Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


2013 Honda Senata
POLICY# 5029506J1543001

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-287-RC-23-1 09/10/2023 09/18/2023 On Receipt 287 R/C Fire & Rescue

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

    $500.00
    1.25
    $625.00

  2. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: Hwy 287 & CR 3290- Kerens, TX

Subtotal $625.00
Total Due $625.00


Updated
September 18, 2023 @ 1:18 pm

Invoice updated by Geoffrey.

Status Update
September 18, 2023 @ 1:18 pm

Status changed: Draft to Pending.