Bill To:


USAA
9800 Fredericksburg Rd.
San Antonio, TX 78288

Services Rendered To:


Tracy Atwood
195 CR 3329
Atlanta, TX 75551
POLICY# 0102511827102

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-24-409 04/09/2024 04/16/2024 On Receipt Douglassville V.F.D.

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    1.5
    $600.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.5
    $375.00
  3. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 2791 & CR 2115- Cass County

    Ordinance Info: Douglassville Volunteer Fire Dept. Resolution

Subtotal $1,005.00
Total Due $1,005.00


Updated
April 16, 2024 @ 1:20 pm

Invoice updated by Geoffrey.

Status Update
April 16, 2024 @ 1:20 pm

Status changed: Draft to Pending.