Bill To:


Metropolitan Reporting Bureau
PO Box 926
Philadelphia, PA 19105

Services Rendered To:


William Ferguson
212 CR 107
Whitesboro, TX 76273
POLICY# 06469B

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-23-3101 07/24/2023 08/28/2023 On Receipt Callisburg V.F.D.

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

    $500.00
    1
    $500.00
  2. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  3. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00
  4. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  5. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 1487 CR 118- Whitesboro, TX

    Ordinance Info: City Of Callisburg Resolution

Subtotal $1,140.00
Total Due $1,140.00


Updated
August 28, 2023 @ 12:24 pm

Invoice updated by Geoffrey.

Status Update
August 28, 2023 @ 12:24 pm

Status changed: Draft to Pending.