Bill To:


USA Specialty Insurance
2370 Rice Boulevard Office #109
Houston, TX 77005

Services Rendered To:


Barbara Soriano Rosell
11710 Briar Forest Dr Apt# 705
Houston, TX 77077


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

    $500.00
    1.25
    $625.00
  2. 331 Air Bags (# Used)

    $150.00
    1
    $150.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US Hwy 36- Hamilton County, TX

Subtotal $1,142.50
Total Due $1,142.50


Updated
March 19, 2024 @ 3:39 pm

Invoice updated by Geoffrey.

Status Update
March 19, 2024 @ 3:39 pm

Status changed: Draft to Pending.