Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Vehicle Owner
Vin # 2HGFB2F58CH587083
License Plate# MWM-4992
POLICY # 627-2993-B25-430


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

    $300.00
    1
    $300.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 226 SB IH 45 Angus, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $562.00
Total Due $562.00


Updated
September 19, 2022 @ 4:17 pm

Invoice updated by Geoffrey.

Status Update
September 19, 2022 @ 4:17 pm

Status changed: Draft to Pending.

Updated
September 19, 2022 @ 4:18 pm

Invoice updated by Geoffrey.