Bill To:

METROPOLITAN CASUALTY – MEDICAL
PO BOX 350
WARWICK, RI 02887-0350

Services Rendered To:

Susie Gunn
2222 Louise Street
Sequin, Texas 78155
Policy # A7999825100


Product
Price
Qty
Amount

  1. 405 Medical Extrication – Lvl 1

    Patient:

    Susie Gunn
    2222 Louise Street
    Sequin, Texas 78155
    Policy # A7999825100

    $500.00
    1
    $500.00

    2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 78 & FM 1044 - McQueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution 4521

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
October 7, 2021 @ 4:00 pm

Invoice updated by Geoffrey.