Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Paul Parrott
720 Westwood Drive
Wake Village, Texas 75501
Policy # 4257463-F03-43-002

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY205-2020-0531 05/31/2020 06/10/2020 On Receipt Douglassville Volunteer Fire Department

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

    $350.00
    1.25
    $437.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    2 x 1.25 Hours ea.

    $100.00
    2.5
    $250.00

  4. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: State Highway 77 - 3 Miles East of State Highway 8 - Cass County Texas

    Ordinance Info: City of Atlanta Ordinance Supplement No. 28 - Section 5.109

Subtotal $1,062.50
Total Due $1,062.50
Updated
June 10, 2020 @ 2:21 pm

Invoice updated by Karen Smith.

Status Update
June 10, 2020 @ 2:21 pm

Status changed: Draft to Pending.

Viewed
March 28, 2024 @ 11:50 pm

Invoice viewed by 66.249.72.5 for the first time.

Viewed
March 30, 2024 @ 7:46 am

Invoice viewed by 66.249.72.6 for the first time.