Bill To:


GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:


Dylan Mcpeek
750 W. Lingleville Rd
Stephenville, TX 76401
POLICY# 4-304-10665345

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HW-405-23-107 08/31/2023 09/01/2023 On Receipt Hico VFD

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    2
    $800.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    2
    $500.00
  3. 102 Engine Response (Per Hour)

    $500.00
    2
    $1,000.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  6. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  7. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  8. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  9. 404 Scene Lighting (Per Hour)

    $75.00
    2
    $150.00
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 281 N - Hico, TX

Subtotal $3,012.00
Total Due $3,012.00


Updated
September 1, 2023 @ 11:39 am

Invoice updated by Geoffrey.

Status Update
September 1, 2023 @ 11:39 am

Status changed: Draft to Pending.