Bill To:

Progressive Northwestern Insurance Company
6300 Wilson Mills Road
Cleveland, OH 44143

Services Rendered To:

Eric Gates
401 S. Vine St
Harrison, Arkansas 72601
POLICY# 8007764737


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1.75
    $612.50

  2. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.75
    $262.50

  3. 103 Rescue Response (Per Hour)

    $300.00
    1.75
    $525.00

  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  5. 211 Salvage Cover (Amt Used)           

    $35.00
    1
    $35.00

  6. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    3
    $150.00

  7. 304 SCBA Cylinder (# Used)

    $25.00
    3
    $75.00

  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00

  9. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

    10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 East Bound MM 247- Henryetta, OK

    Ordinance Info: Tiger Mountain - McIntosh County Resolution 72021

Subtotal $2,135.00
Total Due $2,135.00


Checks Payable To:

Sure Fire Recovery Service, LLC
9711 S Mason Road 125-120
Richmond, TX 77407
Federal Tax ID – 83-4417185


  Please Include Incident Number On All Correspondence.
Updated
November 28, 2022 @ 11:51 am

Invoice updated by Geoffrey.

Status Update
November 28, 2022 @ 11:51 am

Status changed: Draft to Pending.