Bill To:


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

Services Rendered To:


Stephanie Lashun Roberson
170 Elm Grove Road
Valley View, Texas 76272
Policy # 946654278

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-2021-431491-B 06/15/2021 06/23/2021 On Receipt Callisburg V.F.D.

Product
Price
Qty
Amount
  1. 206 Latex Gloves (Pairs Used)

    $2.00
    1
    $2.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1772 Thrasher Road - Callisburg, Texas

Subtotal $452.00
Total Due $452.00


Updated
June 22, 2021 @ 1:19 pm

Invoice updated by Geoffrey.