Bill To:


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

Services Rendered To:


Antonio Gonzalez
Valley Mills Texas
Progressive Insurance
Policy # 932213821

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AZ-409-2020-79 10/11/2020 10/27/2020 On Receipt Valley Mills V.F.D.

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.5
    $225.00
  2. 410 Fire Department Response Fee – Lvl 1

    $200.00
    1
    $200.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Farm to Market Road 56 and County Road 3199 - Valley Mills, Texas

Subtotal $425.00
Total Due $425.00
Updated
October 27, 2020 @ 5:22 pm

Invoice updated by Geoffrey.

Status Update
October 27, 2020 @ 5:22 pm

Status changed: Draft to Pending.

Viewed
January 17, 2022 @ 3:56 pm

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

Viewed
November 20, 2022 @ 1:43 pm

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