Bill To:


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

Services Rendered To:


Policy# SNH458790
Scott Erraby

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-GV-301-24-4075 03/31/2024 04/01/2024 On Receipt Dew Volunteer Fire Dept.

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

    $500.00
    1
    $500.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-45 @ 189 NB, Teague, TX 75860

Subtotal $1,000.00
Total Due $1,000.00


Updated
April 1, 2024 @ 9:26 pm

Invoice updated by Karen Smith.

Status Update
April 1, 2024 @ 9:26 pm

Status changed: Draft to Pending.

Viewed
July 22, 2024 @ 9:38 pm

Invoice viewed by 173.252.83.7 for the first time.