Bill To:


MGA INSURANCE COMPANY
3333 Lee Parkway Suite 1200 PO Box 199023
Dallas, TX 75219

Services Rendered To:


Gerardo Sanchez
606 Circle Dr
Marshall, TX 75670
POLICY# 03MGEP0449443-20

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KB-403-23-15913 07/04/2023 08/14/2023 On Receipt Woodlawn Fire Department

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

    $500.00
    1
    $500.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 59 & N Industrial- Marshall, TX

Subtotal $800.00
Total Due $800.00


Updated
August 14, 2023 @ 11:08 am

Invoice updated by Geoffrey.

Status Update
August 14, 2023 @ 11:08 am

Status changed: Draft to Pending.