Bill To:

Acord Insurance
1 Blue Hill Plaza PO Box 1529
Pearl River, NY 10965

Services Rendered To:

Percy Express LLC
6206 Purple Sage Rd
Houston, TX 77049
POLICY# PRA 2433822-01


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00

  2. 104 Tanker Response (Per Hour)

    $300.00
    1.25
    $375.00

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  5. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00

  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  7. 324 Traffic Cone (# Used)

    $5.00
    5
    $25.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 219 NB IH 45- Richland, TX

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $1,177.00
Total Due $1,177.00


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
March 14, 2023 @ 11:16 am

Invoice updated by Geoffrey.

Status Update
March 14, 2023 @ 11:16 am

Status changed: Draft to Pending.

Updated
April 4, 2023 @ 10:14 am

Invoice updated by Geoffrey.

Updated
May 24, 2023 @ 2:47 pm

Invoice updated by Geoffrey.