Bill To:

ALFA INSURANCE
207 Hwy 78 W
Jasper, AL 35501

Services Rendered To:

TCW Construction
1100 County Rd 73
Randolph, AL 36792
POLICY# A2260471


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    1.5
    $450.00

  3. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00

  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00

  5. 206 Latex Gloves (Pairs Used)

    $2.00
    1
    $2.00

  6. 216 Oxygen (# Used)

    $25.00
    1
    $25.00

  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  8. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

    9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 900 Block AL Hwy 155- Jemison, AL

Subtotal $1,377.00
Total Due $1,377.00


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
January 27, 2023 @ 11:22 am

Invoice updated by Geoffrey.

Status Update
January 27, 2023 @ 11:22 am

Status changed: Draft to Pending.