Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Luis Marin Jr
1406 Sledge St
Marshall, TX 75670
POLICY# 151-2245-H12-43L-004

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KB-403-23-334 08/26/2023 09/13/2023 On Receipt Woodlawn Fire Department

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

    $500.00
    1.25
    $625.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.25
    $312.50
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.25
    $250.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 4016 Hwy 59- Marshall, TX

Subtotal $1,537.50
Total Due $1,537.50


Updated
September 13, 2023 @ 1:20 pm

Invoice updated by Geoffrey.

Status Update
September 13, 2023 @ 1:20 pm

Status changed: Draft to Pending.

Viewed
May 30, 2024 @ 3:26 am

Invoice viewed by 195.113.175.60 for the first time.