Bill To:


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

Services Rendered To:


Harold Mason
809 West Maple
Tecumseh, OK 74873
Policy # 010443646


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

    $350.00
    1.25
    $437.50
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 10785 Highway 205 - Lavon, Texas

    Ordinance Info: City of Lavon - RESOLUTION NO. 2020-03-01

Subtotal $843.50
Total Due $843.50
Updated
November 3, 2020 @ 12:56 pm

Invoice updated by Geoffrey.

Status Update
November 3, 2020 @ 12:56 pm

Status changed: Draft to Pending.

Viewed
March 29, 2024 @ 4:07 pm

Invoice viewed by 66.249.72.6 for the first time.

Viewed
March 30, 2024 @ 5:43 am

Invoice viewed by 66.249.72.5 for the first time.