Bill To:

AAA Texas County Mutual Insurance
3333 Fairview Road
Costa Mesa, CA 92626

Services Rendered To:

Jennifer Walker
7700 Ranch Road
Athens, Texas 75751
Policy # TPA0706057


Product
Price
Qty
Amount

  1. 406 Medical Extrication – Lvl 2

    Patient:

    Garrett Brown
    7589 Weeping Willow
    Big Sandy, Texas 75755

    $1,500.00
    1
    $1,500.00

    2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6322 Highway 64 - Ben Wheeler, Texas

Subtotal $1,500.00
Total Due $1,500.00


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 1, 2021 @ 12:18 am

Invoice updated by Geoffrey.