Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Scott Bevis
202 North Whatley
White Oak, Texas 75693
Claim # 43-09G117X


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

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  4. 306 Gas/Co Detector (# Used)

    $50.00
    1
    $50.00
  5. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  6. 311 PPV / Ventilation Fan (# Used)

    $50.00
    1
    $50.00
  7. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  8. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00

  9. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 202 North Whatley White Oak, Texas 75693

Subtotal $1,225.00
Total Due $1,225.00
Updated
December 26, 2020 @ 6:21 pm

Invoice updated by Geoffrey.

Status Update
December 26, 2020 @ 6:21 pm

Status changed: Draft to Pending.

Updated
December 26, 2020 @ 6:21 pm

Invoice updated by Geoffrey.

Updated
December 26, 2020 @ 6:24 pm

Invoice updated by Geoffrey.

Viewed
October 25, 2022 @ 2:46 pm

Invoice viewed by 64.124.8.25 for the first time.