Bill To:

STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:

Vehicle Owner
State Farm
Policy # 4532411A2001


Product
Price
Qty
Amount

  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00

  2. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00

  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 107652 Highway 150 - Checotah, OK

Subtotal $2,015.00
Total Due $2,015.00


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, 2021 @ 2:51 pm

Invoice updated by Geoffrey.

Status Update
July 3, 2021 @ 2:51 pm

Status changed: Draft to Pending.