Bill To:


ALLSTATE FIRE AND CASUALTY
2775 SANDERS ROAD
NORTHBROOK, IL 60062-6110

Services Rendered To:


Roy Reiland
227 Pecan Drive SW
McQueeney, TX 78130
Policy # 000000838681002


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

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  7. 207 Wetting Agent (Amt Used)

    $25.00
    1
    $25.00
  8. 324 Traffic Cone (# Used)

    $5.00
    10
    $50.00
  9. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  10. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  11. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 78 and FM 725 - McQueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution

Subtotal $1,208.00
Total Due $1,208.00


Updated
March 31, 2021 @ 3:17 pm

Invoice updated by Geoffrey.