Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Abram Garza
POLICY# 3840318E0953G001

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BB-326-24-88 05/05/2024 05/16/2024 On Receipt Rosharon VFD

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.5
    $300.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1.5
    $750.00
  3. 104 Tanker Response (Per Hour)

    $400.00
    1.5
    $600.00
  4. 104 Tanker Response (Per Hour)

    $400.00
    1.5
    $600.00
  5. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00
  6. 324 Traffic Cone (# Used)

    $5.00
    5
    $25.00
  7. 221 Turbo Flare (# Used)

    $5.00
    10
    $50.00
  8. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  9. 303 SCBA Breathing Apparatus (# Used)

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

    $25.00
    2
    $50.00
  11. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  12. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 288 S of Cr 51- Rosharon, TX

    Ordinance Info: Rosharon Cost Recovery Resolution

Subtotal $2,805.00
Total Due $2,805.00


Updated
May 16, 2024 @ 1:44 pm

Invoice updated by Geoffrey.

Status Update
May 16, 2024 @ 1:44 pm

Status changed: Draft to Pending.