Bill To:


GEICO INSURANCE
ONE GEICO BLVD
FREDERICKSBURG, VA 22412-9000

Services Rendered To:


Christy Brightwell-Alvarado
592 Ridgecliff Drive
New Braunfels, Texas 78130
Policy # 0969301100

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HS-403-2021-62-A 02/05/2021 02/09/2021 On Receipt McQueeney V.F.D.

Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  5. 324 Traffic Cone (# Used)

    $5.00
    4
    $20.00
  6. 407 Patient Care / Evaluation (Per Patient)

    $50.00
    1
    $50.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 4100 FM 725 - New Braunfels, Texas

Subtotal $882.00
Total Due $882.00


Updated
February 9, 2021 @ 12:18 am

Invoice updated by Geoffrey.

Status Update
February 9, 2021 @ 12:18 am

Status changed: Draft to Pending.