Bill To:

Buford Fox
20185 S.E. 43rd
Harrah, OK 73045

Services Rendered To:

Buford Fox
20185 S.E. 43rd
Harrah, OK 73045


*** Please Submit this to your PROPERTY/HOMEOWNER 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. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  2. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00

  3. 216 Oxygen (# Used)

    $25.00
    1
    $25.00

  4. 232 N95 Mask (Per Unit/Per Use)

    $10.00
    3
    $30.00

  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    6. Additional Incident Info

    Incident Type: Fire Department Response

    Incident Location: 20185 S.E. 43rd - Harrah, OK 73045

Subtotal $621.00
Total Due $621.00


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 24, 2022 @ 5:05 pm

Invoice updated by Geoffrey.

Status Update
January 24, 2022 @ 5:05 pm

Status changed: Draft to Pending.

Updated
January 24, 2022 @ 5:06 pm

Invoice updated by Geoffrey.

Updated
January 24, 2022 @ 5:06 pm

Invoice updated by Geoffrey.