Bill To:


Farmers Insurance
PO Box 268993
Oklahoma City, OK 73126

Services Rendered To:


Amanda Muniz
605 Doma
White Oak, Texas 75693
Policy # 31875-79-06


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

    $350.00
    11
    $3,850.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    11
    $3,300.00
  3. 102 Engine Response (Per Hour)

    $350.00
    11
    $3,850.00
  4. 103 Rescue Response (Per Hour)

    $300.00
    11
    $3,300.00
  5. 105 Utility Vehicle Response (Per Hour)

    $150.00
    11
    $1,650.00
  6. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    11
    $1,650.00
  7. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    11
    $1,650.00
  8. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  9. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    50
    $12.50
  10. 402 Fire/Police Services (Per Hour)    

    $100.00
    11
    $1,100.00
  11. 306 Gas/Co Detector (# Used)

    $50.00
    1
    $50.00
  12. 319 Generator (Per Generator/Per Hour)

    $50.00
    11
    $550.00
  13. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  14. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  15. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  16. 311 PPV / Ventilation Fan (# Used)

    $50.00
    1
    $50.00
  17. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    5
    $250.00
  18. 304 SCBA Cylinder (# Used)

    $25.00
    5
    $125.00
  19. 306 Hose Per 50′ (Amt Used)

    $25.00
    12
    $300.00

  20. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 605 Doma White Oak, Texas 75693

Subtotal $21,902.50
Total Due $21,902.50


Updated
January 4, 2021 @ 9:58 pm

Invoice updated by Geoffrey.

Status Update
January 4, 2021 @ 9:58 pm

Status changed: Draft to Pending.

Updated
February 24, 2021 @ 6:41 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 7:07 am

Invoice viewed by 64.124.8.31 for the first time.