Bill To:


Loya Insurance Company
P.O. Box 972450
El Paso, TX 79997

Services Rendered To:


Catherine Hines
1949 FM 248
Jefferson, TX 75657
Policy # 66429813739


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

    $350.00
    1.75
    $612.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 319 Generator (Per Generator/Per Hour)

    $50.00
    1.75
    $87.50
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  7. 404 Scene Lighting (Per Hour)

    $75.00
    1.75
    $131.25
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 4918 US-59 North - Marshal, Texas

Subtotal $2,051.75
Total Due $2,051.75


Updated
February 6, 2022 @ 1:15 pm

Invoice updated by Geoffrey.

Status Update
February 6, 2022 @ 1:15 pm

Status changed: Draft to Pending.