Bill To:


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

Services Rendered To:


Cathryn Sherrod
202 County Road 4860
Azle, Texas 76020
Policy # 916320131

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB-206-2020-690 08/13/2020 12/01/2020 On Receipt Briar-Reno Fire Department

Product
Price
Qty
Amount
  1. 104 Tanker Response (Per Hour)

    $300.00
    1.25
    $375.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1030 Arvel Circle - Azle, Texas

    Ordinance Info: Briar Reno Cost recovery Amendment

Subtotal $491.75
Total Due $491.75
Updated
December 1, 2020 @ 3:27 pm

Invoice updated by Geoffrey.

Status Update
December 1, 2020 @ 3:27 pm

Status changed: Draft to Pending.

Updated
December 1, 2020 @ 3:28 pm

Invoice updated by Geoffrey.

Viewed
June 24, 2021 @ 4:54 pm

Invoice viewed by Karen Smith (KarenS) for the first time.