Bill To:


Tokio Marine America Co
5340 Legacy Drive Suite 135
Plano, TX 75024

Services Rendered To:


Marla Hamilton
11467 Mason Dr
Lavon, TX 75166
POLICY# 2136303200

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-23-715-A 10/03/2023 10/04/2023 On Receipt Lavon V.F.D.

Product
Price
Qty
Amount
  1. 101 Aerial/Ladder Response (Per Hour)

    $550.00
    1.75
    $962.50
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  6. 419 Environmental Spill

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: SH 205 & CR 485 - Lavon, Texas

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $1,684.50
Total Due $1,684.50


Updated
October 4, 2023 @ 11:11 am

Invoice updated by Geoffrey.

Status Update
October 4, 2023 @ 11:11 am

Status changed: Draft to Pending.