Bill To:


American Modern Insurance Group
PO Box 5323
Cincinnati, OH 45201-5323

Services Rendered To:


VAQUERO HOMES LLC
1311 N. Whatley Rd. Lot 70
White Oak, TX 75693
POLICY# 081CD88426001

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HP-309-22-330 12/20/2022 12/23/2022 On Receipt White Oak VFD

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    4.5
    $675.00
  2. 102 Engine Response (Per Hour)

    $350.00
    4.5
    $1,575.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    4.5
    $675.00
  4. 104 Tanker Response (Per Hour)

    $300.00
    4.5
    $1,350.00
  5. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  6. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    200
    $50.00
  7. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  8. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  9. 301 Hand Tool (# Used)

    $15.00
    5
    $75.00
  10. 211 Salvage Cover (Amt Used)           

    $35.00
    1
    $35.00
  11. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    4
    $200.00
  12. 304 SCBA Cylinder (# Used)

    $25.00
    22
    $550.00
  13. 306 Hose Per 50′ (Amt Used)

    $25.00
    22
    $550.00

  14. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 1311 N Whatley Rd Lot 70 - White Oak, TX

    Ordinance Info: City of White Oak Ordinance 2021-02

Subtotal $5,970.00
Total Due $5,970.00


Updated
December 23, 2022 @ 2:54 pm

Invoice updated by Geoffrey.

Status Update
December 23, 2022 @ 2:54 pm

Status changed: Draft to Pending.