Bill To:


John David Hale
3641 Waters Edge Dr
Midlothian, TX 76065

Services Rendered To:


John David Hale
3641 Waters Edge Dr
Midlothian, TX 76065
Claim# 0571250450101042


*** YOUR INSURANCE COMPANY HAS SENT YOU PAYMENT FOR FIRE DEPARTMENT SERVICES. PLEASE REMIT THAT PAYMENT TO OUR OFFICE. ***

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00
  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3500 Block Of St Hwy 22- Hillsboro, TX

    Ordinance Info: Recovery of Service Costs for Peoria VFD

Subtotal $739.00
Total Due $739.00


Updated
March 16, 2023 @ 1:12 pm

Invoice updated by Geoffrey.

Status Update
March 16, 2023 @ 1:12 pm

Status changed: Draft to Pending.

Updated
April 5, 2023 @ 10:23 am

Invoice updated by Geoffrey.

Updated
May 9, 2023 @ 10:43 am

Invoice updated by Geoffrey.

Updated
August 22, 2023 @ 9:53 am

Invoice updated by Geoffrey.