Bill To:

Hickory County Farmers Mutual Ins. Co.
P.O. Box 132
Hermitage, MO 65668

Services Rendered To:

Jeff Bash
17511 Lilac Road
Lebanon, MO 65536
Policy # 1151229


Product
Price
Qty
Amount

  1. 413 Fire Department Response Fee – Lvl 4

    $500.00
    1
    $500.00

    2. Additional Incident Info

    Incident Type: Structure Fire Response

    Incident Location: 17511 Lilac Road Lebanon, MO 65536

Subtotal $500.00
Total Due $500.00


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
July 23, 2021 @ 4:30 pm

Invoice updated by Geoffrey.

Status Update
July 23, 2021 @ 4:30 pm

Status changed: Draft to Pending.

Updated
January 16, 2022 @ 2:58 pm

Invoice updated by Geoffrey.