Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Bonnie & Norman Wright
14475 Texas Highway 8
Douglassville, Texas 75560
Policy # 21798212

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-2020-0717 07/17/2020 08/15/2020 On Receipt Douglassville V.F.D.

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

    $350.00
    2.25
    $787.50
  2. 104 Tanker Response (Per Hour)

    $300.00
    2.25
    $675.00
  3. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  4. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.25
    $225.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 14475 Texas Highway 8 - Cass County- Texas

Subtotal $1,742.50
Total Due $1,742.50
Updated
August 14, 2020 @ 4:23 pm

Invoice updated by Karen Smith.

Status Update
August 14, 2020 @ 4:23 pm

Status changed: Draft to Pending.

Updated
August 14, 2020 @ 4:25 pm

Invoice updated by Karen Smith.

Viewed
October 24, 2022 @ 12:15 pm

Invoice viewed by 64.124.8.30 for the first time.