Bill To:


Texas Farm Bureau Insurance Companies
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Robert Marcucci
5911 Kissing Oak
San Antonio, Texas 78247
Policy # 23387071


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

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 331 Air Bags (# Used)

    $150.00
    2
    $300.00
  5. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  6. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00
  7. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  8. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  9. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00
  10. 317 Rescue Struts (# Used)

    $50.00
    1
    $50.00
  11. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  12. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  13. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  14. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 78 - McQueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution 4521

Subtotal $2,275.00
Total Due $2,275.00


Updated
December 8, 2021 @ 6:52 pm

Invoice updated by Geoffrey.

Viewed
October 22, 2022 @ 8:13 am

Invoice viewed by 64.124.8.27 for the first time.