Paid

Invoice

From:

803 Anita St.
Chula Vista, CA 91911
619-971-2353

Invoice Number INV-21267
Invoice Date May 13, 2019
Due Date June 12, 2019
Total Due $120.50
To:
AMR

8808 Balboa Ave.
San Diego, Ca

Manny A22

Date of service

5/13/19

Hours Equipment RateSub Total
1 Pick up

Amr rig# 76038
License #17618M1

$75.00$75.00
6.5 Milage

From: scripps mercy hospital
To: station 28

$7.00$45.50
Sub Total $120.50
Tax $0.00
Total Due $120.50