Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Bentley Brubaker
4776 County Rd 1053
Farmersville, TX 75442
POLICY# 23445647

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-23-277 05/06/2023 05/08/2023 On Receipt Lavon V.F.D.

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

    $350.00
    1
    $350.00
  2. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: N State Hwy 78/ Fm 6- Lavon, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $525.00
Total Due $525.00


Updated
May 8, 2023 @ 10:19 am

Invoice updated by Geoffrey.

Status Update
May 8, 2023 @ 10:19 am

Status changed: Draft to Pending.

Viewed
April 17, 2024 @ 7:22 pm

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