Bill To:


Morris Ernest
1650 E. Lucas Street
Beaumont, TX 77703

Services Rendered To:


Morris Ernest
1650 East Lucas Street
Beaumont, Texas 77703
Policy # 943494685


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

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  7. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 69 @ Highway 63 - Zavalla, Texas

Subtotal $1,416.00
Total Due $1,416.00


Updated
August 26, 2021 @ 9:10 pm

Invoice updated by Geoffrey.

Status Update
August 26, 2021 @ 9:10 pm

Status changed: Draft to Pending.

Updated
May 16, 2022 @ 6:11 pm

Invoice updated by Geoffrey.