Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Amanda Ratmicoff
7704 Monona Ave
Austin, TX 78717
POLICY# 6147423872

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-XV-414-24-228 02/04/2024 02/12/2024 On Receipt Sam Bass FD

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

    $500.00
    1
    $500.00
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 620 & 45- Austin, TX

    Ordinance Info: Sam Bass Cost Recovery Resolution

Subtotal $752.50
Total Due $752.50


Updated
February 12, 2024 @ 6:57 pm

Invoice updated by Geoffrey.

Status Update
February 12, 2024 @ 6:57 pm

Status changed: Draft to Pending.