Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Ronny Bearden
6198 S I-45 W
Corsicana, TX 76681

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-214-24-1476 01/20/2024 02/06/2024 On Receipt Richland Township V. F. D.

Product
Price
Qty
Amount
  1. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  4. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  5. 324 Traffic Cone (# Used)

    $5.00
    5
    $25.00

  6. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 6198 S I-45 W Corsicana, TX 76681

    Ordinance Info: Richland Billing Ordinance NO. 170 Cost Recovery

Subtotal $1,250.00
Total Due $1,250.00


Updated
February 6, 2024 @ 2:18 pm

Invoice updated by Geoffrey.

Status Update
February 6, 2024 @ 2:18 pm

Status changed: Draft to Pending.