Bill To:


Lisa Callahan
112 North Wilson
Boyd, TX 76023

Services Rendered To:


Lisa Callahan
112 North Wilson
Boyd, Texas 76023
Policy # 27199338

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB-206-2020-1067-B 11/29/2020 10/25/2021 On Receipt Briar-Reno Fire Department

*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    5
    $10.00
  6. 326 Safety Fest (# Used)

    $2.50
    5
    $12.50
  7. 302 Hand Light (# Used)

    $5.00
    1
    $5.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 730 North & Portwood Road - Azle, Texas

Subtotal $777.50
Total Due $777.50


Updated
October 24, 2021 @ 2:26 pm

Invoice updated by Geoffrey.

Updated
October 24, 2021 @ 2:27 pm

Invoice updated by Geoffrey.

Updated
October 24, 2021 @ 2:27 pm

Invoice updated by Geoffrey.

Updated
April 21, 2022 @ 4:36 pm

Invoice updated by Geoffrey.

Updated
April 21, 2022 @ 4:37 pm

Invoice updated by Geoffrey.

Updated
April 21, 2022 @ 4:38 pm

Invoice updated by Geoffrey.

Viewed
October 23, 2022 @ 1:52 am

Invoice viewed by 64.124.8.43 for the first time.