Bill To:

Allianz Travel Ins
PO Box 72031
Richmond, VA 23255

Services Rendered To:

Darryl Lewis
110 Windy Knoll Ln
Wylie, TX 75098
POLICY# H85199208


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00

  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00

  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

    4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 221 IH 45- Angus, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $750.00
Total Due $750.00


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
August 31, 2023 @ 11:13 am

Invoice updated by Geoffrey.

Status Update
August 31, 2023 @ 11:13 am

Status changed: Draft to Pending.