Bill To:


Anthony Guillory
9108 NW 99
Yukon, OK 73099

Services Rendered To:


Anthony Guillory
9108 NW 99
Yukon, OK 73099
405-923-9557

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-007-2020-110301 11/30/2020 12/26/2020 On Receipt F.A.I.C. V.F.D.

*** 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)

    $500.00
    1.5
    $750.00
  2. 104 Tanker Response (Per Hour)

    $500.00
    1.5
    $750.00
  3. 103 Rescue Response (Per Hour)

    $500.00
    1.5
    $750.00
  4. 103 Rescue Response (Per Hour)

    $500.00
    1.5
    $750.00

  5. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: I-40 @ MM 259 Just West of Checotah, OK

Subtotal $3,000.00
Total Due $3,000.00


Updated
December 26, 2020 @ 7:43 pm

Invoice updated by Geoffrey.

Status Update
December 26, 2020 @ 7:43 pm

Status changed: Draft to Pending.

Updated
December 26, 2020 @ 7:44 pm

Invoice updated by Geoffrey.

Updated
December 26, 2020 @ 7:45 pm

Invoice updated by Geoffrey.

Updated
May 13, 2021 @ 2:12 pm

Invoice updated by Geoffrey.

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