Bill To:

STATE FARM MUTUAL INSURANCE
ONE STATE FARM PLAZA
BLOOMINGTON, IL 61710-0001

Services Rendered To:

Tonya Gonzales
1401 Scenic Dr
Longview, TX 75604
POLICY# 331 0079-D27-43J


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    4.25
    $1,487.50

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    4.25
    $637.50

  3. 103 Rescue Response (Per Hour)

    $300.00
    4.25
    $1,275.00

  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    4.25
    $637.50

  5. 306 Gas/Co Detector (# Used)

    $50.00
    2
    $100.00

  6. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  8. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  9. 404 Scene Lighting (Per Hour)

    $75.00
    4.25
    $318.75

  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    4.25
    $425.00

  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  12. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  13. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  14. 419 Environmental Spill

    $250.00
    1
    $250.00

    15. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: TX-42 & W Texaco Rd- Longview, TX

    Ordinance Info: City of White Oak Ordinance 2021-02

Subtotal $5,973.25
Total Due $5,973.25


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 3, 2023 @ 5:54 pm

Invoice updated by Geoffrey.

Status Update
July 3, 2023 @ 5:54 pm

Status changed: Draft to Pending.