Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Johnathan Jacob Payne
404 N Terry St
Rockport, TX 78382
POLICY# 4156-05-43-24

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AD-505-24-157 03/25/2024 03/26/2024 On Receipt Rock Port VFD

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    2
    $400.00
  2. 102 Engine Response (Per Hour)

    $500.00
    2
    $1,000.00
  3. 102 Engine Response (Per Hour)

    $500.00
    2
    $1,000.00
  4. 102 Engine Response (Per Hour)

    $500.00
    2
    $1,000.00
  5. 105 Utility Vehicle Response (Per Hour)

    $250.00
    2
    $500.00
  6. 105 Utility Vehicle Response (Per Hour)

    $250.00
    2
    $500.00
  7. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  8. 404 Scene Lighting (Per Hour)

    $75.00
    2
    $150.00
  9. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    2
    $200.00
  10. 306 Hose Per 50′ (Amt Used)

    $25.00
    8
    $200.00
  11. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    6
    $300.00
  12. 304 SCBA Cylinder (# Used)

    $25.00
    6
    $150.00
  13. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  14. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 404 N Terry St- Rockport, TX 78382

    Ordinance Info: City of Rockport Billing Resolution

Subtotal $5,710.00
Total Due $5,710.00


Updated
March 26, 2024 @ 12:48 pm

Invoice updated by Geoffrey.

Status Update
March 26, 2024 @ 12:48 pm

Status changed: Draft to Pending.