损失清单 meaning in English

claim statement

This is a statement of loss and you should indemnify us $ 2 , 450
这是损失清单一张，你方应赔付我方2450美元。
4th , the entire vehicle loses before , after the tenant must compensatethe insurance company to exempt compensates partial and loses thevehicle to compensate this period rent 50 % expense to the insurancecompany
索赔时，承租应向保险公司提交保险单、事故证明、事故调解结案书、损失清单和各种有关费用单据。如实填写机动车辆出险报告单。