Bill To:


Michelle Hernandez
255 Bergfield
New Braunfels, TX 78130

Services Rendered To:


Michelle Hernandez
255 Bergfield
New Braunfels, Texas 78130


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND IGNORED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $300.00
    1
    $300.00
  2. 102 Engine Response (Per Hour)

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

    $150.00
    1
    $150.00
  4. 407 Patient Care / Evaluation (Per Patient)

    $50.00
    1
    $50.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6000 Block of FM 725 - New Braunfels, Texas

Subtotal $850.00
Total Due $850.00


Updated
February 8, 2021 @ 11:28 pm

Invoice updated by Geoffrey.

Status Update
February 8, 2021 @ 11:28 pm

Status changed: Draft to Pending.

Updated
July 21, 2021 @ 7:28 pm

Invoice updated by Geoffrey.

Updated
July 21, 2021 @ 7:28 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 7:11 am

Invoice viewed by 64.124.8.31 for the first time.