Bill To:


MGA INSURANCE COMPANY
3333 Lee Parkway Suite 1200 PO Box 199023
Dallas, TX 75219

Services Rendered To:


Janie Rodriguez
POLICY# 03MGEP1406467


Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  5. 202 Oil Absorbent Sheet (# Used)

    $2.50
    2
    $5.00
  6. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 2977- Richmond, TX

Subtotal $630.00
Total Due $630.00


Updated
January 16, 2024 @ 1:12 pm

Invoice updated by Geoffrey.

Status Update
January 16, 2024 @ 1:12 pm

Status changed: Draft to Pending.

Viewed
March 29, 2024 @ 11:45 pm

Invoice viewed by 66.249.72.6 for the first time.