Bill To:


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

Services Rendered To:


Gisele Schaefer
2003 Woods Cove
Round Rock, TX 78681
POLICY# 886985388


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

    $250.00
    1
    $250.00
  2. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  3. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 16900 Ranch Rd 620- Round Rock, TX

    Ordinance Info: Sam Bass Cost Recovery Resolution

Subtotal $415.00
Total Due $415.00


Updated
March 12, 2024 @ 10:49 am

Invoice updated by Geoffrey.

Status Update
March 12, 2024 @ 10:49 am

Status changed: Draft to Pending.