Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Brenda Pennington
340 Navarro Road
Corsicana, TX 75109
Policy # 23218582

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C21-26717 10/21/2021 12/08/2021 On Receipt Angus Vol. Fire Department

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

    $300.00
    1
    $300.00
  2. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00

  5. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 225 Southbound on Interstate 45 West - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $440.00
Total Due $440.00


Updated
December 8, 2021 @ 5:11 pm

Invoice updated by Geoffrey.

Status Update
December 8, 2021 @ 5:11 pm

Status changed: Draft to Pending.

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