Bill To:

DAIRYLAND INSURANCE
1800 NORTH POINT DRIVE
STEVENS POINT, WI 54481-1253

Services Rendered To:

Ronnie Tullos
11609 CR 3520
Brownsboro, TX 75756
Policy # 11406934194


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  2. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  3. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00

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

    $100.00
    1.25
    $125.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 279 @ CR 4818 - Ben Wheeler, Texas

Subtotal $691.50
Total Due $691.50


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
October 8, 2021 @ 3:43 pm

Invoice updated by Geoffrey.

Status Update
October 8, 2021 @ 3:44 pm

Status changed: Draft to Pending.

Updated
October 8, 2021 @ 3:44 pm

Invoice updated by Geoffrey.

Updated
October 8, 2021 @ 3:45 pm

Invoice updated by Geoffrey.