Bill To:

ALLSTATE PIP / MED PAY
PO BOX 2874
CLINTON, IA 52733-2874

Services Rendered To:

David Alford
677 Oak Grove Road
Westville, Florida 32464
Policy # 9719739731027


Product
Price
Qty
Amount

  1. 406 Medical Extrication – Lvl 2

    Patient:

    David Alford
    677 Oak Grove Road
    Westville, Florida 32464

    $1,500.00
    1
    $1,500.00

    2. Additional Incident Info

    Incident Type: Select One

    Incident Location: 677 Oak Grove Road Westville, Florida 32464

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
March 31, 2021 @ 6:41 pm

Invoice updated by Geoffrey.

Updated
March 31, 2021 @ 6:42 pm

Invoice updated by Geoffrey.

Updated
September 22, 2021 @ 2:56 pm

Invoice updated by Geoffrey.