Bill To:


Liberty County Mutual
175 Berkeley Street
Boston, MA 02116

Services Rendered To:


Michele Jessica Nungesser
3028 English Creek Drive
Azle, Texas 76020
Policy # Y8597030

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB206-2018-243 03/15/2018 11/14/2019 On Receipt Briar - Reno Fire Department

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    B #49

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    BC #52

    $150.00
    1
    $150.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 11800 FM Road 730 North , 100 Lee Drive

Subtotal $450.00
Total Due $450.00
Updated
November 16, 2019 @ 7:22 pm

Invoice updated by Karen Smith.

Status Update
November 16, 2019 @ 7:22 pm

Status changed: Draft to Pending.

Viewed
October 25, 2022 @ 6:44 am

Invoice viewed by 64.124.8.25 for the first time.