Bill To:


James Vargas, Jr.
4618 Richmond Drive
Rosenberg, TX 77471

Services Rendered To:


James Vargas, Jr.
506 Stonewall Drive
Richmond, TX 77469

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-GS-417-22-187 08/08/2022 08/10/2022 On Receipt Fairchild V.F.D.

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Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    6.5
    $1,950.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    6.5
    $975.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    1
    $100.00
  5. 328 GlassMaster (# Used)

    $25.00
    1
    $25.00
  6. 310 Hydraulic Tool (# Used)

    $200.00
    4
    $800.00
  7. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  8. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  9. 404 Scene Lighting (Per Hour)

    $75.00
    6.5
    $487.50
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    6.5
    $650.00
  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    2
    $500.00
  12. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  13. Additional Incident Info

    Incident Type: MVA w/Entrapment Response

    Incident Location: 7698 FM 1994 - Needville, Texas

Subtotal $5,866.50
Total Due $5,866.50


Updated
August 10, 2022 @ 3:48 pm

Invoice updated by Geoffrey.

Status Update
August 10, 2022 @ 3:48 pm

Status changed: Draft to Pending.

Updated
September 12, 2022 @ 5:22 pm

Invoice updated by Geoffrey.