Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Jordan Dick
6698 CR 106
Whitesboro, TX 76273
POLICY# 536 5963 H11 43 001


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

    $350.00
    1
    $350.00
  2. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 323 Portable Radio (# Used)

    $10.00
    4
    $40.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 678 & Thrasher Rd- Callisburg, TX

Subtotal $565.00
Total Due $565.00


Updated
December 13, 2022 @ 11:32 am

Invoice updated by Geoffrey.

Status Update
December 13, 2022 @ 11:32 am

Status changed: Draft to Pending.

Viewed
February 1, 2023 @ 11:32 pm

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