Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Wade Laurence
110 Sanderson
Whitney, Texas 76692
Policy # 377 6695-F01-49E-001


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

    $300.00
    1.25
    $375.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 401 Debris Cleanup/Removal (# Used)

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

    $100.00
    1.25
    $125.00
  5. 205 Foam (Per Gallon)

    $65.00
    4
    $260.00
  6. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  8. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 182 HCR 1159 - Whitney, Texas

Subtotal $1,352.50
Total Due $1,352.50
Updated
August 24, 2020 @ 9:40 pm

Invoice updated by Karen Smith.

Status Update
August 24, 2020 @ 9:40 pm

Status changed: Draft to Pending.