Bill To:


Dashyla Thomas
110 N. Belleview Street
Amarillo, TX 79106

Services Rendered To:


Dashyla Thomas
4525 Ida Louise Court
Amarillo, Texas 79110
Policy # SH356271


*** THIS HAS BEEN SUBMITTED TO YOUR INSURANCE COMPANY AND DENIED. THIS IS NOW YOUR RESPONSIBILITY. ***

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

    $350.00
    1.5
    $525.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    1.5
    $450.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  4. 103 Rescue Response (Per Hour)

    $300.00
    1.5
    $450.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 301 Hand Tool (# Used)

    $15.00
    6
    $90.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 287 Southbound @ 25 - Electra, Texas

    Ordinance Info: City of Electra Resolution NO. 2018-05

Subtotal $2,140.00
Total Due $2,140.00


Updated
December 8, 2021 @ 6:01 pm

Invoice updated by Geoffrey.

Status Update
December 8, 2021 @ 6:01 pm

Status changed: Draft to Pending.

Updated
August 19, 2022 @ 5:18 pm

Invoice updated by Geoffrey.

Updated
September 12, 2022 @ 5:17 pm

Invoice updated by Geoffrey.