Bill To:


Kenneth Morgret
1008 S. Baucum St.
Altus, OK 73521

Services Rendered To:


Kenneth Morgret
1008 S. Baucum St.
Altus, OK 73521
Policy # 5171326C2645


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1
    $500.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1
    $500.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Interstate 40 @ MM 251 Westbound - Checotah, OK

Subtotal $1,862.00
Total Due $1,862.00


Updated
June 2, 2021 @ 4:31 pm

Invoice updated by Geoffrey.

Status Update
June 2, 2021 @ 4:31 pm

Status changed: Draft to Pending.

Updated
June 2, 2021 @ 4:32 pm

Invoice updated by Geoffrey.

Updated
December 28, 2021 @ 7:32 pm

Invoice updated by Geoffrey.

Updated
June 11, 2022 @ 3:35 pm

Invoice updated by Karen Smith.

Updated
June 11, 2022 @ 3:35 pm

Invoice updated by Karen Smith.