Bill To:


Austin Grant
1652 Sheila Drive
Azle, TX 76020

Services Rendered To:


Austin Grant
1652 Sheila Drive
Azle, Texas 76020


*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

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

    $150.00
    1
    $150.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  3. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1600 Sandy Beach Road - Azle, Texas

Subtotal $775.00
Total Due $775.00


Updated
November 8, 2021 @ 1:05 pm

Invoice updated by Geoffrey.

Status Update
November 8, 2021 @ 1:05 pm

Status changed: Draft to Pending.

Updated
November 8, 2021 @ 1:05 pm

Invoice updated by Geoffrey.

Status Update
November 8, 2021 @ 1:05 pm

Status changed: Draft to Pending.