Bill To:


Mas Solutions RLI Marine
P.O. Box 3961
Peoria, IL 61612-3961

Services Rendered To:


Stacks Sawmill
109 CR 2588
Naples, TX 75568
POLICY# ILM0303321

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-23-708 07/08/2023 08/01/2023 On Receipt Douglassville V.F.D.

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

    $500.00
    2.5
    $1,250.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    2.5
    $625.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 205 Foam (Per Gallon)

    $65.00
    2
    $130.00

  5. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 109 CR 2588- Douglasville, TX

    Ordinance Info: Douglassville Volunteer Fire Dept. Resolution

Subtotal $2,020.00
Total Due $2,020.00


Updated
August 1, 2023 @ 10:22 am

Invoice updated by Geoffrey.

Status Update
August 1, 2023 @ 10:22 am

Status changed: Draft to Pending.