Bill To:


Teresa Sousa
241 Lemonwood Drive
Havelock, NC 28532

Services Rendered To:


Teresa Sousa
241 Lemonwood Drive
Havelock, North Carolina 28532


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

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  5. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  6. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 12450 FM 730 - Azle, Texas

    Ordinance Info: Briar Reno - Fire Recovery Cost Bylaws Amendment

Subtotal $791.00
Total Due $791.00


Updated
November 27, 2020 @ 5:33 pm

Invoice updated by Geoffrey.

Status Update
November 27, 2020 @ 5:33 pm

Status changed: Draft to Pending.

Updated
November 27, 2020 @ 5:35 pm

Invoice updated by Geoffrey.

Updated
April 5, 2021 @ 10:01 pm

Invoice updated by Geoffrey.

Updated
April 5, 2021 @ 10:03 pm

Invoice updated by Geoffrey.

Updated
April 5, 2021 @ 10:04 pm

Invoice updated by Geoffrey.