Bill To:


Texas Farm Bureau Insurance Companies
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Brett Hemenway
520 CR 121
Gainesville, TX 76240
POLICY # 23242711


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    1
    $100.00
  5. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  7. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  8. 309 Power Tool (# Used)

    $50.00
    2
    $100.00
  9. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  10. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    1
    $50.00
  11. 304 SCBA Cylinder (# Used)

    $25.00
    1
    $25.00
  12. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  13. 207 Wetting Agent (Amt Used)

    $25.00
    1
    $25.00
  14. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00
  15. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  16. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1765 FM 2896 - Gainesville, Texas

Subtotal $1,798.00
Total Due $1,798.00


Updated
September 21, 2022 @ 12:09 pm

Invoice updated by Geoffrey.

Status Update
September 21, 2022 @ 12:09 pm

Status changed: Draft to Pending.

Updated
September 21, 2022 @ 1:25 pm

Invoice updated by Geoffrey.

Updated
September 21, 2022 @ 1:27 pm

Invoice updated by Geoffrey.