Bill To:


Suresh Pakalapati
142 Rolling Fork Bend
Irving, TX 75039

Services Rendered To:


Suresh Pakalapati
142 Rolling Fork Bend
Irving, TX 75039
POLICY# 4434660215


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    1.5
    $600.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1.5
    $750.00
  3. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: IH 45 NB- Richland, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $2,150.00
Total Due $2,150.00


Updated
January 9, 2024 @ 3:58 pm

Invoice updated by Geoffrey.

Status Update
January 9, 2024 @ 3:58 pm

Status changed: Draft to Pending.

Updated
February 15, 2024 @ 11:43 am

Invoice updated by Geoffrey.