Bill To:

Adam Gibson
600 Cobblestone Rd
Lafayette, LA 70508

Services Rendered To:

Adam Gibson
600 Cobblestone Rd
Lafayette, LA 70508


*** 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. 102 Engine Response (Per Hour)

    $500.00
    3
    $1,500.00

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

    $200.00
    3
    $600.00

  3. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00

  4. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00

  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  8. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  9. 202 Oil Absorbent Sheet (# Used)

    $2.50
    4
    $10.00

  10. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00

  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

    12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 5700 & Airport Rd- Terlton, OK

Subtotal $3,168.00
Total Due $3,168.00


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
July 14, 2023 @ 12:59 pm

Invoice updated by Geoffrey.

Status Update
July 14, 2023 @ 12:59 pm

Status changed: Draft to Pending.

Updated
July 14, 2023 @ 12:59 pm

Invoice updated by Geoffrey.