Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Patricia Ford
109 CR 1241
Kopperl, TX 76652
POLICY# 20624854

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KP-401-23-8 01/10/2023 01/13/2023 On Receipt Peoria VFD

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

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3457 State Hwy 22-Hillsboro, TX

    Ordinance Info: Recovery of Service Costs for Peoria VFD

Subtotal $896.00
Total Due $896.00


Updated
January 13, 2023 @ 11:36 am

Invoice updated by Geoffrey.

Status Update
January 13, 2023 @ 11:36 am

Status changed: Draft to Pending.

Viewed
April 17, 2024 @ 7:36 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.