Bill To:


MGA INSURANCE COMPANY
3333 Lee Parkway Suite 1200 PO Box 199023
Dallas, TX 75219

Services Rendered To:


Policy# 03MGEP1138870
Kyler Prater
1215 Pine St.
Longview, TX 75601


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

    $350.00
    1
    $350.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 806 N. White Oak Rd., White Oak, TX

    Ordinance Info: City of White Oak Ordinance 2021-02

Subtotal $1,000.00
Total Due $1,000.00


Updated
April 28, 2023 @ 10:14 am

Invoice updated by Karen Smith.

Status Update
April 28, 2023 @ 10:14 am

Status changed: Draft to Pending.