Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Trevor Hicks
2710 Hinkles fry
Richmond, TX 77407
POLICY# 381 4759-D05-53D


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

    $350.00
    1
    $350.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  4. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  5. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  9. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  10. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  11. 324 Traffic Cone (# Used)

    $5.00
    5
    $25.00

  12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Fm 1462 & CR 48- Rosharon, TX

    Ordinance Info: Rosharon Cost Recovery Resolution

Subtotal $1,982.00
Total Due $1,982.00


Updated
June 23, 2023 @ 11:28 am

Invoice updated by Geoffrey.

Status Update
June 23, 2023 @ 11:28 am

Status changed: Draft to Pending.