Bill To:


Katlyn Ann Carter
19467 Longview Street
Thackerville, OK 73459

Services Rendered To:


Katlyn Ann Carter
19467 Longview Street
Thackerville, OK 73459
Policy # 923717035

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-2021-431856 06/19/2021 06/23/2021 On Receipt Callisburg V.F.D.

*** 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
    1
    $150.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: CR 147 & CR 174 - Gainesville, TX

Subtotal $600.00
Total Due $600.00


Updated
June 22, 2021 @ 1:27 pm

Invoice updated by Geoffrey.

Status Update
June 22, 2021 @ 1:27 pm

Status changed: Draft to Pending.

Viewed
August 7, 2021 @ 4:22 pm

Invoice viewed by Karen Smith (KarenS) for the first time.

Updated
November 16, 2021 @ 2:58 pm

Invoice updated by Geoffrey.

Updated
June 15, 2022 @ 4:13 pm

Invoice updated by Geoffrey.

Viewed
October 20, 2022 @ 3:30 pm

Invoice viewed by 64.124.8.52 for the first time.

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October 20, 2022 @ 7:08 pm

Invoice viewed by 64.124.8.33 for the first time.

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October 24, 2022 @ 1:12 pm

Invoice viewed by 64.124.8.26 for the first time.