Bill To:


Germania Select Insurance Company
PO Box 645
Brenham, TX 77834

Services Rendered To:


Jason Nichols
Policy# 43043316047


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

    $350.00
    1.25
    $437.50
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  3. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 1399 @ CR 2349

Subtotal $887.50
Total Due $887.50
Updated
September 12, 2019 @ 6:49 pm

Invoice updated by Karen Smith.

Status Update
September 12, 2019 @ 6:49 pm

Status changed: Draft to Pending.

Updated
September 12, 2019 @ 6:56 pm

Invoice updated by Karen Smith.

Updated
September 12, 2019 @ 8:36 pm

Invoice updated by Karen Smith.

Updated
September 12, 2019 @ 8:46 pm

Invoice updated by Karen Smith.