Bill To:


FARM BUREAU INSURANCE
5400 UNIVERSITY AVENUE
WEST DES MOINES, IA 50266-5997

Services Rendered To:


Ashley Eaton
1237 Glenridge
Lebanon, MO 65536
POLICY # APV070494


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

    $350.00
    1
    $350.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 27257 Missouri Drive - Lebanon, MO

Subtotal $708.00
Total Due $708.00


Updated
September 2, 2022 @ 5:49 pm

Invoice updated by Geoffrey.

Status Update
September 2, 2022 @ 5:49 pm

Status changed: Draft to Pending.