Bill To:

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

Services Rendered To:

Eric Swaetzbaugh
1612 Lilac Avenue
Lufkin, Texas 75601
Policy # 336-3566-E06-43L 003


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    2.5
    $875.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    2.5
    $750.00

  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    2.5
    $375.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    10
    $20.00

  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  6. 404 Scene Lighting (Per Hour)

    $75.00
    2.5
    $187.50

  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  8. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

    9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 63 @ TC Pouland Road - Zavalla, Texas

Subtotal $2,722.50
Total Due $2,722.50


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 26, 2021 @ 9:22 pm

Invoice updated by Geoffrey.

Status Update
August 26, 2021 @ 9:22 pm

Status changed: Draft to Pending.