Bill To:

State Farm Insurance
One State Farm Plaza
Bloomington, IL 61710

Services Rendered To:

Jaylon Martin
Policy# 3088177


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.75
    $612.50

  2. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00

  3. 409 Manpower (Per Hour)

    $20.00
    5
    $100.00

  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

    5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: South Highway 77 @ CR 2229

Subtotal $1,252.50
Total Due $1,252.50

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 24, 2019 @ 7:25 pm

Invoice updated by Karen Smith.

Status Update
August 24, 2019 @ 7:25 pm

Status changed: Draft to Pending.