Bill To:

Home State County Mutual Insurance
P.O. Box 8036
Waco, TX 76714-8036

Services Rendered To:

Aguirre Arnulfo
411 E Lilly
Arlington, TX 76010
POLICY# X42S-40036075-0000


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00

  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  8. 324 Traffic Cone (# Used)

    $5.00
    10
    $50.00

    9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: E Hwy 82 @ County Rd 163- Gainesville, TX

Subtotal $1,165.00
Total Due $1,165.00


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
December 5, 2022 @ 2:16 pm

Invoice updated by Geoffrey.

Status Update
December 5, 2022 @ 2:16 pm

Status changed: Draft to Pending.