Bill To:


Germania Select Insurance Company
PO Box 645
Brenham, TX 77834

Services Rendered To:


Maxwell Miller
25146 Texas Highway 77 West
Naples, Texas 75568-7768
Policy # 43043363755


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

    $350.00
    4
    $1,400.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    4
    $1,200.00
  3. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  6. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    4
    $400.00
  8. 409 Manpower (Per Hour)

    3 Men x 4 Hours each (12)

    $20.00
    12
    $240.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: State Highway 77 West - 1 Mile from Morris County Texas

Subtotal $3,805.00
Total Due $3,805.00
Updated
May 16, 2020 @ 8:38 pm

Invoice updated by Karen Smith.

Status Update
May 16, 2020 @ 8:38 pm

Status changed: Draft to Pending.

Viewed
April 27, 2022 @ 5:15 pm

Invoice viewed by GEOFFREY SMITH (Geoffrey) for the first time.

Viewed
October 23, 2022 @ 12:31 am

Invoice viewed by 64.124.8.45 for the first time.