Bill To:


WELLINGTON INSURANCE
P. O. Box 1116
Fort Worth, TX 76101

Services Rendered To:


Gene Fleming
182 Forest Ridge Rd
Zavalla, TX 75980
POLICY# PIC51206


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

    $350.00
    2.5
    $875.00
  2. 207 Wetting Agent (Amt Used)

    $25.00
    1
    $25.00
  3. 306 Hose Per 50′ (Amt Used)

    $25.00
    6
    $150.00

  4. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 182 Forest Ridge Rd-Zavalla, TX

Subtotal $1,050.00
Total Due $1,050.00


Updated
October 12, 2022 @ 3:15 pm

Invoice updated by Geoffrey.

Status Update
October 12, 2022 @ 3:15 pm

Status changed: Draft to Pending.