Bill To:


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

Services Rendered To:


Robert Lee Waterhouse
1612 Cedar Crest Dr
Forney, TX 75126
POLICY# 0294700447102

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-GV-301-23-3952 10/29/2023 12/07/2023 On Receipt Dew VFD

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

    $400.00
    1.5
    $600.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1.5
    $750.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  8. 324 Traffic Cone (# Used)

    $5.00
    10
    $50.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I45 @ 183 South- Dew, TX

Subtotal $2,080.00
Total Due $2,080.00


Updated
December 7, 2023 @ 7:02 pm

Invoice updated by Geoffrey.

Status Update
December 7, 2023 @ 7:02 pm

Status changed: Draft to Pending.

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