Bill To:


GARRISON PROPERTY & CASUALTY
9800 FREDERICKSBURG ROAD
SAN ANTONIO, TX 78288-4100

Services Rendered To:


Joshua Cornell
644 CR 103
Jemison, AL 35085
POLICY# 0120351987101

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-01-403-23-1123 10/11/2023 10/24/2023 On Receipt Jemison Fire Department

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

    $500.00
    1
    $500.00
  2. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  3. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  4. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 644 CR 103- Jemison, AL

Subtotal $1,000.00
Total Due $1,000.00


Updated
October 24, 2023 @ 1:36 pm

Invoice updated by Geoffrey.

Status Update
October 24, 2023 @ 1:36 pm

Status changed: Draft to Pending.