Bill To:


Riley James Dwyer
1620 Peach Leaf Street
Houston, TX 77039

Services Rendered To:


Riley James Dwyer
1620 Peach Leaf Street
Houston, Texas 77039
Policy # DCLPGQ


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $300.00
    2
    $600.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2
    $300.00
  3. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 220 Southbound on Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $1,150.00
Total Due $1,150.00


Updated
October 12, 2021 @ 3:14 pm

Invoice updated by Geoffrey.

Status Update
October 12, 2021 @ 3:14 pm

Status changed: Draft to Pending.

Viewed
October 24, 2022 @ 1:26 am

Invoice viewed by 64.124.8.25 for the first time.

Updated
March 28, 2023 @ 11:24 am

Invoice updated by Geoffrey.