Bill To:


GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:


Timmy Jordy
1038 Campus Drive
Zavalla, TX 75980
Policy # 7-600-663-1627


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

    $350.00
    3.25
    $1,137.50
  2. 104 Tanker Response (Per Hour)

    $300.00
    3.25
    $975.00
  3. 103 Rescue Response (Per Hour)

    $300.00
    3.25
    $975.00
  4. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  6. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    1
    $50.00
  7. 304 SCBA Cylinder (# Used)

    $25.00
    1
    $25.00
  8. 404 Scene Lighting (Per Hour)

    $75.00
    3.25
    $243.75
  9. 207 Wetting Agent (Amt Used)

    $25.00
    1
    $25.00
  10. 306 Hose Per 50′ (Amt Used)

    $25.00
    8
    $200.00

  11. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 1038 Campus Drive Zavalla, TX 75980

Subtotal $3,696.25
Total Due $3,696.25


Updated
December 28, 2021 @ 12:53 pm

Invoice updated by Geoffrey.

Status Update
December 28, 2021 @ 12:53 pm

Status changed: Draft to Pending.