Bill To:


ROOT INSURANCE COMPANY
80 EAST RICH STREET - SUITE 500
COLUMBUS, OH 43215-5249

Services Rendered To:


Patty Brown
160 C.R. 2338
Douglassville, Texas 75560
Policy # 8JBQG2


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

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 302 Hand Light (# Used)

    $5.00
    1
    $5.00
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 409 Manpower (Per Hour)

    $50.00
    3
    $150.00

  6. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 160 C.R. 2338 Douglassville, Texas 75560

Subtotal $820.00
Total Due $820.00
Updated
January 6, 2021 @ 2:16 pm

Invoice updated by Geoffrey.

Status Update
January 6, 2021 @ 2:16 pm

Status changed: Draft to Pending.