Bill To:

Erie Insurance
100 Erie Insurance Place
Erie, PA 16530

Services Rendered To:

Travis Grider
5844 Beaver Dam Rd
Leitchfield, KY 42754
POLICY# Q07-0411732 (PL)


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $500.00
    1.25
    $625.00

  2. 103 Rescue Response (Per Hour)

    $400.00
    1.25
    $500.00

  3. 103 Rescue Response (Per Hour)

    $400.00
    1.25
    $500.00

  4. 309 Power Tool (# Used)

    $50.00
    1
    $50.00

  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

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

    $100.00
    1.25
    $125.00

  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6899 Priceville Rd- Munfordville, KY

Subtotal $2,065.00
Total Due $2,065.00


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.