Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Deborah Taylor
800 South Cardinal Road
Azle, Texas 76020
Policy # 838047206


Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    2
    $600.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    2
    $300.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  7. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 7120 Briar Road - Azle, Texas

Subtotal $1,668.00
Total Due $1,668.00


Updated
July 23, 2021 @ 7:05 pm

Invoice updated by Geoffrey.

Status Update
July 23, 2021 @ 7:05 pm

Status changed: Draft to Pending.

Updated
July 23, 2021 @ 7:05 pm

Invoice updated by Geoffrey.

Updated
July 23, 2021 @ 7:27 pm

Invoice updated by Geoffrey.