Bill To:


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

Services Rendered To:


Jennifer Broadway
7331 Emerald Glade Ln
Humble, TX 77396
POLICY# 465 1727-D19-53A


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

    $350.00
    1
    $350.00
  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  4. 301 Hand Tool (# Used)

    $15.00
    5
    $75.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 726 Westbound I-10- Sealy, TX

Subtotal $958.00
Total Due $958.00


Updated
December 22, 2022 @ 1:05 pm

Invoice updated by Geoffrey.

Viewed
February 1, 2023 @ 11:30 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.

Viewed
March 29, 2024 @ 11:24 pm

Invoice viewed by 66.249.72.5 for the first time.