Bill To:

Bennett Truck Transport
801 North Second Avenue
Carbon Cliff, IL 61239

Services Rendered To:

Bennett Truck Transport
801 North Second Avenue
Carbon Cliff, IL 61239
Driver: Robert Tennison
Policy # MC285766


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Product
Price
Qty
Amount

  1. 406 Medical Extrication – Lvl 2

    Patient:

    William Wade
    399 Medford Womack Road
    Zavalla, Texas 75980

    $1,500.00
    1
    $1,500.00

    2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 63 in Front of High School - Zavalla, Texas

Subtotal $1,500.00
Total Due $1,500.00


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
December 16, 2021 @ 9:53 pm

Invoice updated by Geoffrey.