Bill To:

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

Services Rendered To:

Amber Miller
702 Lynda Ln Apt B
Wylie, TX 75098
POLICY#LEG0108820


Product
Price
Qty
Amount

  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  2. 101 Aerial/Ladder Response (Per Hour)

    $400.00
    1
    $400.00

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00

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

    $100.00
    1
    $100.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: SH 205 & SH78- Lavon, TX

    Ordinance Info: City of Lavon Resolution NO. 2020-03-01

Subtotal $908.00
Total Due $908.00


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
October 5, 2022 @ 5:09 pm

Invoice updated by Geoffrey.

Status Update
October 5, 2022 @ 5:09 pm

Status changed: Draft to Pending.