Bill To:

Redpoint County Mutual Insurance Co.
13215 Bee Cave Parkway
Bldg. 2, Suite 150
Austin, TX 78738

Services Rendered To:

Marie Shalene
650 Chisholm Rd
Whitesboro, TX 76273
POLICY# BGS01012569


Product
Price
Qty
Amount

  1. 406 Medical Extrication – Lvl 2

    Patient

    Alicia Aguilar
    55 Hogan Ln
    Whitesboro, TX 76240

    $1,500.00
    1
    $1,500.00

    2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: CR 118 & FM 678- Whitesboro, TX

    Ordinance Info: City Of Callisburg Resolution

Subtotal $1,500.00
Total Due $1,500.00


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
May 11, 2023 @ 1:29 pm

Invoice updated by Geoffrey.