Bill To:

Southern Farm Bureau
1800 E County Line Rd
Ridgeland, MS 39157

Services Rendered To:

Bonnie Smith
11509 Old 88 Rd
Rudy, AR 72932
POLICY# 030200024900


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1.75
    $437.50

  2. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00

    3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: EB I-40 MM 247-Henryetta, OK

    Ordinance Info: Tiger Mountain - McIntosh County Resolution 72021

Subtotal $441.50
Total Due $441.50


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
September 8, 2023 @ 11:48 am

Invoice updated by Geoffrey.

Status Update
September 8, 2023 @ 11:48 am

Status changed: Draft to Pending.