Bill To:


NATIONAL GENERAL INSURANCE
PO BOX 3199
WINSTON SALEM, NC 27102-3199

Services Rendered To:


Edgar Garcia
3400 Treeline Ct Apt 910
Birmingham, AL 35216
POLICY# 2018046770


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

    $500.00
    2
    $1,000.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    2
    $800.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    4
    $800.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  6. 216 Oxygen (# Used)

    $25.00
    1
    $25.00
  7. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 8855 CR 73- Montevalio, AL

Subtotal $2,683.00
Total Due $2,683.00


Updated
December 7, 2023 @ 7:51 pm

Invoice updated by Geoffrey.

Status Update
December 7, 2023 @ 7:51 pm

Status changed: Draft to Pending.