Bill To:


GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:


Winford Allen
1047 Bones Chapel Rd
Whitesboro, TX 76273
POLICY# 43043406250


Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  2. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  3. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  4. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US Hwy 82 & County Rd 179- Whitesboro, TX

Subtotal $950.00
Total Due $950.00


Updated
January 23, 2023 @ 11:00 am

Invoice updated by Geoffrey.

Status Update
January 23, 2023 @ 11:00 am

Status changed: Draft to Pending.