Bill To:


FOREMOST INSURANCE
PO BOX 2450
GRAND RAPIDS, MI 49501-2450

Services Rendered To:


Donna Williams
1073 CR 2339
Douglassville, Texas 75560
Policy # 106-069791066-19


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

    Unit# Engine 1

    $350.00
    1.5
    $525.00
  2. 103 Rescue Response (Per Hour)

    Unit# Rescue 1

    $300.00
    1.5
    $450.00
  3. 205 Foam (Per Gallon)

    $65.00
    2
    $130.00
  4. 302 Hand Light (# Used)

    $5.00
    1
    $5.00
  5. 409 Manpower (Per Hour)

    2 firefighters on scene for 1.5 hours each

    $20.00
    3
    $60.00

  6. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 1073 CR 2339 Douglassville, Texas 75560

Subtotal $1,170.00
Total Due $1,170.00
Updated
December 22, 2019 @ 2:21 pm

Invoice updated by Karen Smith.

Status Update
December 22, 2019 @ 2:21 pm

Status changed: Draft to Pending.