Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Heston Wallace
5978 FM 2727
Kaulman, TX 75142
POLICY# 23431720

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WZ-208-23-3031 03/24/2023 03/27/2023 On Receipt Van Zandt Midway V.F.D.

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

    $350.00
    1.5
    $525.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    3
    $6.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 64 @ 4825- Ben Wheeler, TX

Subtotal $1,381.00
Total Due $1,381.00


Updated
March 27, 2023 @ 3:46 pm

Invoice updated by Geoffrey.

Status Update
March 27, 2023 @ 3:46 pm

Status changed: Draft to Pending.

Viewed
April 17, 2024 @ 7:34 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.