Bill To:


USAA CASUALTY INSURANCE
9800 FREDERICKSBURG ROAD
SAN ANTONIO, TX 78240-4100

Services Rendered To:


Darrin Biel
1447 N. Bittercreek Terrace
Mustang, OK 73064
Policy # 0103908757101


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

    $300.00
    1
    $300.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Indian Nation Turnpike @ MM 97 - Henryetta, OK

    Ordinance Info: SALEM-RYAL FIRE DEPT. RESOLUTION NO. 72821

Subtotal $662.00
Total Due $662.00


Updated
August 23, 2021 @ 3:30 pm

Invoice updated by Geoffrey.

Status Update
August 23, 2021 @ 3:30 pm

Status changed: Draft to Pending.