Bill To:


CLEAR BLUE INSURANCE
B7 TABONUCO STREET - 9TH FLOOR SANTANDER TOWER
GUAYNABO, PR 00968-3342

Services Rendered To:


Policy# AQ1YTX00177002
Owner: Truck King LLC
Driver: Glenn Lane
PO Box 1717
Denton, TX 76202


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

    $350.00
    1.75
    $612.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1.75
    $612.50
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00

  5. Additional Incident Info

    Incident Type: Select One

    Incident Location: 3037 US Hwy. 87, O'Donnell, TX

Subtotal $1,925.00
Total Due $1,925.00


Updated
September 21, 2021 @ 11:26 pm

Invoice updated by Karen Smith.

Status Update
September 21, 2021 @ 11:26 pm

Status changed: Draft to Pending.