Bill To:


Texas Farm Bureau Insurance Companies
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:


Aletha Downing
1035 Meadow Oaks Street
Azle, Texas 76020
Policy # 23250283


Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient:

    Paydne Downing
    1035 Meadow Oaks
    Azle, Texas 76020

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Portwood Road & FM 730 North - Azle, Texas

Subtotal $1,500.00
Total Due $1,500.00


Updated
November 8, 2021 @ 1:50 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 12:26 pm

Invoice viewed by 64.124.8.30 for the first time.