Bill To:


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

Services Rendered To:


James Gillispie

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
MO-06-607-23-708 05/23/2023 06/09/2023 On Receipt Brumley Fire Protection District

Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 218 Cervical Collar (# Used)

    $25.00
    2
    $50.00
  4. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    12
    $24.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  7. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  8. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  9. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00
  10. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 42 & Castle Rd- Brumley, MO

Subtotal $1,474.00
Total Due $1,474.00


Updated
June 9, 2023 @ 1:09 pm

Invoice updated by Geoffrey.

Status Update
June 9, 2023 @ 1:09 pm

Status changed: Draft to Pending.