Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Jake Robbins
Allstate
Policy # 00000083907252

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-2020-418704 12/30/2020 02/23/2021 On Receipt Callisburg V.F.D.

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

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  7. 413 Fire Department Response Fee – Lvl 4

    Extrication of child

    $500.00
    1
    $500.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 678 - Gainesville, Texas

Subtotal $1,515.00
Total Due $1,515.00


Updated
February 22, 2021 @ 4:52 pm

Invoice updated by Geoffrey.

Status Update
February 22, 2021 @ 4:52 pm

Status changed: Draft to Pending.

Updated
July 17, 2021 @ 6:11 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 2:39 pm

Invoice viewed by 64.124.8.25 for the first time.