Bill To:

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

Services Rendered To:

Jackie Byrd
115 S.E. 6th Street
Checotah, OK 74426
Policy # 3624069925001


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3
    $450.00

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3
    $450.00

  3. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

    4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 266 & 72 Junction Council Hill, Oklahoma

Subtotal $1,150.00
Total Due $1,150.00


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
May 14, 2021 @ 4:29 pm

Invoice updated by Geoffrey.