Bill To:


Cassidy Mitchell
455 Harter Lane
Azle, TX 76020

Services Rendered To:


Cassidy Mitchell
455 Harter Lane
Azle, Texas 76020
Policy # Not Available At Scene


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Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1360 FM 730 North - Azle, Texas

    Ordinance Info: City of Briar Reno- Cost Recovery Amendment

Subtotal $908.00
Total Due $908.00


Updated
December 1, 2020 @ 3:12 pm

Invoice updated by Geoffrey.

Status Update
December 1, 2020 @ 3:12 pm

Status changed: Draft to Pending.

Updated
December 1, 2020 @ 3:13 pm

Invoice updated by Geoffrey.

Updated
December 1, 2020 @ 3:14 pm

Invoice updated by Geoffrey.

Updated
October 18, 2021 @ 5:20 pm

Invoice updated by Geoffrey.

Updated
October 18, 2021 @ 5:21 pm

Invoice updated by Geoffrey.