Bill To:


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

Services Rendered To:


Robert Coulter
503 FM 2554
Ivanhoe, Texas 75447
Policy # Unavailable at Scene

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-GH-311-2020-001 11/14/2020 11/20/2020 On Receipt Telephone VFD

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

    $350.00
    3.25
    $1,137.50
  2. 104 Tanker Response (Per Hour)

    $300.00
    3.25
    $975.00
  3. 103 Rescue Response (Per Hour)

    $300.00
    3.25
    $975.00
  4. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3.25
    $487.50
  5. 309 Power Tool (# Used)

    $50.00
    3
    $150.00
  6. 319 Generator (Per Generator/Per Hour)

    $50.00
    3.25
    $162.50
  7. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    2
    $200.00
  8. 318 Ladder (# Used)

    $35.00
    2
    $70.00
  9. 301 Hand Tool (# Used)

    $15.00
    5
    $75.00
  10. 311 PPV / Ventilation Fan (# Used)

    $50.00
    1
    $50.00
  11. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    5
    $250.00
  12. 304 SCBA Cylinder (# Used)

    $25.00
    5
    $125.00
  13. 404 Scene Lighting (Per Hour)

    $75.00
    3.25
    $243.75
  14. 306 Hose Per 50′ (Amt Used)

    $25.00
    15
    $375.00

  15. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 503 FM 2554 Ivanhoe, Texas 75447

Subtotal $5,276.25
Total Due $5,276.25
Updated
November 19, 2020 @ 6:44 pm

Invoice updated by Geoffrey.

Status Update
November 19, 2020 @ 6:44 pm

Status changed: Draft to Pending.

Viewed
October 22, 2022 @ 7:38 pm

Invoice viewed by 64.124.8.36 for the first time.