Bill To:

Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:

Wayback Ranch LP
2383 FM 183
Evant, Texas 76525
Policy # 21968261


Product
Price
Qty
Amount

  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  2. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00

  3. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50

  4. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00

  7. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00

  8. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  9. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    1
    $50.00

  10. 304 SCBA Cylinder (# Used)

    $25.00
    1
    $25.00

  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    3
    $75.00

    12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Farm to Market Road 215 - Valley Mills, Texas

Subtotal $1,867.50
Total Due $1,867.50

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
December 15, 2020 @ 12:56 pm

Invoice updated by Geoffrey.

Status Update
December 15, 2020 @ 12:56 pm

Status changed: Draft to Pending.