Bill To:


GARRISON PROPERTY & CASUALTY
9800 FREDERICKSBURG ROAD
SAN ANTONIO, TX 78288-4100

Services Rendered To:


Policy# 0415139344-3979
Owner: Linda Lee Richardson
410 VZVR 4822
Chandler, TX 75758
Driver: Susan Kip White
1600 VZCR 4702
Ben Wheeler, TX 75754

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WZ-208-2020-201165 11/03/2020 11/10/2020 On Receipt Van Zandt Midway VFD

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

    $150.00
    1.5
    $225.00
  2. 105 Utility Brush Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  3. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6164 SH 64, Van Zandt, TX

Subtotal $1,135.00
Total Due $1,135.00
Updated
November 9, 2020 @ 5:30 pm

Invoice updated by Karen Smith.

Status Update
November 9, 2020 @ 5:30 pm

Status changed: Draft to Pending.

Updated
November 9, 2020 @ 5:44 pm

Invoice updated by Karen Smith.

Updated
November 9, 2020 @ 5:44 pm

Invoice updated by Karen Smith.

Updated
November 9, 2020 @ 5:51 pm

Invoice updated by Karen Smith.

Viewed
October 24, 2022 @ 7:42 am

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