Bill To:


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

Services Rendered To:


Michael Glenn Gray
PO Box 887
Jewett, TX 75846
POLICY# 913581223

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-GV-301-23-3931 10/02/2023 12/07/2023 On Receipt Dew VFD

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  2. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 313 TIC Thermal Imaging Camera (# Used)

    $100.00
    1
    $100.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 75 & FCR 400- Freestone CO, TX

Subtotal $975.00
Total Due $975.00


Updated
December 7, 2023 @ 6:51 pm

Invoice updated by Geoffrey.

Status Update
December 7, 2023 @ 6:51 pm

Status changed: Draft to Pending.