Bill To:


National Union Fire Ins Co of Pittsburg
1271 Ave of the Americas FL 37
New York, NY 10020

Services Rendered To:


Jason Nguyen
687 Austin Ln
Lavon, TX 75166
POLICY# VFNU-CM-0020068

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-23-395-A 09/30/2023 10/03/2023 On Receipt Lavon VFD

Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $550.00
    1
    $550.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00
  6. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  7. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  8. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  10. 419 Environmental Spill

    $250.00
    1
    $250.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: SH 78/ Lake Rd- Lavon, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $1,760.00
Total Due $1,760.00


Updated
October 3, 2023 @ 11:12 am

Invoice updated by Geoffrey.

Status Update
October 3, 2023 @ 11:12 am

Status changed: Draft to Pending.

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March 29, 2024 @ 9:15 pm

Invoice viewed by 66.249.72.6 for the first time.

Viewed
March 30, 2024 @ 6:14 am

Invoice viewed by 66.249.72.5 for the first time.