Bill To:


Elizabeth Deutsch
2958 Masters CT S.
Burleson, TX 76028

Services Rendered To:


Elizabeth Deutsch
2958 Masters CT S
Burleson, Texas 76028
Policy # 6055190102221


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

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00
  4. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  5. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  8. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6132 FM 933 - Blum, Texas

Subtotal $1,340.00
Total Due $1,340.00


Updated
May 30, 2021 @ 1:05 pm

Invoice updated by Geoffrey.

Status Update
May 30, 2021 @ 1:05 pm

Status changed: Draft to Pending.

Updated
June 27, 2022 @ 5:34 pm

Invoice updated by Geoffrey.

Updated
June 27, 2022 @ 5:34 pm

Invoice updated by Geoffrey.