Bill To:


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

Services Rendered To:


Kristina Daniel
1405 County Road 670
Ranburne, AL 36273
Policy # 93601952


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

    $300.00
    1.75
    $525.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00
  3. 407 Patient Care / Evaluation (Per Patient)

    $50.00
    1
    $50.00

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 46 Near County Road 41 - Heflin, Alabama

Subtotal $750.00
Total Due $750.00


Updated
December 16, 2021 @ 10:04 pm

Invoice updated by Geoffrey.

Status Update
December 16, 2021 @ 10:04 pm

Status changed: Draft to Pending.