Bill To:


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

Services Rendered To:


William Young
1028 Shaver Rd
Aransas Pass, TX 78336
POLICY# 436008189

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AD-505-23-252 06/04/2023 06/06/2023 On Receipt Rock Port VFD

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 2400 Lake View Dr- Rockport, TX

Subtotal $615.00
Total Due $615.00


Updated
June 6, 2023 @ 10:49 am

Invoice updated by Geoffrey.

Status Update
June 6, 2023 @ 10:49 am

Status changed: Draft to Pending.

Updated
June 9, 2023 @ 3:48 pm

Invoice updated by Geoffrey.