Bill To:


Farmer's Insurance
PO Box 0991
Carol Stream, IL 60132-0991

Services Rendered To:


Cynthia Edwards
11300 Highway 271
Tyler, Texas 75708
POLICY # 45327290


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

    $300.00
    1
    $300.00
  2. 328 GlassMaster (# Used)

    $25.00
    1
    $25.00
  3. 310 Hydraulic Tool (# Used)

    $200.00
    3
    $600.00
  4. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 69 Southbound @ Deadman's Road - Zavalla, Texas

Subtotal $1,225.00
Total Due $1,225.00


Updated
May 16, 2022 @ 4:51 pm

Invoice updated by Geoffrey.

Status Update
May 16, 2022 @ 4:51 pm

Status changed: Draft to Pending.

Updated
June 7, 2022 @ 2:11 pm

Invoice updated by Geoffrey.

Updated
June 7, 2022 @ 2:12 pm

Invoice updated by Geoffrey.