Bill To:

Progressive County Mutual Insurance
6300 Wilson Mills Rd.
Mayfield, OH 44143

Services Rendered To:

Victoria Brennan
11397 South FM 730
Texas, 76020
Policy # 927615199


Product
Price
Qty
Amount

  1. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00

  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    Battalion Chief

    $150.00
    1
    $150.00

  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    Squad

    $150.00
    1
    $150.00

  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  7. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  8. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00

  9. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00

  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  11. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    12. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Northwest Parkway and Manor Drive - Reno, Texas

    Ordinance Info: Resolution

Subtotal $1,377.00
Total Due $1,377.00

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
March 16, 2020 @ 6:47 pm

Invoice updated by Karen Smith.

Status Update
March 16, 2020 @ 6:47 pm

Status changed: Draft to Pending.

Updated
March 16, 2020 @ 6:49 pm

Invoice updated by Karen Smith.

Updated
March 16, 2020 @ 6:50 pm

Invoice updated by Karen Smith.