Bill To:


Consumers County Mutual Insurance
4245 N. Central Expressway, Suite 500
Dallas, TX 75205

Services Rendered To:


Quentin Thomas
Ph # 214-934-3082
Policy # 9952644072221

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-2020-118-B 04/14/2020 04/16/2020 On Receipt Lavon Volunteer Fire Department

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

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 78 and Highway 6 - Lavon, Texas

    Ordinance Info: RESOLUTION NO. 2020-03-01

Subtotal $850.00
Total Due $850.00
Updated
April 16, 2020 @ 2:26 pm

Invoice updated by Karen Smith.

Viewed
October 22, 2022 @ 8:01 am

Invoice viewed by 64.124.8.27 for the first time.