Bill To:

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

Services Rendered To:

Kenneth Maynard
751 CR 230
Sargent, TX 77414


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  3. 206 Latex Gloves (Pairs Used)

    $2.00
    1
    $2.00

  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: 25150 FM 457 - Sargent, Texas

Subtotal $777.00
Total Due $777.00


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
December 22, 2021 @ 5:52 pm

Invoice updated by Geoffrey.

Status Update
December 22, 2021 @ 5:52 pm

Status changed: Draft to Pending.

Updated
December 22, 2021 @ 5:53 pm

Invoice updated by Geoffrey.