Bill To:


Johnny Klement
149 CR 149
Gainesville, TX 76240-6890

Services Rendered To:


Johnny Klement
149 CR 149
Gainesville, TX 76240-6890
POLICY # TX 00235282-02


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    3.25
    $487.50
  2. 104 Tanker Response (Per Hour)

    $300.00
    3.25
    $975.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3.25
    $487.50
  4. 102 Engine Response (Per Hour)

    $350.00
    3.25
    $1,137.50
  5. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3.25
    $487.50
  6. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  7. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  8. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  9. 301 Hand Tool (# Used)

    $15.00
    12
    $180.00
  10. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  11. 320 Portable Pond (# Used)

    $150.00
    1
    $150.00
  12. 211 Salvage Cover (Amt Used)   

    $35.00
    1
    $35.00
  13. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    4
    $200.00
  14. 304 SCBA Cylinder (# Used)

    $25.00
    8
    $200.00
  15. 404 Scene Lighting (Per Hour)

    $75.00
    3.25
    $243.75
  16. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    3.25
    $325.00

  17. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 149 CR 149 Gainesville, TX 76240

Subtotal $5,143.75
Total Due $5,143.75


Updated
June 4, 2022 @ 5:24 pm

Invoice updated by Geoffrey.

Status Update
June 4, 2022 @ 5:24 pm

Status changed: Draft to Pending.

Updated
July 21, 2022 @ 1:49 pm

Invoice updated by Geoffrey.

Updated
July 21, 2022 @ 1:49 pm

Invoice updated by Geoffrey.