Bill To:


National Union Fire Insurance Co.
175 Water Street
New York, NY 10038

Services Rendered To:


Halliburton
Driver- Reyes, Clark

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AC-501-23-119 09/15/2023 10/10/2023 On Receipt Moffett VFD

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    1.75
    $700.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.75
    $437.50
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.75
    $175.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  6. 202 Oil Absorbent Sheet (# Used)

    $2.50
    4
    $10.00
  7. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  8. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  10. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  11. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.75
    $350.00
  12. 419 Environmental Spill

    $250.00
    1
    $250.00

  13. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 842- Lufkin, TX

Subtotal $2,474.50
Total Due $2,474.50


Updated
October 10, 2023 @ 10:37 am

Invoice updated by Geoffrey.

Status Update
October 10, 2023 @ 10:37 am

Status changed: Draft to Pending.