Bill To:


Jimmy George
11835 Liberty School Road
Azle, TX 76020

Services Rendered To:


Jimmy George
11835 Liberty School Road
Azle, Texas 76020
Driver: Morgan Honeycutt
Policy # EAB1627125


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Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1.25
    $375.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  4. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  7. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  9. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  10. 330 Backboard (# Used)

    $25.00
    2
    $50.00
  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 730 North & Knob Hill Road - Azle, Texas

Subtotal $1,553.00
Total Due $1,553.00


Updated
November 12, 2021 @ 4:37 pm

Invoice updated by Geoffrey.

Status Update
November 12, 2021 @ 4:37 pm

Status changed: Draft to Pending.

Updated
November 12, 2021 @ 4:38 pm

Invoice updated by Geoffrey.

Updated
April 21, 2022 @ 6:06 pm

Invoice updated by Geoffrey.

Updated
April 21, 2022 @ 6:06 pm

Invoice updated by Geoffrey.

Updated
April 21, 2022 @ 6:07 pm

Invoice updated by Geoffrey.

Viewed
October 25, 2022 @ 8:54 am

Invoice viewed by 64.124.8.56 for the first time.