Bill To:


Infinity Auto Insurance
2201 4th Avenue North
N. Birmingham, AL 35203

Services Rendered To:


Atekelt Abeyehu
115 Liberty
Wylie, Texas 75098
Policy # 142560188949001

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-2021-8-B 01/03/2021 02/10/2021 On Receipt Lavon V.F.D.

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

    $350.00
    1.75
    $612.50
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 204 Flate (# Used)

    $8.00
    10
    $80.00
  6. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  7. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00
  8. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  9. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00
  12. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  13. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  14. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 78 & Grand Heritage Blvd. - Lavon, Texas

    Ordinance Info: City of Lavon, Texas - Resolution NO. 2020-03-01

Subtotal $2,821.50
Total Due $2,821.50


Updated
February 9, 2021 @ 11:23 am

Invoice updated by Geoffrey.

Status Update
February 9, 2021 @ 11:23 am

Status changed: Draft to Pending.

Updated
February 9, 2021 @ 11:44 am

Invoice updated by Geoffrey.

Updated
February 9, 2021 @ 11:54 am

Invoice updated by Geoffrey.

Viewed
July 12, 2021 @ 12:57 pm

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

Viewed
October 24, 2022 @ 6:14 am

Invoice viewed by 64.124.8.42 for the first time.