Bill To:


Infinity County Mutual
3700 Colonade Parkway
Birmingham, AL 35243

Services Rendered To:


Joann Saenz
409 Country Acres Drive
Sequin, Texas 78155
POLICY # 142560575999001


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

    Patient:

    Joann Saenz
    409 Country Acres Drive
    Sequin, Texas 78155
    POLICY # 142560575999001

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Terminal Loop and FM 725 Intersection - McQueeney, Texas

    Ordinance Info: RESOLUTION-McQueeney Cost Recovery Resolution 4521

Subtotal $1,500.00
Total Due $1,500.00


Updated
August 17, 2022 @ 4:47 pm

Invoice updated by Geoffrey.