Bill To:


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

Services Rendered To:


John Thomas
7230 Allyn Drive
Azle, Texas 76020
Policy # 945185083

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WB-206-2021-313 03/30/2021 04/07/2021 On Receipt Briar-Reno Fire Department

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

    $150.00
    1
    $150.00
  2. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00
  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  4. 301 Hand Tool (# Used)

    $15.00
    4
    $60.00
  5. 202 Oil Absorbent Sheet (# Used)

    $2.50
    1
    $2.50
  6. 203 Oil Boom (# Used)

    $20.00
    1
    $20.00
  7. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00
  8. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  9. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  10. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  11. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 14520 FM 730 North - Azle, Texas

    Ordinance Info: Briar-Reno Cost Recovery Amendment

Subtotal $1,292.50
Total Due $1,292.50


Updated
April 7, 2021 @ 6:55 pm

Invoice updated by Geoffrey.

Status Update
April 7, 2021 @ 6:55 pm

Status changed: Draft to Pending.

Updated
April 30, 2021 @ 4:20 pm

Invoice updated by Geoffrey.

Viewed
June 24, 2021 @ 5:02 pm

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

Viewed
October 22, 2022 @ 3:04 pm

Invoice viewed by 64.124.8.25 for the first time.