Bill To:

FARM BUREAU INSURANCE
5400 UNIVERSITY AVENUE
WEST DES MOINES, IA 50266-5997

Services Rendered To:

Clara Chapman
4009 Sabio Drive # 218
Austin, Texas 75749
Policy # 23248440


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

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

    $150.00
    1
    $150.00

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00

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

    $100.00
    1
    $100.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 789 & Lake road - Lavon, Texas

    Ordinance Info: City of Lavon - Resolution NO. 2020-03-01

Subtotal $866.00
Total Due $866.00


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
August 8, 2021 @ 7:25 pm

Invoice updated by Geoffrey.

Status Update
August 8, 2021 @ 7:25 pm

Status changed: Draft to Pending.

Updated
August 8, 2021 @ 7:25 pm

Invoice updated by Geoffrey.