Bill To:


COUNTRY INSURANCE
1100 W Evergreen Ave
Effingham, IL 62401

Services Rendered To:


Earl Willis
POLICY# JA7726864
License Plate# CRSMCN


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

    $300.00
    1.25
    $375.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 242 Old 280 Rd- Camp Hill, AL

Subtotal $500.00
Total Due $500.00


Updated
June 13, 2023 @ 11:12 am

Invoice updated by Geoffrey.

Status Update
June 13, 2023 @ 11:12 am

Status changed: Draft to Pending.