Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Jason Pruitt
221 N. Anderson
Bremond, TX 76629
Policy # 23130054


Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $400.00
    1
    $400.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 78 & Highway 205 - Lavon, Texas

    Ordinance Info: City of Lavon - Resolution NO. 2020-03-01

Subtotal $762.00
Total Due $762.00


Updated
October 14, 2021 @ 5:35 pm

Invoice updated by Geoffrey.