Bill To:


Valerie Valdez
8507 Rose Manor Dr Houston, TX 77095
Houston, TX 77095

Services Rendered To:


Valerie Valdez
8507 Rose Manor Dr
Houston, TX 77095
POLICY# 053 221 145

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AK-305-23-323-E 02/23/2023 03/03/2023 On Receipt San Felipe/ Frydek VFD

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Product
Price
Qty
Amount
  1. 405 Medical Extrication – Lvl 1

    Patient

    Valerie Valdez
    8507 Rose Manor Dr
    Houston, TX 77095
    POLICY# 053 221 145

    $500.00
    1
    $500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 723 WB- Sealy, TX

Subtotal $500.00
Total Due $500.00


Updated
March 3, 2023 @ 9:51 am

Invoice updated by Geoffrey.

Updated
March 21, 2023 @ 5:13 pm

Invoice updated by Geoffrey.