Bill To:


GREAT WEST CASUALTY
1100 WEST 29th STREET
SOUTH SOUIX CITY, NE 68776-3130

Services Rendered To:


Brice Martin
202 Noble St
Maud, OK 74873
License Plate # AN-1195
Vin# 1W14412A9J2269370


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

    $350.00
    4.5
    $1,575.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    4.5
    $1,350.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    4.5
    $675.00
  4. 105 Utility Vehicle Response (Per Hour)

    $150.00
    4.5
    $675.00
  5. 104 Tanker Response (Per Hour)

    $300.00
    4.5
    $1,350.00
  6. 102 Engine Response (Per Hour)

    $350.00
    4.5
    $1,575.00
  7. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  8. 419 Environmental Spill

    $250.00
    1
    $250.00
  9. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  10. 306 Gas/Co Detector (# Used)

    $50.00
    1
    $50.00
  11. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  12. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  13. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  14. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  15. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    3
    $150.00
  16. 304 SCBA Cylinder (# Used)

    $25.00
    3
    $75.00
  17. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    4.5
    $450.00
  18. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  19. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 105500 S. Hwy 177- Meeker, OK

Subtotal $8,825.00
Total Due $8,825.00


Updated
May 15, 2023 @ 5:10 pm

Invoice updated by Geoffrey.

Status Update
May 15, 2023 @ 5:10 pm

Status changed: Draft to Pending.