Bill To:

Continental Western Group
11201 Douglas Avenue
Urbandale, IA 50322

Services Rendered To:

C and C Produce
1100 Atlantic Avenue
N. Kansas City, MO 64116
Policy # CPA3261242
CLAIM # 182267
Adjuster - Warren Lindsey


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    3
    $1,050.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    3
    $900.00

  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    3
    $450.00

  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  5. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  6. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

  7. 203 Oil Boom (# Used)

    $20.00
    6
    $120.00

  8. 201 Oil Absorbent Material (# Used)

    $35.00
    4
    $140.00

  9. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    3
    $300.00

  10. 207 Wetting Agent (Amt Used)

    $25.00
    3
    $75.00

  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

    12. Additional Incident Info

    Incident Type: Hazardous Material Response

    Incident Location: Highway 65 and CR 50 - Cross Timbers, MO

Subtotal $3,368.00
Total Due $3,368.00


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
March 23, 2022 @ 5:20 pm

Invoice updated by Geoffrey.

Status Update
March 23, 2022 @ 5:20 pm

Status changed: Draft to Pending.

Updated
March 23, 2022 @ 5:38 pm

Invoice updated by Geoffrey.

Updated
May 13, 2022 @ 4:54 pm

Invoice updated by Geoffrey.

Updated
July 5, 2022 @ 5:40 pm

Invoice updated by Geoffrey.

Updated
July 5, 2022 @ 5:46 pm

Invoice updated by Geoffrey.

Updated
July 5, 2022 @ 5:47 pm

Invoice updated by Geoffrey.

Updated
July 5, 2022 @ 5:47 pm

Invoice updated by Geoffrey.

Updated
July 5, 2022 @ 5:53 pm

Invoice updated by Geoffrey.

Updated
August 31, 2022 @ 5:16 pm

Invoice updated by Geoffrey.