Bill To:

Texas Farm Bureau
7420 Fish Pond Road
Waco, TX 76710

Services Rendered To:

Wendy Romero
220 PR 8327
Woodville, TX 77979
Policy # 23033174


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  3. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  4. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 69 South @ Quinn Road - Zavalla, Texas

Subtotal $927.00
Total Due $927.00


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 14, 2021 @ 7:13 pm

Invoice updated by Geoffrey.

Status Update
March 14, 2021 @ 7:13 pm

Status changed: Draft to Pending.