Bill To:


Bradley Mathis
1129 Willow Road
Pampa, TX 79065

Services Rendered To:


Bradley Mathis
1129 Willow Road
Pampa, Texas 79065

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HK-101-21-199 11/03/2021 11/10/2021 On Receipt Hoover V.F.D.

*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND IGNORED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  4. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  5. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  6. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    8
    $400.00
  7. 304 SCBA Cylinder (# Used)

    $25.00
    8
    $200.00

  8. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 1129 Willow Road Pampa, Texas 79065

Subtotal $1,460.00
Total Due $1,460.00


Updated
November 9, 2021 @ 2:25 pm

Invoice updated by Geoffrey.

Status Update
November 9, 2021 @ 2:25 pm

Status changed: Draft to Pending.

Updated
November 9, 2021 @ 2:37 pm

Invoice updated by Geoffrey.

Updated
June 15, 2022 @ 5:22 pm

Invoice updated by Geoffrey.

Viewed
October 25, 2022 @ 6:33 am

Invoice viewed by 64.124.8.25 for the first time.