Bill To:


Matthew Lichtenberg
327 W George Richey Rd
Gladewater, TX 75647

Services Rendered To:


Matthew Lichtenberg
327 W George Richey Rd
Gladewater, TX 75647
POLICY# 31095774

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HP-401-23-7231 12/07/2023 12/09/2023 On Receipt Clarksville City- Warren City VFD

*** DUE TO NO INSURANCE COVERAGE AT THE TIME OF THIS LOSS, YOU ARE NOW RESPONSIBLE FOR PAYMENT. ***

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

    $500.00
    1.25
    $625.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1.25
    $500.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.25
    $312.50
  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.25
    $250.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  7. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  8. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  10. 302 Hand Light (# Used)

    $5.00
    7
    $35.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: George Richey Rd & Warren Plant Rd- Warren City, TX

Subtotal $2,214.25
Total Due $2,214.25


Updated
December 9, 2023 @ 11:13 am

Invoice updated by Geoffrey.

Status Update
December 9, 2023 @ 11:13 am

Status changed: Draft to Pending.

Updated
March 19, 2024 @ 12:08 pm

Invoice updated by Geoffrey.