Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


Veronica Brewer
20431 State Hwy 49
Medicine Park, OK 73507
POLICY# 006977915U7101


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

    $500.00
    1
    $500.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 7738 NW Madische Rd- Medicine Park, OK

    Ordinance Info: Wichita Mountain Estates Resolution- 1-1-23

Subtotal $1,390.00
Total Due $1,390.00


Updated
October 10, 2023 @ 10:51 am

Invoice updated by Geoffrey.

Status Update
October 10, 2023 @ 10:51 am

Status changed: Draft to Pending.