Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Larry Pennyaman
License Plate# 62A16CM
POLICY# 831629950


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

    $350.00
    1.75
    $612.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00
  6. 404 Scene Lighting (Per Hour)

    $75.00
    1.75
    $131.25
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  8. 207 Wetting Agent (Amt Used)

    $25.00
    10
    $250.00
  9. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00
  10. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  11. 419 Environmental Spill

    $250.00
    1
    $250.00

  12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Old 280 & Hwy 280- Camp Hill, AL

Subtotal $2,753.75
Total Due $2,753.75


Updated
June 13, 2023 @ 11:23 am

Invoice updated by Geoffrey.

Status Update
June 13, 2023 @ 11:23 am

Status changed: Draft to Pending.