Bill To:


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

Services Rendered To:


John Douglas Dougherty
2014 CR 122
Gainesville, TX 76240
Policy # 439 2172-E07-43-001


Product
Price
Qty
Amount
  1. 206 Latex Gloves (Pairs Used)

    $2.00
    1
    $2.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1772 Thrasher Road - Callisburg, Texas

Subtotal $452.00
Total Due $452.00


Updated
June 22, 2021 @ 1:13 pm

Invoice updated by Geoffrey.

Status Update
June 22, 2021 @ 1:13 pm

Status changed: Draft to Pending.