Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Pricila Islam
1510 W. Lovers Lane, Apt # 6
Arlington, Texas 76013
Policy # 4621933243

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-2021-422 10/03/2021 10/08/2021 On Receipt Lavon V.F.D.

Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $400.00
    1
    $400.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 78 & FM 6 - Lavon Texas

    Ordinance Info: City of Lavon - Billing Resolution NO. 2020-03-01

Subtotal $836.00
Total Due $836.00


Updated
October 7, 2021 @ 9:13 pm

Invoice updated by Geoffrey.

Status Update
October 7, 2021 @ 9:14 pm

Status changed: Draft to Pending.

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January 9, 2022 @ 8:48 pm

Invoice viewed by Karen Smith (KarenS) for the first time.

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October 23, 2022 @ 12:21 am

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