Bill To:


Merry Elliott
1209 Beeblossom Drive
Desoto, TX 75115

Services Rendered To:


Merry Elliott
1209 Beeblossom Dr.
Desoto, Texas 75115
Policy # 66639539854


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

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1.25
    $375.00
  2. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  3. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    14
    $28.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  7. 302 Hand Light (# Used)

    $5.00
    3
    $15.00
  8. 232 N95 Mask (Per Unit/Per Use)

    $10.00
    7
    $70.00
  9. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 223 S.B. / Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization Item # 7

Subtotal $1,328.00
Total Due $1,328.00


Updated
March 11, 2021 @ 2:27 pm

Invoice updated by Geoffrey.

Status Update
March 11, 2021 @ 2:27 pm

Status changed: Draft to Pending.

Updated
September 29, 2021 @ 5:16 pm

Invoice updated by Geoffrey.

Updated
September 29, 2021 @ 5:18 pm

Invoice updated by Geoffrey.