Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Katherine Virginia Jennings
106 CR 1418
Morgan, Texas 76671
Policy # 0351445804


Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    5.25
    $787.50
  2. 102 Engine Response (Per Hour)

    $350.00
    5.25
    $1,837.50
  3. 331 Air Bags (# Used)

    $150.00
    4
    $600.00
  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  7. 206 Latex Gloves (Pairs Used)

    $2.00
    15
    $30.00
  8. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  9. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  10. 211 Salvage Cover (Amt Used)       

    $35.00
    1
    $35.00
  11. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    5.25
    $525.00
  12. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  13. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 22 and HCR 1313 - Hillsboro, Texas

Subtotal $4,825.00
Total Due $4,825.00
Updated
December 15, 2020 @ 2:18 pm

Invoice updated by Geoffrey.

Status Update
December 15, 2020 @ 2:18 pm

Status changed: Draft to Pending.

Updated
December 15, 2020 @ 2:19 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 2:33 pm

Invoice viewed by 64.124.8.25 for the first time.