Bill To:

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

Services Rendered To:

Christopher Charles
10510 Trey Road
Needville, Texas 77461
Policy # 953104361


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00

  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  4. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00

  5. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00

  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 361 & Needville Fairchild Road - Fairchild, Texas

Subtotal $1,410.00
Total Due $1,410.00


Checks Payable To:

Sure Fire Recovery Service, LLC
9711 S Mason Road 125-120
Richmond, TX 77407
Federal Tax ID – 83-4417185


  Please Include Incident Number On All Correspondence.
Updated
December 16, 2021 @ 10:37 pm

Invoice updated by Geoffrey.

Status Update
December 16, 2021 @ 10:37 pm

Status changed: Draft to Pending.