Bill To:


GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:


Policy# 7600-1102-9896
LaVeta M. Sweeney
103 Stevens
Marietta, Texas 75566
Agent: Mike Pruitt
ph# 512-446-6085
Claim # 10255506


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

    $350.00
    2
    $700.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    2
    $600.00
  3. 302 Hand Light (# Used)

    $5.00
    2
    $10.00
  4. 318 Ladder (# Used)

    $35.00
    1
    $35.00
  5. 301 Hand Tool (# Used)

    $15.00
    6
    $90.00
  6. 311 PPV / Ventilation Fan (# Used)

    $50.00
    1
    $50.00
  7. 409 Manpower (Per Hour)

    6 x 2 Hours each

    $50.00
    12
    $600.00

  8. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 103 Stevens Marietta, Texas 75566

Subtotal $2,085.00
Total Due $2,085.00
Updated
October 2, 2020 @ 2:33 pm

Invoice updated by Geoffrey.

Status Update
October 2, 2020 @ 2:33 pm

Status changed: Draft to Pending.

Updated
November 12, 2020 @ 1:28 pm

Invoice updated by Karen Smith.

Updated
November 12, 2020 @ 1:32 pm

Invoice updated by Karen Smith.