Bill To:

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

Services Rendered To:

Jon Payne
12450 South State Highway 205
Lavon, Texas 75166
Policy # 005184385C7-7108-2


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00

  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  4. 309 Power Tool (# Used)

    $50.00
    1
    $50.00

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00

  7. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

    9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 12446 South State Highway 205 Lavon, Texas 75166

    Ordinance Info: City of Lavon, Texas - Resolution NO. 2020-03-01

Subtotal $1,279.00
Total Due $1,279.00


Checks Payable To:

Sure Fire Recovery Service, LLC
9711 S Mason Road 125-120
Richmond, TX 77407
Federal Tax ID – 83-4417185


  Please Include Incident Number On All Correspondence.
Updated
February 3, 2021 @ 3:31 pm

Invoice updated by Geoffrey.

Status Update
February 3, 2021 @ 3:31 pm

Status changed: Draft to Pending.