Bill To:


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

Services Rendered To:


Lacey Jones
P.O. Box 2358
Bloomington, IL 61702
POLICY# 678 9918-A05-25B


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

    $500.00
    1.5
    $750.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.5
    $375.00
  3. 209 Extinguisher (# Used)

    $50.00
    1
    $50.00
  4. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  5. 319 Generator (Per Generator/Per Hour)

    $50.00
    1.5
    $75.00
  6. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  7. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  8. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  9. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  10. 404 Scene Lighting (Per Hour)

    $75.00
    1.5
    $112.50
  11. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  12. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

  13. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: Brushy Ranch & Hwy 42- Brumley, MO

Subtotal $1,907.50
Total Due $1,907.50


Updated
February 29, 2024 @ 7:08 pm

Invoice updated by Geoffrey.

Status Update
February 29, 2024 @ 7:09 pm

Status changed: Draft to Pending.