Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


Heather Miller
730 Colina Parkway
Farmersville, TX 75442
POLICY# 003873869 7102

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-23-5321 11/01/2023 11/06/2023 On Receipt Lavon V.F.D.

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

    $500.00
    1
    $500.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: St Hwy 205/ County Rd 485- Lavon, TX

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

Subtotal $958.00
Total Due $958.00


Updated
November 6, 2023 @ 9:47 am

Invoice updated by Geoffrey.

Status Update
November 6, 2023 @ 9:47 am

Status changed: Draft to Pending.