Bill To:

Farmers Insurance
PO Box 268993
Oklahoma City, OK 73126

Services Rendered To:

Edward King
1618 County Road
Marietta, TX 75566
Policy # 43906579


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.75
    $612.50

  2. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00

  3. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00

  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  5. 216 Oxygen (# Used)

    $25.00
    1
    $25.00

  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    9
    $900.00

  7. 408 Air Medical Landing Zone (Used)

    $250.00
    2
    $500.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: South Highway 77@ County Road 2345 Marietta, TX 75556

Subtotal $2,627.50
Total Due $2,627.50

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
August 24, 2019 @ 5:47 pm

Invoice updated by Karen Smith.

Status Update
August 24, 2019 @ 5:47 pm

Status changed: Draft to Pending.

Updated
December 4, 2019 @ 1:34 pm

Invoice updated by Karen Smith.

Updated
December 4, 2019 @ 1:52 pm

Invoice updated by Karen Smith.

Updated
December 4, 2019 @ 1:52 pm

Invoice updated by Karen Smith.

Updated
December 4, 2019 @ 1:54 pm

Invoice updated by Karen Smith.

Updated
December 4, 2019 @ 1:54 pm

Invoice updated by Karen Smith.

Updated
December 4, 2019 @ 1:56 pm

Invoice updated by Karen Smith.