Farmers Insurance
PO Box 268993
Oklahoma City, OK 73126

Services Rendered To:


VEHICLE OWNER
LIC.# CA 8PZU395
POLICY # 046845432


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

    $300.00
    1
    $300.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 225 Southbound on Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $650.00
Total Due $650.00


Updated
September 17, 2022 @ 3:46 pm

Invoice updated by Geoffrey.

Status Update
September 17, 2022 @ 3:46 pm

Status changed: Draft to Pending.