Bill To:


Ray Horton
1149 C.R. 162
Cedar Lane, TX 77414

Services Rendered To:


Ray Horton
1149 C.R. 162
Cedar Lane, TX 77414


*** Please Submit this to your PROPERTY/HOMEOWNER Insurance Company for processing and payment OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00

  5. Additional Incident Info

    Incident Type: Uncontrolled Burn

    Incident Location: 1149 C.R. 162 Cedar Lane, TX 77414

Subtotal $715.00
Total Due $715.00


Updated
December 22, 2021 @ 5:44 pm

Invoice updated by Geoffrey.

Status Update
December 22, 2021 @ 5:44 pm

Status changed: Draft to Pending.

Updated
August 8, 2022 @ 7:37 pm

Invoice updated by Geoffrey.

Updated
August 8, 2022 @ 7:38 pm

Invoice updated by Geoffrey.