Bill To:


Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:


Rebecca Lynn Reynolds
315 Terrell Street
Sequin, Texas 78155
Policy # TX0002270H


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

    $350.00
    1.5
    $525.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.5
    $450.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.5
    $150.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    14
    $28.00
  6. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  7. 201 Oil Absorbent Material (# Used)

    $35.00
    10
    $350.00
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  9. 215 Trauma Kit (# Used)

    $25.00
    2
    $50.00
  10. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 725 and Terminal Road - McQueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution 4521

Subtotal $2,248.00
Total Due $2,248.00


Updated
October 24, 2021 @ 3:01 pm

Invoice updated by Geoffrey.

Status Update
October 24, 2021 @ 3:01 pm

Status changed: Draft to Pending.

Viewed
October 24, 2022 @ 1:58 pm

Invoice viewed by 64.124.8.26 for the first time.