Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Lorine McCord
200 N. Shaddix St.
Marietta, TX 75566
Policy# 4445453378

Attn: Almitra Robinson
CLAIM # 0567171220101012

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY205-2019-0306-A 03/06/2019 09/16/2019 On Receipt Douglassville Volunteer Fire Department

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

    $350.00
    1.5
    $525.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.5
    $450.00
  3. 803 Basic EMS Assistance (Response Fee)

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

    $15.00
    2
    $30.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    6
    $600.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: SH 77 West @ FM250

Subtotal $1,855.00
Total Due $1,855.00
Updated
September 12, 2019 @ 5:55 pm

Invoice updated by Karen Smith.

Status Update
September 12, 2019 @ 5:55 pm

Status changed: Draft to Pending.

Updated
September 12, 2019 @ 5:57 pm

Invoice updated by Karen Smith.

Updated
September 12, 2019 @ 5:58 pm

Invoice updated by Karen Smith.

Updated
September 12, 2019 @ 6:08 pm

Invoice updated by Karen Smith.

Updated
September 12, 2019 @ 8:54 pm

Invoice updated by Karen Smith.

Updated
November 6, 2019 @ 6:41 pm

Invoice updated by Karen Smith.

Updated
November 6, 2019 @ 6:42 pm

Invoice updated by Karen Smith.

Viewed
July 4, 2024 @ 12:37 am

Invoice viewed by 8.219.196.178 for the first time.