Bill To:


AAA Insurance
1000 AAA Drive
Heathrow, FL 32746-AAA

Services Rendered To:


Shirley Ladner
19721 Poverty Point Rd
Rogers, AR 72756
POLICY# MOA181789330

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
MO-08-409-24-24 02/29/2024 03/12/2024 On Receipt Dunnegan Rural FD

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

    $400.00
    1.25
    $500.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 123 & E 379 Rd- Dunnegan, MO

Subtotal $879.00
Total Due $879.00


Updated
March 12, 2024 @ 10:24 am

Invoice updated by Geoffrey.

Status Update
March 12, 2024 @ 10:24 am

Status changed: Draft to Pending.

Viewed
July 23, 2024 @ 9:20 am

Invoice viewed by 173.252.83.25 for the first time.