Bill To:

STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:

Brent Heath
8451 Gholson Road
Waco, Texas 76705
Policy # 224 5054-G07-43E 001


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  5. 319 Generator (Per Generator/Per Hour)

    $50.00
    1
    $50.00

  6. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  9. 409 Manpower (Per Hour)

    $20.00
    7
    $140.00

    10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 182 / 1/2 Mile South of County Line - Clifton, Texas

    Ordinance Info: Cost Recovery Ammendment Policy #55 -1-1-2020

Subtotal $1,448.00
Total Due $1,448.00

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
July 20, 2020 @ 11:48 pm

Invoice updated by Karen Smith.

Status Update
July 20, 2020 @ 11:48 pm

Status changed: Draft to Pending.

Updated
July 20, 2020 @ 11:48 pm

Invoice updated by Karen Smith.