Bill To:


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

Services Rendered To:


James Ebarb
102 North 11th Street
Valley Mills, Texas 76689
Policy # 932992473

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-AZ-409-2021-39 04/25/2021 04/27/2021 On Receipt Valley Mills V.F.D.

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  4. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  6. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  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. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 6 and Baylor Camp Road - Crawford, Texas

Subtotal $1,395.00
Total Due $1,395.00


Updated
April 26, 2021 @ 4:44 pm

Invoice updated by Geoffrey.

Status Update
April 26, 2021 @ 4:44 pm

Status changed: Draft to Pending.

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June 24, 2021 @ 5:05 pm

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

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