Bill To:


Hochheim Prairie Claims
500 US Highway 77A S
Yoakum, TX 77995-1399

Services Rendered To:


Francis Tucker
3280 Martin Cochran Road
Huntington, Texas 75949
Policy # FM005601027

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AC-309-2021-006 02/15/2021 02/23/2021 On Receipt Zavalla Fire Department

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

    $350.00
    2.5
    $875.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    2.5
    $750.00
  3. 102 Engine Response (Per Hour)

    $350.00
    2.5
    $875.00
  4. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    2
    $200.00
  5. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  6. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  7. 311 PPV / Ventilation Fan (# Used)

    $50.00
    1
    $50.00
  8. 306 Hose Per 50′ (Amt Used)

    $25.00
    5
    $125.00

  9. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 3280 Martin Cochran Road - Huntington, Texas

Subtotal $2,940.00
Total Due $2,940.00


Updated
February 22, 2021 @ 5:18 pm

Invoice updated by Geoffrey.

Status Update
February 22, 2021 @ 5:18 pm

Status changed: Draft to Pending.

Updated
February 22, 2021 @ 5:19 pm

Invoice updated by Geoffrey.

Updated
February 22, 2021 @ 5:20 pm

Invoice updated by Geoffrey.

Updated
March 8, 2021 @ 6:03 pm

Invoice updated by Geoffrey.

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