Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Ronny Bearden
6198 S Int Hwy 45 W
Angus, TX
POLICY# 436067761

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C24-1476 01/20/2024 02/05/2024 On Receipt Angus VFD

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $400.00
    2.75
    $1,100.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    2.75
    $1,100.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    2.75
    $687.50
  4. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  5. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  6. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  7. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  8. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.75
    $275.00
  10. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  11. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 6198 S Int Hwy 45 W Angus, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $3,637.50
Total Due $3,637.50


Updated
February 5, 2024 @ 7:43 pm

Invoice updated by Geoffrey.

Status Update
February 5, 2024 @ 7:43 pm

Status changed: Draft to Pending.