Bill To:


Infinity Auto Insurance
2201 4th Avenue North
N. Birmingham, AL 35203

Services Rendered To:


Paco Lopez Barrios
1201 Legacy #1413
Plano, TX 75023
POLICY # 142140335286001

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C22-21236 08/22/2022 09/17/2022 On Receipt Angus Vol. Fire Department

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 14 and Southwest C.R. 2410 - Richland, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $400.00
Total Due $400.00


Updated
September 17, 2022 @ 5:04 pm

Invoice updated by Geoffrey.

Status Update
September 17, 2022 @ 5:04 pm

Status changed: Draft to Pending.

Viewed
October 24, 2022 @ 1:47 am

Invoice viewed by 64.124.8.25 for the first time.

Updated
January 26, 2023 @ 1:23 pm

Invoice updated by Karen Smith.

Viewed
January 26, 2023 @ 1:24 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.