Bill To:


STATE FARM FIRE CLAIMS
PO BOX 106169
ATLANTA, GA 30348-6169

Services Rendered To:


Bryan Block
9660 Sunset Drive
Lavon, Texas 75166
Claim # 4307L089X


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

    Engine 1

    $350.00
    10.25
    $3,587.50
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    Command 1

    $150.00
    10.25
    $1,537.50
  3. 105 Utility Vehicle Response (Per Hour)

    Squad 1

    $150.00
    10.25
    $1,537.50
  4. 105 Utility Vehicle Response (Per Hour)

    Brush 1

    $150.00
    5.75
    $862.50
  5. 208 Fire Line Tap (Per Foot, Amt Used)

    50′ per roll x 4

    $0.25
    200
    $50.00
  6. 306 Gas/Co Detector (# Used)

    $50.00
    1
    $50.00
  7. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    2
    $200.00
  8. 318 Ladder (# Used)

    $35.00
    5
    $175.00
  9. 301 Hand Tool (# Used)

    $15.00
    10
    $150.00
  10. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    12
    $600.00
  11. 304 SCBA Cylinder (# Used)

    $25.00
    24
    $600.00
  12. 311 PPV / Ventilation Fan (# Used)

    $50.00
    2
    $100.00
  13. 211 Salvage Cover (Amt Used)   

    $35.00
    1
    $35.00
  14. 306 Hose Per 50′ (Amt Used)

    $25.00
    15
    $375.00
  15. 205 Foam (Per Gallon)

    $65.00
    5
    $325.00

  16. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 9660 Sunset Drive Lavon, Texas 75166

    Ordinance Info: CITY OF LAVON, TEXAS RESOLUTION NO. 2020-03-01

Subtotal $10,185.00
Total Due $10,185.00
Updated
June 17, 2020 @ 2:22 pm

Invoice updated by Karen Smith.

Status Update
June 17, 2020 @ 2:22 pm

Status changed: Draft to Pending.

Updated
June 17, 2020 @ 2:22 pm

Invoice updated by Karen Smith.

Status Update
June 17, 2020 @ 2:22 pm

Status changed: Draft to Pending.

Updated
June 17, 2020 @ 2:28 pm

Invoice updated by Karen Smith.

Updated
June 17, 2020 @ 2:31 pm

Invoice updated by Karen Smith.

Viewed
October 22, 2022 @ 1:22 pm

Invoice viewed by 64.124.8.54 for the first time.