Bill To:

STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:

Kurt Vandoran
Policy # 194 6501-614-4314
State Farm


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00

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

    $100.00
    1
    $100.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 400 Block Highway 78 - Lavon, Texas

    Ordinance Info: RESOLUTION NO. 2020-03-01

Subtotal $870.00
Total Due $870.00

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
March 26, 2020 @ 4:49 pm

Invoice updated by Karen Smith.

Status Update
March 26, 2020 @ 4:49 pm

Status changed: Draft to Pending.