Bill To:


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

Services Rendered To:


Policy# 94267995
Dorian Felder
18800 Lina St.
Dallas, TX, 75287

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-214-2020-95 10/23/2020 11/13/2020 On Receipt Richland VFD

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. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 219 I-45 Exit, Richland, TX

Subtotal $1,150.00
Total Due $1,150.00
Updated
November 12, 2020 @ 2:21 pm

Invoice updated by Karen Smith.

Status Update
November 12, 2020 @ 2:21 pm

Status changed: Draft to Pending.

Viewed
October 22, 2022 @ 3:01 pm

Invoice viewed by 64.124.8.25 for the first time.