Bill To:


GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:


Annette Wooten
114 Courtney Ln
Callisburg, TX 76240
POLICY# 2302211027945


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  2. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50
  3. 331 Air Bags (# Used)

    $150.00
    1
    $150.00
  4. 332 Air Tools (# Used)

    $50.00
    1
    $50.00
  5. 218 Cervical Collar (# Used)

    $25.00
    4
    $100.00
  6. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00
  7. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  8. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00
  9. 204 Flare (# Used)

    $8.00
    5
    $40.00
  10. 310 Hydraulic Tool (# Used)

    $200.00
    3
    $600.00
  11. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  12. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  13. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  14. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  15. 317 Rescue Struts (# Used)

    $50.00
    2
    $100.00
  16. 211 Salvage Cover (Amt Used)           

    $35.00
    2
    $70.00
  17. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  18. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  19. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75
  20. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  21. 215 Trauma Kit (# Used)

    $25.00
    4
    $100.00
  22. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00
  23. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  24. 330 Backboard (# Used)

    $25.00
    4
    $100.00

  25. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Fm 2896 & Blankship Hill Lane- Gainesville, TX

Subtotal $3,405.75
Total Due $3,405.75


Updated
January 11, 2023 @ 2:40 pm

Invoice updated by Geoffrey.

Status Update
January 11, 2023 @ 2:40 pm

Status changed: Draft to Pending.