Bill To:


Texarkana Fence and Access
359 Dodd Street
Nash, TX 75569

Services Rendered To:


Texarkana Fence and Access
359 Dodd Street
Nash, Texas 75569
Policy # WPP1598731 02

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-2020-1005 10/05/2020 10/14/2020 On Receipt Douglassville Volunteer Fire Department

*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $350.00
    4
    $1,400.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    4
    $1,200.00
  3. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 302 Hand Light (# Used)

    $5.00
    1
    $5.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  7. 211 Salvage Cover (Amt Used)   

    $35.00
    1
    $35.00
  8. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    4
    $400.00
  10. 409 Manpower (Per Hour)

    3 Responders for 4 hours each

    $50.00
    12
    $600.00
  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: State Highway 8 and FM 995 - Red Hill - Cass County

Subtotal $4,260.00
Total Due $4,260.00


Updated
October 13, 2020 @ 6:12 pm

Invoice updated by Geoffrey.

Status Update
October 13, 2020 @ 6:12 pm

Status changed: Draft to Pending.

Updated
July 22, 2021 @ 6:16 pm

Invoice updated by Geoffrey.

Updated
July 22, 2021 @ 6:16 pm

Invoice updated by Geoffrey.

Viewed
October 23, 2022 @ 1:33 am

Invoice viewed by 64.124.8.45 for the first time.