Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Kayley
21A Clear Creek Road
Valley Mills, Texas 76689
Policy # N/A at Scene

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AZ-409-2021-24 03/06/2021 03/12/2021 On Receipt Valley Mills V.F.D.

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

    $150.00
    1
    $150.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Barnett Bend and FM 317 - Valley Mills, Texas

Subtotal $900.00
Total Due $900.00


Updated
March 11, 2021 @ 1:07 pm

Invoice updated by Geoffrey.

Status Update
March 11, 2021 @ 1:07 pm

Status changed: Draft to Pending.