Bill To:


Liberty County Mutual
175 Berkeley Street
Boston, MA 02116

Services Rendered To:


Shawn Beatty
3309 Sherry Ln Apt 259
Abilene, TX 79601
POLICY# Y9644625

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-23-3031 04/09/2023 06/26/2023 On Receipt Callisburg V.F.D.

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

    $350.00
    2.5
    $875.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    2.5
    $375.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    2.5
    $250.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.5
    $250.00
  8. 419 Environmental Spill

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 800 Block of CR 121- Gainesville, TX

    Ordinance Info: City Of Callisburg Resolution

Subtotal $2,315.00
Total Due $2,315.00


Updated
June 26, 2023 @ 11:32 am

Invoice updated by Geoffrey.

Status Update
June 26, 2023 @ 11:32 am

Status changed: Draft to Pending.