Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Christopher Watson
829 SEC 3048D
Corsicana, TX 75109
POLICY# 23478486

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-401-24-8852 04/18/2024 05/08/2024 On Receipt 287 R/C Fire & Rescue

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

    $500.00
    1.5
    $750.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.5
    $375.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 10411 S Hwy 287- Corsicana, TX

Subtotal $1,525.00
Total Due $1,525.00


Updated
May 8, 2024 @ 9:54 pm

Invoice updated by Geoffrey.

Status Update
May 8, 2024 @ 9:54 pm

Status changed: Draft to Pending.