Bill To:


PROGRESSIVE INSURANCE
6300 WILSON MILLS ROAD
MAYFIELD VILLAGE, OH 44143-2109

Services Rendered To:


Hershel Russell
180 Clemmer Court
Boyd, Texas 76023
Policy # 913070170

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB-206-2021-470-A 05/21/2021 11/23/2021 On Receipt Briar-Reno Fire Department

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  4. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 14109 Liberty School Road - Azle, Texas

Subtotal $757.50
Total Due $757.50


Updated
November 23, 2021 @ 5:24 pm

Invoice updated by Geoffrey.

Status Update
November 23, 2021 @ 5:24 pm

Status changed: Draft to Pending.

Updated
November 23, 2021 @ 5:24 pm

Invoice updated by Geoffrey.

Viewed
July 27, 2022 @ 6:44 pm

Invoice viewed by Karen Smith (KarenS) for the first time.

Viewed
October 23, 2022 @ 12:53 am

Invoice viewed by 64.124.8.45 for the first time.