Bill To:


Loya Insurance Company
P.O. Box 972450
El Paso, TX 79997

Services Rendered To:


Tomas Camacho
291 VZCR 4926
Ben Wheeler, TX 75754
Policy # 66E97413017


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

    $350.00
    1.5
    $525.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.5
    $150.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 63 @ VZCR 4923 - Ben Wheeler, Texas

Subtotal $1,308.00
Total Due $1,308.00


Updated
May 7, 2021 @ 4:53 pm

Invoice updated by Geoffrey.