Bill To:


Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:


Fatima Rodriguez
225 Serdero Dr
Garland, TX 75040
POLICY# SP3- 343466-0012


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

    $400.00
    1.5
    $600.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.5
    $375.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 183 N 145- Dew, TX

Subtotal $1,375.00
Total Due $1,375.00


Updated
January 31, 2024 @ 1:57 pm

Invoice updated by Geoffrey.

Status Update
January 31, 2024 @ 1:57 pm

Status changed: Draft to Pending.