Bill To:

KENTUCKY FARM BUREAU MUTUAL
9201 BUNSEN PARKWAY
LOUISVILLE, KY 40220-3792

Services Rendered To:

Chad Faulkner
128 S. High Street
Burkesville, Y 42717
Policy # 0020997356


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 13951 Burkesville Road - Breeding, Kentucky

Subtotal $1,265.00
Total Due $1,265.00


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
April 13, 2022 @ 8:19 pm

Invoice updated by Geoffrey.

Status Update
April 13, 2022 @ 8:19 pm

Status changed: Draft to Pending.