Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Mary Wheeler
1575 Kings Road
Denton, Texas 76209
Policy # 4408758482


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

    $300.00
    1.25
    $375.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  4. 218 Cervical Collar (# Used)

    $25.00
    4
    $100.00
  5. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00
  6. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    1
    $0.25
  7. 328 GlassMaster (# Used)

    $25.00
    1
    $25.00
  8. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  9. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00
  10. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  11. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  12. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  13. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  14. 211 Salvage Cover (Amt Used)       

    $35.00
    1
    $35.00
  15. 330 Backboard (# Used)

    $25.00
    2
    $50.00
  16. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  17. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  18. 407 Patient Care / Evaluation (Per Patient)

    $50.00
    4
    $200.00
  19. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  20. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 14400 FM 730 - Azle, Texas

    Ordinance Info: Briar-Reno Cost Recovery Bylaws Amendment

Subtotal $2,507.75
Total Due $2,507.75
Updated
December 1, 2020 @ 2:48 pm

Invoice updated by Geoffrey.