Bill To:

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

Services Rendered To:

Cory Briggs
36478 Moccasin Trail Rd Lot#2
Shawnee, OK 74804
Vin# 3GNDA13D17S564768


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00

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

    $150.00
    1
    $150.00

  3. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00

  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. 330 Backboard (# Used)

    $25.00
    1
    $25.00

  6. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00

  7. 419 Environmental Spill

    $250.00
    1
    $250.00

    8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 970000 S Hwy 177- Wellston, OK

Subtotal $1,022.00
Total Due $1,022.00


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
May 17, 2023 @ 4:19 pm

Invoice updated by Geoffrey.

Status Update
May 17, 2023 @ 4:19 pm

Status changed: Draft to Pending.