Bill To:

GERMANIA INSURANCE COMPANY
507 Hwy. 290 E
Brenham, TX 77833

Services Rendered To:

Annette Wooten
114 Courtney Ln
Callisburg, TX 76240
POLICY# 2302211027945


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  2. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50

  3. 331 Air Bags (# Used)

    $150.00
    1
    $150.00

  4. 332 Air Tools (# Used)

    $50.00
    1
    $50.00

  5. 218 Cervical Collar (# Used)

    $25.00
    4
    $100.00

  6. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00

  7. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  8. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00

  9. 204 Flare (# Used)

    $8.00
    5
    $40.00

  10. 310 Hydraulic Tool (# Used)

    $200.00
    3
    $600.00

  11. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  12. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  13. 309 Power Tool (# Used)

    $50.00
    2
    $100.00

  14. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00

  15. 317 Rescue Struts (# Used)

    $50.00
    2
    $100.00

  16. 211 Salvage Cover (Amt Used)           

    $35.00
    2
    $70.00

  17. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00

  18. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00

  19. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75

  20. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  21. 215 Trauma Kit (# Used)

    $25.00
    4
    $100.00

  22. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  23. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  24. 330 Backboard (# Used)

    $25.00
    4
    $100.00

    25. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Fm 2896 & Blankship Hill Lane- Gainesville, TX

Subtotal $3,405.75
Total Due $3,405.75


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
January 11, 2023 @ 2:40 pm

Invoice updated by Geoffrey.

Status Update
January 11, 2023 @ 2:40 pm

Status changed: Draft to Pending.