Bill To:


Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:


Isabella Briones
2725 Blue Ridge Dr
Mesquite, TX 75150
POLICY# 00175626


Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    1.25
    $500.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1.25
    $625.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 219 NB IH 45- Richland, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $1,500.00
Total Due $1,500.00


Updated
January 9, 2024 @ 4:07 pm

Invoice updated by Geoffrey.

Status Update
January 9, 2024 @ 4:07 pm

Status changed: Draft to Pending.