Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Richard Ruscher
5842 Bender Rd
Humble, TX 77396
POLICY# 616358648

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C23-19625 08/01/2023 11/14/2023 On Receipt Angus Vol. Fire Department

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  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: 223 SB IH 45- Angus, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $750.00
Total Due $750.00


Updated
November 14, 2023 @ 3:14 pm

Invoice updated by Geoffrey.

Status Update
November 14, 2023 @ 3:14 pm

Status changed: Draft to Pending.