Bill To:


General Insurance Company of America
175 Berkeley Street
Boston, MA 02116

Services Rendered To:


Gregory Travis Ludwig SR.
7150 Allyn Drive
Azle, Texas 76020
Policy # Y7401335

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB206-2018-381 04/28/2018 11/14/2019 On Receipt Briar - Reno Fire Department

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

    E- #449

    $350.00
    1
    $350.00
  2. 102 Engine Response (Per Hour)

    E- #52

    $350.00
    1
    $350.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    SQD #49

    $150.00
    1
    $150.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 12300 block of Liberty School Road / 6400 Peden Road

Subtotal $850.00
Total Due $850.00
Updated
November 14, 2019 @ 3:33 pm

Invoice updated by Karen Smith.

Status Update
November 14, 2019 @ 3:34 pm

Status changed: Draft to Pending.

Updated
November 14, 2019 @ 3:36 pm

Invoice updated by Karen Smith.