Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


William Skidmore
513 CR 1145
Atlanta, Texas 75551
Policy# 00100 66 23C


Product
Price
Qty
Amount
  1. 330 Backboard (# Used)

    $25.00
    2
    $50.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00
  3. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00
  4. 409 Manpower (Per Hour)

    $20.00
    3
    $60.00
  5. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 995 3 mi east of SH8 , Atlanta Texas 75551

    Ordinance Info: City of Atlanta Code of Ordinances Sec. 5.109

Subtotal $785.00
Total Due $785.00
Updated
August 24, 2019 @ 10:41 pm

Invoice updated by Karen Smith.

Status Update
August 24, 2019 @ 10:41 pm

Status changed: Draft to Pending.

Updated
December 4, 2019 @ 2:51 pm

Invoice updated by Karen Smith.

Updated
December 4, 2019 @ 5:10 pm

Invoice updated by Karen Smith.