Bill To:


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

Services Rendered To:


James Elbert Jr Morris
111 CR 160
Whitesboro, TX 76273
POLICY# 816388720

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-23-3139 09/05/2023 09/05/2023 On Receipt Callisburg V.F.D.

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 209 Extinguisher (# Used)

    $50.00
    1
    $50.00
  6. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    100
    $25.00
  7. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  8. 306 Gas/Co Detector (# Used)

    $50.00
    1
    $50.00
  9. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  10. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  11. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  12. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  13. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 111 CR 160 Whitesboro, TX 76273

    Ordinance Info: City Of Callisburg Resolution

Subtotal $1,625.00
Total Due $1,625.00


Updated
September 5, 2023 @ 3:47 pm

Invoice updated by Geoffrey.

Status Update
September 5, 2023 @ 3:47 pm

Status changed: Draft to Pending.