Bill To:


Apollo Insurance
P.O. Box 833399
Richardson, TX 75083

Services Rendered To:


NaviStart
License Plate # 111-0045
POLICY# 22-F0647

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-23-44965-EE 03/16/2023 03/23/2023 On Receipt Lavon V.F.D.

Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient

    Martin Huerta

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: State Hwy 78/ Lakepointe Blvd- Lavon, TX

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

Subtotal $1,500.00
Total Due $1,500.00


Updated
March 23, 2023 @ 7:25 pm

Invoice updated by Geoffrey.

Updated
June 6, 2023 @ 3:24 pm

Invoice updated by Geoffrey.