Bill To:

Salem Leasing Corporation
6150 Lumberdale Road
Houston, TX 77092

Services Rendered To:

Salem Leasing Corporation
6150 Lumberdale Road
Houston, Texas 77092
Driver:
Joe Arnaldo Rivera Hernandez
539 East Dickerson Avenue
San Antonio, Texas 75247


*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    3
    $1,050.00

  2. 103 Rescue Response (Per Hour)

    $300.00
    3
    $900.00

  3. 331 Air Bags (# Used)

    $150.00
    1
    $150.00

  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  5. 402 Fire/Police Services (Per Hour)    

    $100.00
    3
    $300.00

  6. 206 Latex Gloves (Pairs Used)

    $2.00
    3
    $6.00

  7. 202 Oil Absorbent Sheet (# Used)

    $2.50
    2
    $5.00

  8. 201 Oil Absorbent Material (# Used)

    $35.00
    10
    $350.00

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

    $100.00
    3
    $300.00

    10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 78 and FM 1044 - McQueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution NO. 4521

Subtotal $3,311.00
Total Due $3,311.00


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
August 8, 2021 @ 5:49 pm

Invoice updated by Geoffrey.

Status Update
August 8, 2021 @ 5:50 pm

Status changed: Draft to Pending.

Updated
October 7, 2021 @ 4:36 pm

Invoice updated by Geoffrey.