Bill To:

AAA Texas County Mutual Insurance
3333 Fairview Road
Costa Mesa, CA 92626

Services Rendered To:

Mary Lloyd
100 C.R. 2125
Douglassville, TX 75560
POLICY # TPA154771875


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00

  2. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  3. 302 Hand Light (# Used)

    $5.00
    1
    $5.00

  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

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

    $100.00
    1.5
    $150.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: State Highway 77 West @ CR 2229 - Douglassville, Texas

Subtotal $420.00
Total Due $420.00


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
June 2, 2022 @ 3:08 pm

Invoice updated by Geoffrey.

Status Update
June 2, 2022 @ 3:08 pm

Status changed: Draft to Pending.