Bill To:


GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:


Gilbert Flores
325 Buttercup Lane
Floresville, TX 78114
Policy # 430412328753


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

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 324 Traffic Cone (# Used)

    $5.00
    15
    $75.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 78 and FM 1044 - Marion, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution 4521

Subtotal $1,510.00
Total Due $1,510.00


Updated
April 30, 2021 @ 5:08 pm

Invoice updated by Geoffrey.

Status Update
April 30, 2021 @ 5:08 pm

Status changed: Draft to Pending.