Bill To:

John Torres
501 N. 5th Street
Lometa, TX 76853-2129

Services Rendered To:

John Torres
201 E. Pecan Street
Lometa, TX 76853


*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    2.25
    $675.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50

  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.25
    $337.50

  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. 310 Hydraulic Tool (# Used)

    $200.00
    3
    $600.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    20
    $40.00

  8. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00

  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.25
    $225.00

  10. 327 Windshield Kit (# Used)

    $25.00
    1
    $25.00

  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  12. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

    13. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 281 S. @ Honey Creek Bridge - Hamilton County, Texas

Subtotal $3,075.00
Total Due $3,075.00


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 25, 2021 @ 4:50 pm

Invoice updated by Geoffrey.

Status Update
May 25, 2021 @ 4:50 pm

Status changed: Draft to Pending.