Bill To:


DAIRYLAND INSURANCE
1800 NORTH POINT DRIVE
STEVENS POINT, WI 54481-1253

Services Rendered To:


Allen William
404 Locust Street
Naples, Texas 75568
Policy # 11405870826

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY205-2020-0709 07/09/2020 07/21/2020 On Receipt Douglassville Volunteer Fire Department

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

    $350.00
    2
    $700.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2
    $300.00
  3. 302 Hand Light (# Used)

    $5.00
    2
    $10.00
  4. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    2
    $150.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 409 Manpower (Per Hour)

    $20.00
    4
    $80.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 2791 - Cass County, Texas

Subtotal $1,370.00
Total Due $1,370.00
Updated
July 21, 2020 @ 12:16 am

Invoice updated by Karen Smith.

Status Update
July 21, 2020 @ 12:16 am

Status changed: Draft to Pending.

Updated
August 10, 2020 @ 4:14 pm

Invoice updated by Karen Smith.

Updated
September 22, 2020 @ 1:53 pm

Invoice updated by Geoffrey.

Viewed
September 22, 2020 @ 1:53 pm

Invoice viewed by GEOFFREY SMITH (Geoffrey) for the first time.

Viewed
October 24, 2022 @ 1:29 pm

Invoice viewed by 64.124.8.26 for the first time.