Bill To:


Jaden Whitehead
1007 E. 11th Avenue
Corsicana, TX 75110

Services Rendered To:


Jaden Whitehead
1007 E. 11th Avenue
Corsicana, TX 75110
POLICY # 944747156

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C22-11831 05/21/2022 06/01/2022 On Receipt Angus Vol. Fire Department

*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $300.00
    1.25
    $375.00
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 226 Southbound on Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $750.00
Total Due $750.00


Updated
June 1, 2022 @ 4:37 pm

Invoice updated by Geoffrey.

Status Update
June 1, 2022 @ 4:37 pm

Status changed: Draft to Pending.

Viewed
July 27, 2022 @ 6:38 pm

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

Viewed
August 22, 2022 @ 9:10 pm

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

Updated
August 25, 2022 @ 2:44 pm

Invoice updated by Geoffrey.