Bill To:


ALLSTATE FIRE AND CASUALTY
2775 SANDERS ROAD
NORTHBROOK, IL 60062-6110

Services Rendered To:


Keenah Wilbourn
223 Cheyenne Run
Hallsville, TX 75650
POLICY# 000000429685486

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HP-309-23-131 05/03/2023 05/11/2023 On Receipt White Oak VFD

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

    $150.00
    1
    $150.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    100
    $25.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 100 Hwy US 80- White Oak, TX

    Ordinance Info: City of White Oak Ordinance 2021-02

Subtotal $625.00
Total Due $625.00


Updated
May 11, 2023 @ 3:56 pm

Invoice updated by Geoffrey.

Status Update
May 11, 2023 @ 3:56 pm

Status changed: Draft to Pending.