Bill To:


Allstate Insurance Company
PO Box 660598
Dallas, TX 75266-0598

Services Rendered To:


Elijah Barkley
1129 MT Marcy
Lawton, OK 73507
Policy # 000000821906100


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

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 202 Oil Absorbent Sheet (# Used)

    $2.50
    5
    $12.50
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 26020 State Highway 58 - Lawton, OK

Subtotal $1,108.50
Total Due $1,108.50


Updated
April 10, 2022 @ 6:04 pm

Invoice updated by Geoffrey.

Status Update
April 10, 2022 @ 6:04 pm

Status changed: Draft to Pending.