Bill To:

HARTFORD INSURANCE
ONE HARTFORD PLAZA
HARTFORD, CT 06115-1707

Services Rendered To:

Elton Ware
20696 East C.R. 176
Elmer, OK 73539
Policy # 55PHT696916


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  3. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50

  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. 204 Flate (# Used)

    $8.00
    4
    $32.00

  7. 319 Generator (Per Generator/Per Hour)

    $50.00
    1.25
    $62.50

  8. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00

  9. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  10. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  11. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50

  12. 201 Oil Absorbent Material (# Used)

    $35.00
    3
    $105.00

  13. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  14. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

  15. 327 Windshield Kit (# Used)

    $25.00
    1
    $25.00

  16. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    17. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US Highway 62 - Lawton, OK

Subtotal $2,102.50
Total Due $2,102.50


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
May 3, 2021 @ 7:27 pm

Invoice updated by Geoffrey.

Status Update
May 3, 2021 @ 7:27 pm

Status changed: Draft to Pending.

Updated
May 3, 2021 @ 7:34 pm

Invoice updated by Geoffrey.

Updated
February 14, 2022 @ 2:52 pm

Invoice updated by Geoffrey.