Bill To:


AMERICAN ACCESS INSURANCE
2211 BUTTERFIELD ROAD - SUITE 200
DOWNERS GROVE, IL 60515-1493

Services Rendered To:


Eney Maldonado Garcia
12215 Northwood Forest Dr. Apt 97
Houston, Texas 77039
Policy # 42AU000726457

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AK-305-2021-80 06/03/2021 07/01/2021 On Receipt San Felipe Frydek V.F.D.

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 725 Eastbound on Interstate 10 - Sealy, Texas

Subtotal $1,100.00
Total Due $1,100.00


Updated
June 30, 2021 @ 11:49 pm

Invoice updated by Geoffrey.

Status Update
June 30, 2021 @ 11:49 pm

Status changed: Draft to Pending.

Viewed
October 25, 2022 @ 12:48 am

Invoice viewed by 64.124.8.51 for the first time.