Bill To:


Jeannette Thompson
174 Tom Hough Road
Zavalla, TX 75980

Services Rendered To:


Jeannette Thompson
174 Tom Hough Road
Zavalla, Texas 75980
Policy # H3729869423040

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AC-309-2021-47 09/25/2021 09/29/2021 On Receipt Zavalla Fire Department

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

    $350.00
    3.5
    $1,225.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3.5
    $525.00
  3. 104 Tanker Response (Per Hour)

    $300.00
    3.5
    $1,050.00
  4. 306 Hose Per 50′ (Amt Used)

    $25.00
    6
    $150.00

  5. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 174 Tom Hough Road Zavalla, Texas 75980

Subtotal $2,950.00
Total Due $2,950.00


Updated
September 28, 2021 @ 6:46 pm

Invoice updated by Geoffrey.

Status Update
September 28, 2021 @ 6:46 pm

Status changed: Draft to Pending.

Updated
June 14, 2022 @ 1:05 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 6:01 am

Invoice viewed by 64.124.8.42 for the first time.