Bill To:


PROGRESSIVE CLAIMS*
PO Box 94670
Cleveland, OH 44101

Services Rendered To:


Triad Timber & Land
115 S Gifford Ln
Richfield, NC 28137
POLICY# 082825790

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
NC-08-417-24-3204 05/15/2024 05/21/2024 On Receipt Southside VFD

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

    $400.00
    3
    $1,200.00
  2. 102 Engine Response (Per Hour)

    $500.00
    3
    $1,500.00
  3. 101 Aerial/Ladder Response (Per Hour)

    $550.00
    3
    $1,650.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    3
    $300.00
  6. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 16562 A US Hwy 52 S- Norwood, NC

Subtotal $5,000.00
Total Due $5,000.00


Updated
May 21, 2024 @ 10:40 am

Invoice updated by Geoffrey.

Status Update
May 21, 2024 @ 10:40 am

Status changed: Draft to Pending.

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May 28, 2024 @ 1:28 pm

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