Bill To:


ALLSTATE FIRE AND CASUALTY
2775 SANDERS ROAD
NORTHBROOK, IL 60062-6110

Services Rendered To:


Mihika Busa
27711 Wilson Run
Fulshear, TX 77441
POLICY# 836609097

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-GV-301-24-4091 04/22/2024 04/30/2024 On Receipt Dew VFD

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

    $400.00
    1
    $400.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I45 & 189 Mile Post- Teague, TX

Subtotal $1,250.00
Total Due $1,250.00


Updated
April 30, 2024 @ 1:22 pm

Invoice updated by Geoffrey.

Status Update
April 30, 2024 @ 1:22 pm

Status changed: Draft to Pending.