Bill To:

OKLAHOMA FARM BUREAU MUTUAL INSURANCE COMPANY
2501 N Stiles Ave,
Oklahoma City, OK 73105

Services Rendered To:

Samantha Hubler
9707 E 73rd St S
Braggs, OK 74423
POLICY# 09852419


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $500.00
    1
    $500.00

  2. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00

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

    $100.00
    1
    $100.00

    4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: IH 40 WB- Henryetta, OK

    Ordinance Info: McIntosh County Resolution 72021

Subtotal $1,100.00
Total Due $1,100.00


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
June 13, 2023 @ 1:49 pm

Invoice updated by Geoffrey.

Status Update
June 13, 2023 @ 1:49 pm

Status changed: Draft to Pending.