Bill To:

Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:

Angela Marie Mannis
2385 SH 22
Whitney, TX 76692
POLICY# 00102807


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  3. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00

  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  5. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75

  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

    7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3724 State Hwy 22- Hillsboro, TX

    Ordinance Info: Recovery of Service Costs for Peoria VFD

Subtotal $882.75
Total Due $882.75


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
February 6, 2023 @ 4:52 pm

Invoice updated by Geoffrey.

Status Update
February 6, 2023 @ 4:52 pm

Status changed: Draft to Pending.