Bill To:


Victor Luis_Serrano
6827 Autumn Thistle Dr.
Katy, TX 77449-7208

Services Rendered To:


Victor Luis Serrano
6827 Autumn Thistle Dr.
Katy, Texas 77449-7208
Policy # 3120546-102-43F004

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-214-C21-26643 10/20/2021 10/28/2021 On Receipt Richland Volunteer Fire Department

*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

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

    $300.00
    2.75
    $825.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.75
    $275.00
  3. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 219 Northbound Interstate 45 - Richland, Texas

    Ordinance Info: Richland Billing Ordinance NO. 170 Cost Recovery

Subtotal $1,350.00
Total Due $1,350.00


Updated
October 27, 2021 @ 7:06 pm

Invoice updated by Geoffrey.

Status Update
October 27, 2021 @ 7:06 pm

Status changed: Draft to Pending.

Updated
April 28, 2022 @ 4:22 pm

Invoice updated by Geoffrey.

Updated
April 28, 2022 @ 4:22 pm

Invoice updated by Geoffrey.

Updated
June 11, 2022 @ 5:11 pm

Invoice updated by Karen Smith.

Viewed
June 11, 2022 @ 5:11 pm

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

Updated
June 11, 2022 @ 5:12 pm

Invoice updated by Karen Smith.

Viewed
October 22, 2022 @ 6:50 am

Invoice viewed by 64.124.8.31 for the first time.

Viewed
March 29, 2024 @ 4:52 pm

Invoice viewed by 66.249.72.4 for the first time.