Bill To:

Joe Holt
11464 St Hwy 19 N
Athens, TX 75752

Services Rendered To:

Joe Holt
11464 St Hwy 19 N
Athens, TX 75752
POLICY# 254-857-8405


*** 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
    $350.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  5. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00

  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 182 N of CR 220-Gatesville, TX

    Ordinance Info: Ordinance #55: Recovery of Services Costs for Turnersville VFD

Subtotal $1,279.00
Total Due $1,279.00


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
March 2, 2023 @ 2:44 pm

Invoice updated by Geoffrey.

Status Update
March 2, 2023 @ 2:44 pm

Status changed: Draft to Pending.

Updated
May 22, 2023 @ 11:38 am

Invoice updated by Geoffrey.