Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Gabriel Chairez
2311 Norwich Court
Arlington, Texas 76015
Policy # 1219610-B12-43J


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

    $350.00
    1
    $350.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 78 and Highway 205 - Lavon, Texas

    Ordinance Info: RESOLUTION NO. 2020-03-01

Subtotal $700.00
Total Due $700.00
Updated
May 26, 2020 @ 2:12 pm

Invoice updated by Karen Smith.

Status Update
May 26, 2020 @ 2:12 pm

Status changed: Draft to Pending.