Bill To:


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

Services Rendered To:


Robert Alton Jones
9 Osaiaw Loop
Simpsonville, SC 29681
Policy # 013921382U71021

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C22-02547-A 02/04/2022 03/17/2022 On Receipt Angus Vol. Fire Department

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

    $300.00
    1
    $300.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 229 Southbound Interstate Highway 45 - Corsicana, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $400.00
Total Due $400.00


Updated
March 17, 2022 @ 3:23 pm

Invoice updated by Geoffrey.

Status Update
March 17, 2022 @ 3:23 pm

Status changed: Draft to Pending.

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