Bill To:


Progressive County Mutual Insurance
6300 Wilson Mills Rd.
Mayfield, OH 44143

Services Rendered To:


Zachary Miles
242 Oak Crest
Huntington, TX 75949
POLICY # 921598051

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AC-409-22-167 09/18/2022 09/22/2022 On Receipt City of Huntington VFD

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00
  2. 319 Generator (Per Generator/Per Hour)

    $50.00
    1.25
    $62.50
  3. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  7. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 790 US Hwy 69S-Hunington, TX

Subtotal $1,136.25
Total Due $1,136.25


Updated
September 21, 2022 @ 12:21 pm

Invoice updated by Geoffrey.

Status Update
September 21, 2022 @ 12:21 pm

Status changed: Draft to Pending.

Updated
September 21, 2022 @ 12:25 pm

Invoice updated by Geoffrey.

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