Bill To:

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

Services Rendered To:

Patrick Cruz
145 N.E. Fairfield Drive
Elgin, OK 73538
Policy # 0137170427108


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  3. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00

  4. 315 Cribbing – Lvl 2 (Class B Vehicle) (Used)

    $200.00
    1
    $200.00

  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    5
    $10.00

  8. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  9. 201 Oil Absorbent Material (# Used)

    $35.00
    5
    $175.00

  10. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00

  11. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  12. 330 Backboard (# Used)

    $25.00
    1
    $25.00

  13. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    14. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US-Highway 62 and Northwest Mcintosh Road - Lawton, OK

Subtotal $1,900.00
Total Due $1,900.00


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
April 21, 2022 @ 7:45 pm

Invoice updated by Geoffrey.

Status Update
April 21, 2022 @ 7:45 pm

Status changed: Draft to Pending.