Bill To:


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

Services Rendered To:


Brenda Sue Shaffer
Progressive Insurance
Policy # 933457243

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CW-201-2020-417914 12/18/2020 02/23/2021 On Receipt Callisburg V.F.D.

Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  3. 301 Hand Tool (# Used)

    $15.00
    1
    $15.00
  4. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 371 and CR 134 - Gainesville, Texas

Subtotal $940.00
Total Due $940.00


Updated
February 22, 2021 @ 4:37 pm

Invoice updated by Geoffrey.

Status Update
February 22, 2021 @ 4:37 pm

Status changed: Draft to Pending.

Viewed
June 24, 2021 @ 5:01 pm

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

Viewed
November 20, 2022 @ 1:42 pm

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