Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


Michael Mitchell
1643 CR 140
Whitesboro, TX 76273
POLICY# 416 102 166

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-23-3092 07/02/2023 01/25/2024 On Receipt Callisburg VFD

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

    $500.00
    1.75
    $875.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.75
    $350.00
  3. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.75
    $175.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    1.75
    $131.25
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  7. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 844 CR 167- Whitesboro, TX

    Ordinance Info: City Of Callisburg Resolution

Subtotal $1,991.25
Total Due $1,991.25


Updated
January 25, 2024 @ 10:52 am

Invoice updated by Geoffrey.

Status Update
January 25, 2024 @ 10:52 am

Status changed: Draft to Pending.