Bill To:


Bailey Bark Material
3366 FM 2259
Nacogdoches, TX 75961

Services Rendered To:


Bailey Bark Material
3366 FM 2259
Nacogdoches, TX 75961
Vin# 1Z92C4526PT199089
License Plate# TX 202B586

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KB-403-23-2484 02/19/2023 02/20/2023 On Receipt Woodlawn VFD

*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $350.00
    2
    $700.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    2
    $600.00
  3. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    2
    $150.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  7. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US 59 @ Woodlawn Oaks Rd- Jefferson, TX

Subtotal $1,825.00
Total Due $1,825.00


Updated
February 20, 2023 @ 11:08 am

Invoice updated by Geoffrey.

Status Update
February 20, 2023 @ 11:08 am

Status changed: Draft to Pending.

Updated
May 9, 2023 @ 11:20 am

Invoice updated by Geoffrey.