Bill To:


Southern County Mutual Insurance Co.
PO Box 809076
Dallas, TX 75380-9076

Services Rendered To:


Betty White
13171 Big Oak Bay Road
Tyler, Texas 75707
Policy # 55DTX576112


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    Unit # B-1

    $150.00
    1.5
    $225.00
  2. 105 Utility Vehicle Response (Per Hour)

    Unit # B-2

    $150.00
    1.5
    $225.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.5
    $150.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 64 @ CR 4926 - Ben Wheeler, Texas

Subtotal $1,004.00
Total Due $1,004.00


Updated
October 8, 2021 @ 5:24 pm

Invoice updated by Geoffrey.

Status Update
October 8, 2021 @ 5:24 pm

Status changed: Draft to Pending.

Viewed
March 10, 2022 @ 9:00 pm

Invoice viewed by Karen Smith (KarenS) for the first time.