Bill To:

DAIRYLAND INSURANCE
1800 NORTH POINT DRIVE
STEVENS POINT, WI 54481-1253

Services Rendered To:

D Antre Marque Smith
933 Allende Street
Sequin, TX 78155
Policy # 11406568781


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00

  5. 206 Latex Gloves (Pairs Used)

    $2.00
    3
    $6.00

  6. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00

  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 1044 and FM 78 - McQueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution 4521

Subtotal $1,026.00
Total Due $1,026.00


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 24, 2022 @ 2:52 pm

Invoice updated by Geoffrey.

Status Update
May 24, 2022 @ 2:52 pm

Status changed: Draft to Pending.