Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Jacob Heath
305 Cedarwood
Azle, Texas 76020
Policy # 000000886138285


Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1037 Southeast Parkway - Azle, Texas

Subtotal $815.00
Total Due $815.00


Updated
November 12, 2021 @ 3:43 pm

Invoice updated by Geoffrey.

Status Update
November 12, 2021 @ 3:43 pm

Status changed: Draft to Pending.

Updated
November 12, 2021 @ 3:46 pm

Invoice updated by Geoffrey.