Bill To:

FOREMOST INSURANCE
PO BOX 2450
GRAND RAPIDS, MI 49501-2450

Services Rendered To:

Raymond Butler
191 Elm Branch
Whitney, TX 76692
POLICY# 7006006919


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2
    $300.00

  2. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00

  3. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00

  4. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00

    5. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 191 Elm Branch Whitney, TX 76692

Subtotal $475.00
Total Due $475.00


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
May 11, 2023 @ 12:57 pm

Invoice updated by Geoffrey.

Status Update
May 11, 2023 @ 12:57 pm

Status changed: Draft to Pending.