Bill To:


Gainsco Insurance
3333 Lee Parkway #1200
Dallas, TX 75219

Services Rendered To:


Ryan Shuemake
2401 Bridge Street
Gatesville, Texas 76528
Policy # 03MEGP1254525

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CX-409-2020-32 07/25/2020 07/28/2020 On Receipt Turnersville Volunteer Fire Company

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    2.25
    $675.00
  3. 102 Engine Response (Per Hour)

    $350.00
    2.25
    $787.50
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 319 Generator (Per Generator/Per Hour)

    $50.00
    2.25
    $112.50
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  7. 404 Scene Lighting (Per Hour)

    $75.00
    2.25
    $168.75
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.25
    $225.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3935 County Road 238 - Gatesville, Texas

    Ordinance Info: Turnersville, Texas - Policy # 55 Recovery of Services Costs

Subtotal $2,560.25
Total Due $2,560.25
Updated
July 28, 2020 @ 11:22 am

Invoice updated by Karen Smith.

Status Update
July 28, 2020 @ 11:22 am

Status changed: Draft to Pending.