Bill To:


Ashley Shine
1909 FM-664
Ferris, TX 75125

Services Rendered To:


Ashley Shine
1909 FM-664
Ferris, TX 75125
POLICY# BGS01020258

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CX-409-23-66 10/22/2023 10/23/2023 On Receipt Turnersville Fire Department

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

    $400.00
    1.25
    $500.00
  2. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  4. 409 Manpower (Per Hour)

    $50.00
    2
    $100.00
  5. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  6. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  8. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 9000 Block Fm 215- Valley Mills, TX

    Ordinance Info: Recovery of Services Costs for Turnersville VFD

Subtotal $1,254.00
Total Due $1,254.00


Updated
October 23, 2023 @ 10:32 am

Invoice updated by Geoffrey.

Status Update
October 23, 2023 @ 10:32 am

Status changed: Draft to Pending.

Updated
January 23, 2024 @ 2:31 pm

Invoice updated by Geoffrey.

Viewed
March 20, 2024 @ 5:48 pm

Invoice viewed by 66.249.72.6 for the first time.