Bill To:

Farmers Texas County Mutual
6301 Owensmouth Ave.
Woodland Hills, CA 91367

Services Rendered To:

Steven Blalock
6297 CR 1915
Mt Pleasant, TX 75455
POLICY# 45266625


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. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  4. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  5. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  6. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00

  8. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00

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

    $100.00
    1
    $100.00

    10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6000 Block State Hwy 6 NB- Waco, TX

Subtotal $1,424.00
Total Due $1,424.00


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
December 8, 2022 @ 5:00 pm

Invoice updated by Geoffrey.

Status Update
December 8, 2022 @ 5:00 pm

Status changed: Draft to Pending.