Bill To:


Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:


Tracie Marie Moore
8341 CR 1200
Grandview, TX 76050
Policy # 2013698623


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 324 Traffic Cone (# Used)

    $5.00
    3
    $15.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 2852 State Highway 22 - Whitney, Texas

    Ordinance Info: Recovery of Service Costs for Peoria VFD

Subtotal $592.00
Total Due $592.00


Updated
January 25, 2022 @ 12:21 pm

Invoice updated by Geoffrey.

Status Update
January 25, 2022 @ 12:22 pm

Status changed: Draft to Pending.

Updated
January 25, 2022 @ 12:22 pm

Invoice updated by Geoffrey.