Bill To:


Sugey Garcia
11419 Sharpview
Houston, TX 77072

Services Rendered To:


Sugey Garcia
11419 Sharpview
Houston, Texas 77072
Policy # 45288115

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C21-18357 07/19/2021 07/28/2021 On Receipt Angus Vol. Fire Department

*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $300.00
    1
    $300.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 226 Southbound and Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $650.00
Total Due $650.00


Updated
July 27, 2021 @ 1:56 pm

Invoice updated by Geoffrey.

Status Update
July 27, 2021 @ 1:56 pm

Status changed: Draft to Pending.

Updated
October 21, 2021 @ 6:40 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 8:30 am

Invoice viewed by 64.124.8.27 for the first time.