Bill To:


Ned Farley Alcorn
15414 Stonehill Drive
Houston, TX 77062

Services Rendered To:


Policy# 0000006290984898
Ned Farley Alcorn
15414 Stonehill Dr.
Houston, TX 77062

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BB-326-2023-053-C 04/17/2023 04/25/2023 On Receipt Rosharon Volunteer Fire Dept.

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

    $350.00
    2
    $700.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    2
    $300.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2
    $300.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: W. FM 1462 and CR 527B RD., Rosharon, TX 77583

Subtotal $1,750.00
Total Due $1,750.00


Updated
April 24, 2023 @ 12:01 pm

Invoice updated by Karen Smith.

Updated
May 9, 2023 @ 11:03 am

Invoice updated by Geoffrey.

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