Bill To:


FEDERATED MUTUAL INSURANCE
121 EAST PARK SQUARE
OWATONNA, MN 55060-3046

Services Rendered To:


Casey Raitz
1111 N. Graham Street
Stephenville, TX 76401
Policy # 9239360


Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    2
    $600.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2
    $300.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    14
    $28.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 281 Northbound @ FM 1602 - Hico, Texas

Subtotal $1,413.00
Total Due $1,413.00


Updated
October 7, 2021 @ 9:02 pm

Invoice updated by Geoffrey.

Status Update
October 7, 2021 @ 9:02 pm

Status changed: Draft to Pending.

Viewed
October 22, 2022 @ 8:56 am

Invoice viewed by 64.124.8.31 for the first time.