Bill To:


TRUMBULL INSURANCE
HARTFORD PLAZA
HARTFORD, CT 06115

Services Rendered To:


Lalisa Webb
112 Beachview
Bridgeport, TX 76426
POLICY# 55PHG821437387270

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-22-474715 12/18/2022 01/11/2023 On Receipt Callisburg VFD

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

    $350.00
    1
    $350.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: CR 142 & E Hwy 82- Whitesboro, TX

Subtotal $450.00
Total Due $450.00


Updated
January 11, 2023 @ 4:36 pm

Invoice updated by Geoffrey.

Status Update
January 11, 2023 @ 4:36 pm

Status changed: Draft to Pending.

Viewed
May 30, 2024 @ 3:00 pm

Invoice viewed by 195.113.175.60 for the first time.