Bill To:

Jasman York
213 Hopkins St
Lufkin, TX 75901

Services Rendered To:

Jasman York
213 Hopkins St
Lufkin, TX 75901


*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $500.00
    4
    $2,000.00

  2. 103 Rescue Response (Per Hour)

    $400.00
    4
    $1,600.00

  3. 105 Utility Vehicle Response (Per Hour)

    $250.00
    4
    $1,000.00

  4. 103 Rescue Response (Per Hour)

    $400.00
    4
    $1,600.00

  5. 105 Utility Vehicle Response (Per Hour)

    $250.00
    4
    $1,000.00

  6. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  7. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    3
    $300.00

  8. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  9. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00

  10. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00

  11. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00

  12. 309 Power Tool (# Used)

    $50.00
    1
    $50.00

  13. 202 Oil Absorbent Sheet (# Used)

    $2.50
    10
    $25.00

  14. 201 Oil Absorbent Material (# Used)

    $35.00
    3
    $105.00

  15. 211 Salvage Cover (Amt Used)       

    $35.00
    2
    $70.00

  16. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    4
    $400.00

  17. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

  18. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  19. 330 Backboard (# Used)

    $25.00
    1
    $25.00

  20. 219 Blanket (# Used)

    $25.00
    1
    $25.00

    21. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: St Hwy 103 E- Lufkin, TX

Subtotal $9,230.00
Total Due $9,230.00


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
November 12, 2023 @ 10:37 pm

Invoice updated by Geoffrey.

Status Update
November 12, 2023 @ 10:37 pm

Status changed: Draft to Pending.

Updated
November 12, 2023 @ 10:38 pm

Invoice updated by Geoffrey.