Bill To:


Redpoint County Mutual Insurance Co.
13215 Bee Cave Parkway
Bldg. 2, Suite 150
Austin, TX 78738

Services Rendered To:


John Fortenberry
3235 Sandusky Rd
Whitesboro, TX 76273
POLICY# SH431605

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-22-463285 07/21/2022 01/23/2023 On Receipt Callisburg VFD

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

    $350.00
    1
    $350.00
  2. 204 Flare (# Used)

    $8.00
    1
    $8.00
  3. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  4. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 11558 E US Hwy 82- Whitesboro, TX

Subtotal $568.00
Total Due $568.00


Updated
January 23, 2023 @ 11:12 am

Invoice updated by Geoffrey.

Status Update
January 23, 2023 @ 11:12 am

Status changed: Draft to Pending.