Bill To:


Farmer's Insurance
PO Box 0991
Carol Stream, IL 60132-0991

Services Rendered To:


Clara Noble
1511 Bluebird Ln
Rockport, TX 78382
POLICY# 51565-14-96


Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $550.00
    1
    $550.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  3. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00
  5. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    1
    $100.00
  6. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  8. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  9. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3100 Business 35- Rockport, TX

    Ordinance Info: City of Rockport Billing Resolution

Subtotal $2,400.00
Total Due $2,400.00


Updated
March 30, 2024 @ 10:54 am

Invoice updated by Geoffrey.

Status Update
March 30, 2024 @ 10:54 am

Status changed: Draft to Pending.