Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Mark Dowell
322 Private Rd 1092
Stephenville, TX 76401
License Plate # GSR-5223
Vin# 3D7MR48CX5G706740

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HW-405-23-200 01/17/2023 01/19/2023 On Receipt Hico 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. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  7. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  8. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    4
    $200.00
  9. 304 SCBA Cylinder (# Used)

    $25.00
    4
    $100.00
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 27705 US 281 S- Erath Co, TX

Subtotal $1,745.00
Total Due $1,745.00


Updated
January 19, 2023 @ 3:33 pm

Invoice updated by Geoffrey.

Status Update
January 19, 2023 @ 3:33 pm

Status changed: Draft to Pending.

Viewed
March 20, 2024 @ 6:29 pm

Invoice viewed by 66.249.72.5 for the first time.