Bill To:

Farmer's Insurance
PO Box 0991
Carol Stream, IL 60132-0991

Services Rendered To:

Eddie Alexander
6642 Glade St
Dallas, TX 75232
POLICY# 535681659


Product
Price
Qty
Amount

  1. 405 Medical Extrication – Lvl 1

    Patient

    Eddie Alexander
    6642 Glade St
    Dallas, TX 75232
    POLICY# 535681659

    $500.00
    1
    $500.00

    2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: South on CR 223 & FM 217- Valley Mills, TX

    Ordinance Info: Ordinance #55: Recovery of Services Costs for Turnersville VFD

Subtotal $500.00
Total Due $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
March 23, 2023 @ 5:09 pm

Invoice updated by Geoffrey.

Updated
August 9, 2023 @ 12:42 pm

Invoice updated by Geoffrey.