Bill To:

Zurich North America
1299 Zurich Way
schaumburg, IL 60196-1056

Services Rendered To:

Polk Mechanical Company
2425 Dillard Street
Grand Prairie, Texas 75051
Policy # BAP38899409


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50

  2. 102 Engine Response (Per Hour)

    $350.00
    2.25
    $787.50

  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50

  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  5. 402 Fire/Police Services (Per Hour)    

    $100.00
    2.25
    $225.00

  6. 328 GlassMaster (# Used)

    $25.00
    1
    $25.00

  7. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00

  8. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  9. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  10. 309 Power Tool (# Used)

    $50.00
    1
    $50.00

  11. 317 Rescue Struts (# Used)

    $50.00
    1
    $50.00

  12. 404 Scene Lighting (Per Hour)

    $75.00
    2.25
    $168.75

  13. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.25
    $225.00

  14. 701 Body Removal (Per Body)    

    $250.00
    1
    $250.00

  15. 390 Winch

    $50.00
    1
    $50.00

    16. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3302 Highway 64 - Ben Wheeler, Texas

Subtotal $2,979.25
Total Due $2,979.25


Checks Payable To:

Sure Fire Recovery Service, LLC
9711 S Mason Road 125-120
Richmond, TX 77407
Federal Tax ID – 83-4417185


  Please Include Incident Number On All Correspondence.
Updated
May 3, 2021 @ 8:25 pm

Invoice updated by Geoffrey.

Status Update
May 3, 2021 @ 8:25 pm

Status changed: Draft to Pending.

Updated
May 3, 2021 @ 8:34 pm

Invoice updated by Geoffrey.