Bill To:


Texas Farm Bureau Insurance Companies
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Clarence Evans
Policy# 60177734

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY205-2017-1217 12/17/2017 08/26/2019 On Receipt Douglassville Volunteer Fire Department

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

    $350.00
    2.5
    $875.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    2.5
    $750.00
  3. 104 Tanker Response (Per Hour)

    $300.00
    2.5
    $750.00
  4. 205 Foam (Per Gallon)

    $65.00
    5
    $325.00
  5. 409 Manpower (Per Hour)

    $20.00
    10
    $200.00
  6. 302 Hand Light (# Used)

    $5.00
    2
    $10.00

  7. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 900 CR 2350 Cass County Texas

Subtotal $2,910.00
Total Due $2,910.00
Updated
August 24, 2019 @ 5:09 pm

Invoice updated by Karen Smith.

Status Update
August 24, 2019 @ 5:09 pm

Status changed: Draft to Pending.

Updated
August 24, 2019 @ 5:18 pm

Invoice updated by Karen Smith.

Viewed
October 22, 2022 @ 7:39 am

Invoice viewed by 64.124.8.27 for the first time.

Viewed
July 4, 2024 @ 12:36 am

Invoice viewed by 8.219.59.78 for the first time.

Viewed
July 24, 2024 @ 3:37 am

Invoice viewed by 173.252.83.23 for the first time.