Bill To:


Brandon Widel
32190 Historic Route 66
Richland, MO 65556

Services Rendered To:


Brandon Widel
32190 Rt66
Richland, MO 65556
POLICY# PAMO-009590520


*** 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)

    $150.00
    1
    $150.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy E- Eldridge, MO

Subtotal $608.00
Total Due $608.00


Updated
May 8, 2023 @ 11:07 am

Invoice updated by Geoffrey.

Status Update
May 8, 2023 @ 11:07 am

Status changed: Draft to Pending.

Updated
July 10, 2023 @ 2:35 pm

Invoice updated by Geoffrey.

Updated
August 9, 2023 @ 12:19 pm

Invoice updated by Geoffrey.

Updated
September 28, 2023 @ 10:49 am

Invoice updated by Geoffrey.