Bill To:


Property Owner
403488 E. 1090 Road
Henryetta, OK 74437

Services Rendered To:


Property Owner
403488 E. 1090 Road
Henryetta, OK 74437


*** Please Submit this to your PROPERTY/HOMEOWNER Insurance Company for processing and payment OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1
    $500.00
  2. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1
    $500.00
  3. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: 403488 E. 1090 Road Henryetta, OK 74437

Subtotal $1,275.00
Total Due $1,275.00


Updated
July 12, 2021 @ 3:52 pm

Invoice updated by Geoffrey.

Status Update
July 12, 2021 @ 3:52 pm

Status changed: Draft to Pending.

Viewed
March 29, 2024 @ 11:47 pm

Invoice viewed by 66.249.72.4 for the first time.