Bill To:


SAFECO INSURANCE
P.O. Box 5014
Scranton, PA 18505

Services Rendered To:


Jeffrey Paul Langston
2089 CR 2360
Decatur, Texas 76234
Policy # Y8535221

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB206-2018-248 03/16/2018 11/14/2019 On Receipt Briar - Reno Fire Department

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    BC #52

    $150.00
    1
    $150.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 11800 FM 730 and 8100 Lee Drive, Tarrant County Texas

Subtotal $300.00
Total Due $300.00
Updated
November 16, 2019 @ 7:56 pm

Invoice updated by Karen Smith.

Status Update
November 16, 2019 @ 7:56 pm

Status changed: Draft to Pending.

Updated
November 16, 2019 @ 7:59 pm

Invoice updated by Karen Smith.

Updated
June 1, 2020 @ 6:14 pm

Invoice updated by Karen Smith.