Bill To:


HARTFORD INSURANCE
ONE HARTFORD PLAZA
HARTFORD, CT 06115-1707

Services Rendered To:


Richard L. Rooks
2904 Forest Park Drive
Granbury, Texas 76048
Policy # 55DTX493781402252

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KS-406-21-Z2103-0202-D 03/02/2021 03/08/2021 On Receipt Hood County V.F.D. # 70

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 2300 Block of Lipan Highway - Granbury, Texas

Subtotal $757.50
Total Due $757.50


Updated
March 6, 2021 @ 1:52 pm

Invoice updated by Geoffrey.

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