Bill To:


Loya Insurance Company
P.O. Box 972450
El Paso, TX 79997

Services Rendered To:


Cassandra Langford
6324 Train Lane
Pearland, TX 77584
POLICY# 651398567127

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BB-326-24-13 01/18/2024 02/29/2024 On Receipt Rosharon VFD

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

    $500.00
    1
    $500.00
  2. 104 Tanker Response (Per Hour)

    $400.00
    1
    $400.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  4. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 1300 RM 655- Rosharon, TX

    Ordinance Info: Rosharon Cost Recovery Resolution

Subtotal $1,250.00
Total Due $1,250.00


Updated
February 29, 2024 @ 7:16 pm

Invoice updated by Geoffrey.

Status Update
February 29, 2024 @ 7:16 pm

Status changed: Draft to Pending.