Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Kim Leventhal
20478 NW 254th Way
High Springs, Florida 32643
POLICY# 273 9741-D10-43S 002


Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $500.00
    1.5
    $750.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.5
    $300.00
  3. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    1
    $2.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  7. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00
  8. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 933 & CR 1227-5016 Fm 933, TX

    Ordinance Info: White Bluff VFD, Hill County, TX Resolution

Subtotal $1,602.00
Total Due $1,602.00


Updated
August 20, 2023 @ 10:23 pm

Invoice updated by Geoffrey.

Status Update
August 20, 2023 @ 10:23 pm

Status changed: Draft to Pending.