Bill To:

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

Services Rendered To:

Jackson Kirgan
9112 Corbin Creek Cove
Austin, TX 78717
POLICY# 448 8328-K19-53B001


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00

  3. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00

  4. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00

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

    $100.00
    1
    $100.00

  6. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

    7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Pocono Dr/ Oconner Dr- Round Rock, TX

    Ordinance Info: Sam Bass Fire Dept. Resolution

Subtotal $1,130.00
Total Due $1,130.00


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
November 3, 2023 @ 11:11 am

Invoice updated by Geoffrey.