Bill To:


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

Services Rendered To:


Theodore Brown
210 Caddo Street
Lipan, Texas 76462
Policy # 008864660

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KS-406-21-Z2103-0202-A 03/02/2021 03/08/2021 On Receipt Hood County V.F.D. # 70

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

    $300.00
    1.25
    $375.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50
  3. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 2300 Block of Lipan Highway - Granbury, Texas

Subtotal $757.50
Total Due $757.50


Updated
March 6, 2021 @ 1:20 pm

Invoice updated by Geoffrey.

Status Update
March 6, 2021 @ 1:20 pm

Status changed: Draft to Pending.

Updated
March 6, 2021 @ 1:47 pm

Invoice updated by Geoffrey.

Viewed
June 24, 2021 @ 5:29 pm

Invoice viewed by Karen Smith (KarenS) for the first time.

Viewed
June 24, 2021 @ 5:29 pm

Invoice viewed by 65.79.192.5 for the first time.

Viewed
October 24, 2022 @ 1:44 am

Invoice viewed by 64.124.8.25 for the first time.