Bill To:


Jennifer Brjon
14210 Maqguire Street
Azle, TX 76020

Services Rendered To:


Jennifer Brjon
14210 Maguire Street
Azle, Texas 76020


*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  4. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 14109 Liberty School Road - Azle, Texas

Subtotal $757.50
Total Due $757.50


Updated
November 23, 2021 @ 5:27 pm

Invoice updated by Geoffrey.

Updated
January 27, 2022 @ 3:12 pm

Invoice updated by Geoffrey.

Updated
January 27, 2022 @ 3:13 pm

Invoice updated by Geoffrey.

Updated
June 11, 2022 @ 3:54 pm

Invoice updated by Karen Smith.

Viewed
June 11, 2022 @ 3:54 pm

Invoice viewed by Karen Smith (KarenS) for the first time.

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October 24, 2022 @ 10:35 pm

Invoice viewed by 64.124.8.27 for the first time.