Bill To:


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

Services Rendered To:


Clifton Barnes
2104 N.W. 54th Street
Lawton, OK 73505
Policy # 015021379


Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  2. 102 Engine Response (Per Hour)

    $350.00
    1.75
    $612.50
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  4. 102 Engine Response (Per Hour)

    $350.00
    1.75
    $612.50
  5. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00
  7. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  8. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  10. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-44 @ MM 46 - Lawton, OK

Subtotal $2,737.50
Total Due $2,737.50


Updated
July 12, 2021 @ 8:10 pm

Invoice updated by Geoffrey.

Status Update
July 12, 2021 @ 8:10 pm

Status changed: Draft to Pending.

Viewed
October 25, 2022 @ 1:12 am

Invoice viewed by 64.124.8.51 for the first time.

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October 29, 2023 @ 10:12 pm

Invoice viewed by 82.64.192.240 for the first time.