Bill To:

Robert Shumake
536 Mitch Street
Saginaw, TX 76179

Services Rendered To:

Robert Shumake
536 Mitch Street
Saginaw, TX 76179


*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount

  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00

  2. 206 Latex Gloves (Pairs Used)

    $2.00
    3
    $6.00

  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  4. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 8106 Moran Road - Azle, Texas

    Ordinance Info: Briar-Reno Cost Recovery Resolution

Subtotal $681.00
Total Due $681.00


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
October 6, 2021 @ 5:07 pm

Invoice updated by Geoffrey.

Status Update
October 6, 2021 @ 5:07 pm

Status changed: Draft to Pending.

Updated
January 20, 2022 @ 1:57 pm

Invoice updated by Geoffrey.

Updated
January 20, 2022 @ 1:57 pm

Invoice updated by Geoffrey.