Bill To:


STATE FARM MUTUAL INSURANCE
ONE STATE FARM PLAZA
BLOOMINGTON, IL 61710-0001

Services Rendered To:


Joseph Allen Epps
State Farm Mutual
POLICY # 536 6039-H07-43 002


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

    $350.00
    1.5
    $525.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00
  4. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  5. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  6. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  7. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  8. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  9. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  10. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  11. 404 Scene Lighting (Per Hour)

    $75.00
    1.5
    $112.50
  12. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  13. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  14. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

  15. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Crawford Street & Big Indian Road - Gainesville, Texas

Subtotal $2,677.50
Total Due $2,677.50


Updated
September 14, 2022 @ 6:50 pm

Invoice updated by Geoffrey.

Status Update
September 14, 2022 @ 6:50 pm

Status changed: Draft to Pending.