Bill To:


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

Services Rendered To:


Vehicle Owner
Claim # 0541428660

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KP-401-2020-109 12/10/2020 12/28/2020 On Receipt Peoria V.F.D.

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

    $150.00
    1.5
    $225.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.5
    $150.00
  5. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  6. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  7. 404 Scene Lighting (Per Hour)

    $75.00
    1.5
    $112.50
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  9. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 22 and HCR 1318 - Hillsboro, Texas

Subtotal $1,602.50
Total Due $1,602.50


Updated
December 27, 2020 @ 3:08 pm

Invoice updated by Geoffrey.

Status Update
December 27, 2020 @ 3:08 pm

Status changed: Draft to Pending.

Updated
July 18, 2021 @ 5:49 pm

Invoice updated by Geoffrey.

Updated
July 18, 2021 @ 5:49 pm

Invoice updated by Geoffrey.