Bill To:


American Zurich Insurance
Orlando PO Box 968084
Schaumburg, IL 60196-8084

Services Rendered To:


Southern Fluid Solutions
1061 Cotton Ford Rd
Center, TX 75935
POLICY# 3537928

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KB-403-24-292-E 01/04/2024 01/11/2024 On Receipt Woodlawn Fire Department

Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 59 & Timberland Dr- Woodlawn, TX

Subtotal $1,500.00
Total Due $1,500.00


Updated
January 11, 2024 @ 1:02 pm

Invoice updated by Geoffrey.

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March 28, 2024 @ 11:16 pm

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March 30, 2024 @ 6:26 am

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