Bill To:


Benchmark Insurance
P.O. Box 166002
Altamonte, FL 32716-6002

Services Rendered To:


Matador Towing
ERL Thornton Fwy #272
Dallas, TX 75228
CLAIM# BIC-WS-01082-01

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-XV-414-24-929 05/29/2024 05/30/2024 On Receipt Sam Bass Fire Department

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

    $500.00
    1.75
    $875.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.75
    $350.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    1.75
    $131.25
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 14582 TX-45- Austin, TX

    Ordinance Info: Sam Bass Fire Dept. Resolution

Subtotal $1,581.25
Total Due $1,581.25


Updated
May 30, 2024 @ 3:06 pm

Invoice updated by Geoffrey.

Status Update
May 30, 2024 @ 3:06 pm

Status changed: Draft to Pending.