Bill To:


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

Services Rendered To:


Don Downard
License# HM5663
2016 Dodge Ram
Phone# 304-922-2805

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-007-23-54 05/03/2023 05/11/2023 On Receipt F.A.I.C FD

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00
  2. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00
  3. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00
  4. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00
  5. 102 Engine Response (Per Hour)

    $500.00
    1.5
    $750.00
  6. 102 Engine Response (Per Hour)

    $500.00
    1.5
    $750.00
  7. 104 Tanker Response (Per Hour)

    $500.00
    1.5
    $750.00
  8. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    2
    $100.00
  9. 304 SCBA Cylinder (# Used)

    $25.00
    2
    $50.00
  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  11. 306 Hose Per 50′ (Amt Used)

    $25.00
    6
    $150.00
  12. 419 Environmental Spill

    $250.00
    1
    $250.00

  13. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 MM 255 WB- Checotah, OK

Subtotal $5,950.00
Total Due $5,950.00


Updated
May 11, 2023 @ 12:09 pm

Invoice updated by Geoffrey.

Status Update
May 11, 2023 @ 12:09 pm

Status changed: Draft to Pending.