Bill To:


Consumers County Mutual Insurance
4245 N. Central Expressway, Suite 500
Dallas, TX 75205

Services Rendered To:


Cindy Salana
12910 Speed Rd
Santa Fe, TX 77517
POLICY# 6058445762221


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

    $500.00
    1
    $500.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  6. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  7. 309 Power Tool (# Used)

    $50.00
    2
    $100.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 1462 & CR 526A- Rosharon, TX

    Ordinance Info: Rosharon Cost Recovery Resolution

Subtotal $1,795.00
Total Due $1,795.00


Updated
July 26, 2023 @ 1:22 pm

Invoice updated by Geoffrey.