Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Margaret Ajanwachuku
3512 Orchard Dr
Mesquite, TX 75181
POLICY# 4330257074

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-24-5665 05/25/2024 05/28/2024 On Receipt Lavon VFD

Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $550.00
    1.25
    $687.50
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.25
    $250.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00
  6. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  7. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00
  8. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  9. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: St Hwy 205- Rockwall, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $2,007.50
Total Due $2,007.50


Updated
May 28, 2024 @ 1:13 pm

Invoice updated by Geoffrey.

Status Update
May 28, 2024 @ 1:13 pm

Status changed: Draft to Pending.