Bill To:


Farmers Texas County Mutual
6301 Owensmouth Ave.
Woodland Hills, CA 91367

Services Rendered To:


Steven Blalock
6297 CR 1915
Mt Pleasant, TX 75455
POLICY# 45266625


Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  5. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  6. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  7. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00
  8. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6000 Block State Hwy 6 NB- Waco, TX

Subtotal $1,424.00
Total Due $1,424.00


Updated
December 8, 2022 @ 5:00 pm

Invoice updated by Geoffrey.

Status Update
December 8, 2022 @ 5:00 pm

Status changed: Draft to Pending.

Viewed
January 27, 2023 @ 3:18 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.