Bill To:


Redpoint County Mutual Insurance Co.
13215 Bee Cave Parkway
Bldg. 2, Suite 150
Austin, TX 78738

Services Rendered To:


Inocente Serrano Lazaro
2636 Fieldale Dr
Dallas, TX 75234
POLICY# TXA1971401290

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C23-7586 03/24/2023 03/27/2023 On Receipt Angus Vol. Fire Department

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: St Hwy 14 & FM 641-Angus, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $625.00
Total Due $625.00


Updated
March 27, 2023 @ 5:50 pm

Invoice updated by Geoffrey.

Status Update
March 27, 2023 @ 5:50 pm

Status changed: Draft to Pending.

Updated
March 27, 2023 @ 5:50 pm

Invoice updated by Geoffrey.

Status Update
March 27, 2023 @ 5:50 pm

Status changed: Draft to Pending.