Bill To:

Aspen Insurance
P. O. Box 270930
Flower Mound, TX 75027-0930

Services Rendered To:

Rashar Alsutani
12405 Alamceta Trace Circle
Austin, TX 78727
POLICY# PPTX 00171108-01


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00

  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  4. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00

  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

    7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 620/ Pearson Ranch- Round Rock, TX

    Ordinance Info: Sam Bass Fire Dept. Resolution

Subtotal $1,120.00
Total Due $1,120.00


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 19, 2023 @ 12:34 pm

Invoice updated by Geoffrey.

Updated
July 24, 2023 @ 4:03 pm

Invoice updated by Geoffrey.