Bill To:


FARM BUREAU INSURANCE
5400 UNIVERSITY AVENUE
WEST DES MOINES, IA 50266-5997

Services Rendered To:


Shawn Henderson
13791 SH 77 West
Douglassville, Texas 75560


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

    $350.00
    1.5
    $525.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.5
    $450.00
  3. 205 Foam (Per Gallon)

    $65.00
    2
    $130.00
  4. 302 Hand Light (# Used)

    $5.00
    1
    $5.00
  5. 409 Manpower (Per Hour)

    4 firefighters 1.5 hours each

    $20.00
    6
    $120.00

  6. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 13791 SH 77 West Douglassville, Texas 75560

Subtotal $1,230.00
Total Due $1,230.00
Updated
December 22, 2019 @ 2:40 pm

Invoice updated by Karen Smith.

Status Update
December 22, 2019 @ 2:40 pm

Status changed: Draft to Pending.

Updated
December 22, 2019 @ 2:42 pm

Invoice updated by Karen Smith.

Updated
February 21, 2020 @ 3:58 pm

Invoice updated by Karen Smith.

Viewed
October 22, 2022 @ 7:39 pm

Invoice viewed by 64.124.8.36 for the first time.