Bill To:


PROGRESSIVE INSURANCE, TX
1045 Wisterwood Dr.
Houston, TX 77043

Services Rendered To:


Leslie Ferguson
2148 Terminal Loop
McQueeney, Texas 78123
Policy # 935552257

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-HS-403-2021-0300 07/22/2021 07/23/2021 On Receipt McQueeney V.F.D.

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. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 402 Fire/Police Services (Per Hour)    

    $100.00
    1
    $100.00
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  7. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  9. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Short Cut Road @ FM -0078 - Mcqueeney, Texas

    Ordinance Info: McQueeney Cost Recovery Resolution 4521

Subtotal $1,539.00
Total Due $1,539.00


Updated
July 23, 2021 @ 5:43 pm

Invoice updated by Geoffrey.

Status Update
July 23, 2021 @ 5:43 pm

Status changed: Draft to Pending.

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August 7, 2021 @ 4:21 pm

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

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October 22, 2022 @ 7:16 pm

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