Bill To:


Larry Dorman
1117 N. Hudson Street
Altus, OK 73521

Services Rendered To:


Larry Dorman
1117 N. Hudson Street
Altus, Oklahoma 73521

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-016-2021-02 04/16/2021 05/17/2021 On Receipt Paradise Point Fire Department

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

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

    $250.00
    3.5
    $875.00
  2. 104 Tanker Response (Per Hour)

    $500.00
    3.5
    $1,750.00
  3. 102 Engine Response (Per Hour)

    $500.00
    3.5
    $1,750.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 @ MM 258 Eastbound - McIntosh County, OK

Subtotal $4,375.00
Total Due $4,375.00


Updated
May 16, 2021 @ 7:11 pm

Invoice updated by Geoffrey.

Status Update
May 16, 2021 @ 7:11 pm

Status changed: Draft to Pending.

Updated
October 4, 2021 @ 10:11 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 1:40 am

Invoice viewed by 64.124.8.25 for the first time.