Bill To:

Farmer's Insurance
PO Box 0991
Carol Stream, IL 60132-0991

Services Rendered To:

Cynthia Edwards
11300 Highway 271
Tyler, Texas 75708
POLICY # 45327290


Product
Price
Qty
Amount

  1. 406 Medical Extrication – Lvl 2

    PATIENT:

    Cynthia Edwards
    11300 Highway 271
    Tyler, Texas 75708
    POLICY # 45327290

    $1,500.00
    1
    $1,500.00

    2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 69 Southbound @ Deadman's Road - Zavalla, Texas

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 16, 2022 @ 4:56 pm

Invoice updated by Geoffrey.

Updated
May 16, 2022 @ 4:56 pm

Invoice updated by Geoffrey.

Updated
June 14, 2022 @ 12:54 pm

Invoice updated by Geoffrey.

Updated
June 14, 2022 @ 12:55 pm

Invoice updated by Geoffrey.