Bill To:

Direct Auto Insurance Claims Department
PO Box 1623
Winston Salem, NC 27102

Services Rendered To:

Sienna Wilson
4540 Colburn Mtn Rd
Russellville, AL 35654
POLICY# 2016788386


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00

  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  4. 205 Foam (Per Gallon)

    $65.00
    5
    $325.00

  5. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 4540 Colburn Mtn Rd- Russellville, AL

Subtotal $1,150.00
Total Due $1,150.00


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
December 13, 2022 @ 12:33 pm

Invoice updated by Geoffrey.

Status Update
December 13, 2022 @ 12:33 pm

Status changed: Draft to Pending.