Bill To:

DAIRYLAND INSURANCE
1800 NORTH POINT DRIVE
STEVENS POINT, WI 54481-1253

Services Rendered To:

Tequilla Washington
195 Holman
Jefferson, Texas 75694


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.5
    $525.00

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00

  3. 404 Scene Lighting (Per Hour)

    $75.00
    1.5
    $112.50

  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00

    5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Us highway 59 @ FM 1997

Subtotal $1,012.50
Total Due $1,012.50

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
December 27, 2020 @ 4:14 pm

Invoice updated by Geoffrey.

Status Update
December 27, 2020 @ 4:14 pm

Status changed: Draft to Pending.

Updated
December 27, 2020 @ 4:14 pm

Invoice updated by Geoffrey.