Bill To:


Liberty County Mutual
175 Berkeley Street
Boston, MA 02116

Services Rendered To:


Blake Fenton
300 E Base Rd Apt# 1013
San Antonio, TX 78209
POLICY# Y9563549


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

    $500.00
    2.25
    $1,125.00
  2. 331 Air Bags (# Used)

    $150.00
    2
    $300.00
  3. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 402 Fire/Police Services (Per Hour)    

    $100.00
    2.25
    $225.00
  6. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  7. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Evant, TX

Subtotal $2,530.00
Total Due $2,530.00


Updated
March 26, 2024 @ 3:58 pm

Invoice updated by Geoffrey.