Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


Kyla Carmichael
3238 Cumberland Ct
Missouri City, TX 77459
POLICY# 010535433 7102

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BB-326-23-68-B 05/04/2023 06/23/2023 On Receipt Rosharon VFD

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

    $350.00
    1
    $350.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  4. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  5. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  9. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  10. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  11. 324 Traffic Cone (# Used)

    $5.00
    5
    $25.00

  12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Fm 1462 & CR 48- Rosharon, TX

    Ordinance Info: Rosharon Cost Recovery Resolution

Subtotal $1,982.00
Total Due $1,982.00


Updated
June 23, 2023 @ 11:31 am

Invoice updated by Geoffrey.

Viewed
July 21, 2024 @ 5:47 pm

Invoice viewed by 69.171.230.115 for the first time.