Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Joyce Lowery
1466 AL Hwy 191
Jemison, AL 35085
POLICY# 1691759C2901B


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

    $500.00
    1
    $500.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  4. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 24007 US Hwy 31- Jemison, AL

Subtotal $1,191.00
Total Due $1,191.00


Updated
December 5, 2023 @ 1:37 pm

Invoice updated by Geoffrey.

Status Update
December 5, 2023 @ 1:37 pm

Status changed: Draft to Pending.