Bill To:


Mark Blackstone
3900 Lakeside Drive
The Colony, TX 75056

Services Rendered To:


Mark Blackstone
3900 Lakeside Drive
The Colony, Texas 75056

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HW-405-2021-48-E2 05/15/2021 05/26/2021 On Receipt Hico V.F.D.

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

    Patient:

    Mark Blackstone
    3900 Lakeside Drive
    The Colony, Texas 75056

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 281 S. @ Honey Creek Bridge - Hamilton County, Texas

Subtotal $1,500.00
Total Due $1,500.00


Updated
August 25, 2021 @ 5:09 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 7:06 am

Invoice viewed by 64.124.8.45 for the first time.