Bill To:


ROOT INSURANCE COMPANY
80 EAST RICH STREET - SUITE 500
COLUMBUS, OH 43215-5249

Services Rendered To:


Andrea Thurston
427 South Fort Street
WY
Root -Policy # 68ZJKC

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB206-2020-213 03/12/2020 03/17/2020 On Receipt Briar - Reno Fire Department

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

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  5. 201 Oil Absorbent Material (# Used)

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

    $100.00
    1
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 11787 FM Road 730 North - Azle, Texas

    Ordinance Info: Resolution

Subtotal $850.00
Total Due $850.00
Updated
March 16, 2020 @ 7:43 pm

Invoice updated by Karen Smith.

Status Update
March 16, 2020 @ 7:43 pm

Status changed: Draft to Pending.

Updated
March 16, 2020 @ 7:47 pm

Invoice updated by Karen Smith.

Viewed
October 24, 2022 @ 6:40 am

Invoice viewed by 64.124.8.42 for the first time.