Bill To:

NATIONAL GENERAL INSURANCE
PO BOX 3199
WINSTON SALEM, NC 27102-3199

Services Rendered To:

James Wright Jr
153 Cobb Dr
Jemison, AL 35040
POLICY# 2010379353


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  3. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  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: CR 219 & CR 5- Jemison, AL

Subtotal $658.00
Total Due $658.00


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
July 3, 2023 @ 5:46 pm

Invoice updated by Geoffrey.

Status Update
July 3, 2023 @ 5:46 pm

Status changed: Draft to Pending.