Bill To:


Salma Kanwal
4512 S Kingston Ave
Tulsa, OK 74135

Services Rendered To:


Saima Kanwal
4512 S Kingston Ave
Tulsa, OK 74135
POLICY# 3624990512


*** DUE TO NO INSURANCE COVERAGE AT THE TIME OF THIS LOSS, YOU ARE NOW RESPONSIBLE FOR PAYMENT. ***

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

    $500.00
    1
    $500.00
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    100
    $25.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  6. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  7. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  9. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Turner Turnpike MM155 - Wellston, OK

Subtotal $1,333.00
Total Due $1,333.00


Updated
November 27, 2023 @ 9:30 pm

Invoice updated by Geoffrey.

Status Update
November 27, 2023 @ 9:30 pm

Status changed: Draft to Pending.

Updated
January 23, 2024 @ 2:50 pm

Invoice updated by Geoffrey.