Bill To:


Zurich North America
1299 Zurich Way
schaumburg, IL 60196-1056

Services Rendered To:


Polk Mechanical Company
2425 Dillard Street
Grand Prairie, Texas 75051
Policy # BAP38899409


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50
  2. 102 Engine Response (Per Hour)

    $350.00
    2.25
    $787.50
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 402 Fire/Police Services (Per Hour)    

    $100.00
    2.25
    $225.00
  6. 328 GlassMaster (# Used)

    $25.00
    1
    $25.00
  7. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  8. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  9. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  10. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  11. 317 Rescue Struts (# Used)

    $50.00
    1
    $50.00
  12. 404 Scene Lighting (Per Hour)

    $75.00
    2.25
    $168.75
  13. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.25
    $225.00
  14. 701 Body Removal (Per Body)    

    $250.00
    1
    $250.00
  15. 390 Winch

    $50.00
    1
    $50.00

  16. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3302 Highway 64 - Ben Wheeler, Texas

Subtotal $2,979.25
Total Due $2,979.25


Updated
May 3, 2021 @ 8:25 pm

Invoice updated by Geoffrey.

Status Update
May 3, 2021 @ 8:25 pm

Status changed: Draft to Pending.

Updated
May 3, 2021 @ 8:34 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 9:29 am

Invoice viewed by 64.124.8.31 for the first time.