Bill To:

SHELTER INSURANCE
1817 WEST BROADWAY
COLUMBIA, MO 65203-1107

Services Rendered To:

David Bollinger
1308 SW 6th Street
Lawton, OK
POLICY# 35-1-010528397-0009


Product
Price
Qty
Amount

  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00

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

    $150.00
    1.5
    $225.00

  3. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00

  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  5. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00

  6. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00

  7. 201 Oil Absorbent Material (# Used)

    $35.00
    4
    $140.00

  8. 202 Oil Absorbent Sheet (# Used)

    $2.50
    2
    $5.00

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

    $100.00
    1.5
    $150.00

  10. 324 Traffic Cone (# Used)

    $5.00
    5
    $25.00

    11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: BUBBAS GAS & SHOP 23260 SH 58- OK

Subtotal $1,610.00
Total Due $1,610.00


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
March 14, 2023 @ 10:36 am

Invoice updated by Geoffrey.

Status Update
March 14, 2023 @ 10:36 am

Status changed: Draft to Pending.