Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


Floyed Sterling
250 Pines Forest Rd
Lufkin, TX 75901
POLICY# 0431536307101

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AC-501-24-3142 03/14/2024 04/11/2024 On Receipt Moffett VFD

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

    $400.00
    2.25
    $900.00
  2. 102 Engine Response (Per Hour)

    $500.00
    2.25
    $1,125.00
  3. 103 Rescue Response (Per Hour)

    $400.00
    2.25
    $900.00
  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  5. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

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

    $250.00
    1
    $250.00
  7. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  8. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  9. 202 Oil Absorbent Sheet (# Used)

    $2.50
    5
    $12.50
  10. 203 Oil Boom (# Used)

    $20.00
    2
    $40.00
  11. 329 Stokes Basket (# Used)

    $25.00
    1
    $25.00
  12. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.25
    $225.00
  13. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  14. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  15. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  16. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 842- Lufkin, TX

Subtotal $4,118.50
Total Due $4,118.50


Status Update
April 11, 2024 @ 11:16 am

Status changed: Pending to Paid.

Updated
April 11, 2024 @ 11:16 am

Invoice updated by Geoffrey.

Status Update
April 11, 2024 @ 11:16 am

Status changed: Draft to Pending.

Updated
April 11, 2024 @ 11:20 am

Invoice updated by Geoffrey.

Status Update
April 11, 2024 @ 11:21 am

Status changed: Paid to Pending.