Bill To:

Rojas Jr Cipriano
1903 N Guadalupe St
Seguin, TX 78155

Services Rendered To:

Rojas Jr Cipriano
1903 N Guadalupe St
Seguin, TX 78155
POLICY# 960465938


*** 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)

    $350.00
    1.5
    $525.00

  2. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00

  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00

  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  5. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    1
    $100.00

  6. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  7. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00

  8. 319 Generator (Per Generator/Per Hour)

    $50.00
    2
    $100.00

  9. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00

  10. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  11. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  12. 317 Rescue Struts (# Used)

    $50.00
    2
    $100.00

  13. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

  14. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00

    15. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 7499 Fm 1044- McQueeney, TX

    Ordinance Info: RESOLUTION-McQueeney Cost Recovery Resolution 4521

Subtotal $2,548.00
Total Due $2,548.00


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 25, 2022 @ 11:16 am

Invoice updated by Geoffrey.

Status Update
November 25, 2022 @ 11:16 am

Status changed: Draft to Pending.

Updated
March 15, 2023 @ 11:15 am

Invoice updated by Geoffrey.