Bill To:

STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:

Evaristo Torres
144 Holly Hill Road
Livingston, TX 77351
Policy # 4627915C0Z43


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. 206 Latex Gloves (Pairs Used)

    $2.00
    5
    $10.00

  4. 232 N95 Mask (Per Unit/Per Use)

    $10.00
    5
    $50.00

    5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 224-1/2 Southbound on Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization Item # 7

Subtotal $510.00
Total Due $510.00


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
February 22, 2021 @ 1:50 pm

Invoice updated by Geoffrey.

Status Update
February 22, 2021 @ 1:50 pm

Status changed: Draft to Pending.