Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Alvin Battle
706 W. Allday St
Atlanta, TX 75551
POLICY# 23350198

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-22-129 12/09/2022 12/22/2022 On Receipt Douglassville VFD

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  2. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: SH 77 & Fm 2791

Subtotal $330.00
Total Due $330.00


Updated
December 22, 2022 @ 12:47 pm

Invoice updated by Geoffrey.

Status Update
December 22, 2022 @ 12:47 pm

Status changed: Draft to Pending.