Bill To:


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

Services Rendered To:


Mary Sweek
811 Meadow Hill Dr
Lavon, TX 75166
POLICY# 041 0534-A03-43M-002


Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $400.00
    1
    $400.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: N State Hwy 78/ Bently Dr- Lavon, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $512.00
Total Due $512.00


Updated
February 17, 2023 @ 1:20 pm

Invoice updated by Geoffrey.

Status Update
February 17, 2023 @ 1:20 pm

Status changed: Draft to Pending.