Bill To:

Texas Farm Bureau Insurance Companies
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:

Vehicle #1
Policy# 20624854
Owner: Patricia Mattox Ford
109 CR 1241
Driver: Tracey Shane
Kopperl, TX 76652
Driver: Timothy Shane


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. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00

  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

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

    $100.00
    1
    $100.00

    7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3457 State Highway 22, Hillsboro, TX

    Ordinance Info: Peoria

Subtotal $1,046.00
Total Due $1,046.00


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 17, 2023 @ 4:05 pm

Invoice updated by Karen Smith.

Status Update
January 17, 2023 @ 4:05 pm

Status changed: Draft to Pending.

Updated
January 17, 2023 @ 4:08 pm

Invoice updated by Karen Smith.