Bill To:


Trexis Insurance
PO Box 682322
Franklin, TN 37068

Services Rendered To:


Sincere X
1131 Columbia 78
Magnolia, AR 71753
POLICY# 11-03-021618512

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AR-23-003-23-2311 11/07/2023 11/10/2023 On Receipt Mt.Vernon VFD

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

    $500.00
    1
    $500.00
  2. 104 Tanker Response (Per Hour)

    $400.00
    1
    $400.00
  3. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  4. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 33.268 & -93.2953- Magnolia, AR

Subtotal $1,130.00
Total Due $1,130.00


Updated
November 10, 2023 @ 9:44 am

Invoice updated by Geoffrey.

Status Update
November 10, 2023 @ 9:44 am

Status changed: Draft to Pending.

Viewed
March 22, 2024 @ 10:41 pm

Invoice viewed by 66.249.72.6 for the first time.

Viewed
March 30, 2024 @ 6:43 am

Invoice viewed by 66.249.72.5 for the first time.