Bill To:

Old American County Mutual
P.O. Box 793747
Dallas, TX 75379-3747

Services Rendered To:

Deirdre Rhodes
1557 Nash Road
Lufkin, Texas 75901
Policy # TEJ01721816-02


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00

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

    $150.00
    1.25
    $187.50

  3. 309 Power Tool (# Used)

    $50.00
    1
    $50.00

  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00

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

    $100.00
    1.25
    $125.00

  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 1270 at Saron Road - Zavalla, Texas

Subtotal $1,187.50
Total Due $1,187.50


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
March 4, 2021 @ 3:07 pm

Invoice updated by Geoffrey.

Status Update
March 4, 2021 @ 3:07 pm

Status changed: Draft to Pending.