Bill To:


ELEPHANT INSURANCE
PO BOX 5005
GLEN ALLEN, VA 23058-5005

Services Rendered To:


Bridget Durham
183 County Road 1171
Fairfield, TX 75840
POLICY # 24400218087


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

    $300.00
    1
    $300.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    5
    $10.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 2201/2 SB on Interstate Highway 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $710.00
Total Due $710.00


Updated
July 18, 2022 @ 4:06 pm

Invoice updated by Geoffrey.

Status Update
July 18, 2022 @ 4:06 pm

Status changed: Draft to Pending.

Viewed
October 22, 2022 @ 7:08 am

Invoice viewed by 64.124.8.31 for the first time.