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

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-01-403-23-1270-E 11/26/2023 12/07/2023 On Receipt Jemison Fire Department

Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient

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

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 8855 CR 73- Montevalio, AL

Subtotal $1,500.00
Total Due $1,500.00


Updated
December 7, 2023 @ 7:54 pm

Invoice updated by Geoffrey.