Bill To:


Northland Insurance
P.O. Box 64816
St.Paul, MN 55164

Services Rendered To:


Taylor Trucking LLC
3519 E Jensen Rd E
El Reno, OK 73036
POLICY# 24015

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-24-89645 05/04/2024 05/09/2024 On Receipt Lavon VFD

Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $550.00
    1
    $550.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: State Hwy 78- Lavon, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $1,250.00
Total Due $1,250.00


Updated
May 9, 2024 @ 11:09 am

Invoice updated by Geoffrey.

Status Update
May 9, 2024 @ 11:09 am

Status changed: Draft to Pending.