Bill To:

TRAVELERS INSURANCE GROUP
ONE TOWER SQUARE - 5MS
HARTFORD, CT 06183-0001

Services Rendered To:

Jeri Major
12134 W. Corrine Drive
El Mirage, Arizona 85335
6019281152031


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 Eastbound @ MM 146 - Henryetta, OK

    Ordinance Info: Tiger Mountain - McIntosh County Resolution 72021

Subtotal $1,175.00
Total Due $1,175.00


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
August 12, 2021 @ 2:34 pm

Invoice updated by Geoffrey.

Status Update
August 12, 2021 @ 2:34 pm

Status changed: Draft to Pending.

Updated
August 12, 2021 @ 2:34 pm

Invoice updated by Geoffrey.