Bill To:


MID CENTURY AUTO INSURANCE
6301 Owensmouth Ave.
Woodland Hills, CA 91367
US

Services Rendered To:


Eddie Alexander
6642 Glade St
Dallas, TX 75232
POLICY# 535681659

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CX-409-23-9-E 03/22/2023 03/23/2023 On Receipt Turnersville Fire Department

Product
Price
Qty
Amount
  1. 405 Medical Extrication – Lvl 1

    Patient

    Eddie Alexander
    6642 Glade St
    Dallas, TX 75232
    POLICY# 535681659

    $500.00
    1
    $500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: South on CR 223 & FM 217- Valley Mills, TX

    Ordinance Info: Ordinance #55: Recovery of Services Costs for Turnersville VFD

Subtotal $500.00
Total Due $500.00


Updated
March 23, 2023 @ 5:09 pm

Invoice updated by Geoffrey.

Updated
August 9, 2023 @ 12:42 pm

Invoice updated by Geoffrey.

Updated
March 25, 2024 @ 7:48 pm

Invoice updated by Karen Smith.

Viewed
March 25, 2024 @ 7:49 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.