Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


McWheeny Chun
3001 Bent Tree Loop
Round Rock, TX 78681
POLICY# 00630542U71016

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-XV-414-23-2068 12/15/2023 12/19/2023 On Receipt Sam Bass Fire Department

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

    $500.00
    1.25
    $625.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.25
    $250.00
  3. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1369 Hairy Man Rd- Round Rock, TX

    Ordinance Info: Sam Bass Fire Dept. Resolution

Subtotal $1,280.00
Total Due $1,280.00


Updated
December 19, 2023 @ 11:24 am

Invoice updated by Geoffrey.

Status Update
December 19, 2023 @ 11:24 am

Status changed: Draft to Pending.