Bill To:

State Farm Insurance
One State Farm Plaza
Bloomington, IL 61710

Services Rendered To:

Monica Stephenson
Policy # 440279960543 001


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  3. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. 409 Manpower (Per Hour)

    $50.00
    2
    $100.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Southbound Rest Area - Richland, Texas

Subtotal $1,100.00
Total Due $1,100.00


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
January 12, 2021 @ 4:53 pm

Invoice updated by Geoffrey.

Status Update
January 12, 2021 @ 4:53 pm

Status changed: Draft to Pending.

Updated
February 14, 2022 @ 2:20 pm

Invoice updated by Geoffrey.