Bill To:


Sabrina Lakhdari
3075 Walnut Bend Ln
Houston, TX 77042

Services Rendered To:


Sabrina Lakhdari
3075 Walnut Bend Ln
Houston, TX 77042
POLICY# 507 7802 G24 53 001

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-XV-414-24-20 01/04/2024 01/09/2024 On Receipt Sam Bass Fire Department

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

    $500.00
    1
    $500.00
  2. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 620 Pearson Ranch- Austin, TX

    Ordinance Info: Sam Bass Fire Dept. Resolution

Subtotal $895.00
Total Due $895.00


Updated
January 9, 2024 @ 2:55 pm

Invoice updated by Geoffrey.

Status Update
January 9, 2024 @ 2:55 pm

Status changed: Draft to Pending.

Updated
February 15, 2024 @ 12:21 pm

Invoice updated by Geoffrey.

Viewed
July 22, 2024 @ 5:14 am

Invoice viewed by 173.252.107.112 for the first time.