Bill To:


Falcon Insurance Company
P.O. Box 3577
Oak Brook, IL 60522

Services Rendered To:


Gloria Osorio
11697 CR 586
Royce City, TX 75189
POLICY# 0200607655


Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $400.00
    1
    $400.00
  2. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  3. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 890 S SH 78- Lavon, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $813.00
Total Due $813.00


Updated
December 13, 2022 @ 1:41 pm

Invoice updated by Geoffrey.

Status Update
December 13, 2022 @ 1:41 pm

Status changed: Draft to Pending.