Bill To:


Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Edith Moreno
711 Jefferson Street
Hillsboro, TX 76645
POLICY # 23318616


Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  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. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  6. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  7. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00
  8. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  9. 201 Oil Absorbent Material (# Used)

    $35.00
    4
    $140.00
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  12. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  13. 330 Backboard (# Used)

    $25.00
    1
    $25.00

  14. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3053 SH 22 - Hillsboro, Texas

    Ordinance Info: Recovery of Service Costs for Peoria VFD

Subtotal $1,774.00
Total Due $1,774.00


Updated
September 23, 2022 @ 3:32 pm

Invoice updated by Geoffrey.

Status Update
September 23, 2022 @ 3:32 pm

Status changed: Draft to Pending.