Bill To:


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

Services Rendered To:


Michael Kizziar
1010 PR 8049
Jefferson, Texas 75657
Policy # 933603903

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-KB-403-2021-1160-A 01/14/2021 01/28/2021 On Receipt Woodlawn Fire / Harrison County ESD #6

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

    $350.00
    1.5
    $525.00
  2. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  3. 404 Scene Lighting (Per Hour)

    $75.00
    1.5
    $112.50

  4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 3825 Highway 59 North - Marshall, Texas

Subtotal $787.50
Total Due $787.50


Updated
January 27, 2021 @ 1:22 pm

Invoice updated by Geoffrey.

Status Update
January 27, 2021 @ 1:22 pm

Status changed: Draft to Pending.

Viewed
June 24, 2021 @ 4:21 pm

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

Viewed
October 24, 2022 @ 12:19 am

Invoice viewed by 64.124.8.53 for the first time.