Bill To:


Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:


Michael Sleeman
33435 Howell Rd
Waller, TX 77484
POLICY# 1000268188


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

    $500.00
    1
    $500.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  6. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 59- Woodlawn, TX

Subtotal $1,540.00
Total Due $1,540.00


Updated
January 11, 2024 @ 12:41 pm

Invoice updated by Geoffrey.

Status Update
January 11, 2024 @ 12:41 pm

Status changed: Draft to Pending.