Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Carla Pickard
410 Thomas
White Oak, Tx 75693
Policy # 41033513

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HP-309-2020-99 07/26/2020 12/26/2020 On Receipt White Oak Fire Department

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

    $150.00
    1.5
    $225.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00
  3. 104 Tanker Response (Per Hour)

    $300.00
    1.5
    $450.00
  4. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00
  5. 306 Gas/Co Detector (# Used)

    $50.00
    1
    $50.00
  6. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  7. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  8. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  9. 311 PPV / Ventilation Fan (# Used)

    $50.00
    1
    $50.00
  10. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    3
    $150.00
  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00

  12. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 410 Thomas White Oak, Tx 75693

Subtotal $2,215.00
Total Due $2,215.00
Updated
December 26, 2020 @ 5:47 pm

Invoice updated by Geoffrey.

Status Update
December 26, 2020 @ 5:47 pm

Status changed: Draft to Pending.

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