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


Updated
April 21, 2022 @ 7:45 pm

Invoice updated by Geoffrey.

Status Update
April 21, 2022 @ 7:45 pm

Status changed: Draft to Pending.

Viewed
October 22, 2022 @ 9:21 am

Invoice viewed by 64.124.8.31 for the first time.