Bill To:


Jasman York
213 Hopkins St
Lufkin, TX 75901

Services Rendered To:


Jasman York
213 Hopkins St
Lufkin, TX 75901

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AC-501-23-1026-EE 10/26/2023 11/12/2023 On Receipt Moffett VFD

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Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient

    Rolando Reyes
    3604 Harley Golden Rd
    Huntington, TX 75949

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: St Hwy 103 E- Lufkin, TX

Subtotal $1,500.00
Total Due $1,500.00


Updated
November 12, 2023 @ 10:45 pm

Invoice updated by Geoffrey.

Viewed
July 22, 2024 @ 6:44 am

Invoice viewed by 69.171.249.16 for the first time.