Bill To:


American Family Connect Property and Casualty
3500 Packerland Drive
Depere, WI 54115

Services Rendered To:


Isha Dhar
16615 Morgan Hill
Austin, TX 78723
POLICY# A104198424


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

    $500.00
    1
    $500.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  3. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 16600 RM 620- Round Rock, TX

    Ordinance Info: Sam Bass Fire Dept. Resolution

Subtotal $915.00
Total Due $915.00


Updated
May 2, 2024 @ 3:16 pm

Invoice updated by Geoffrey.

Status Update
May 2, 2024 @ 3:16 pm

Status changed: Draft to Pending.