Bill To:


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

Services Rendered To:


Ahmed Ali
430 Buckingham Rd
Richardson, TX 75081
POLICY# 960294913

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-SH-201-C22-22319C 09/02/2022 09/20/2022 On Receipt Angus Vol. Fire Department

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

    $150.00
    1
    $150.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 226 Southbound on Interstate 45 - Angus, Texas

    Ordinance Info: City of Angus Billing Authorization # 7

Subtotal $562.00
Total Due $562.00


Updated
September 19, 2022 @ 4:32 pm

Invoice updated by Geoffrey.

Status Update
September 19, 2022 @ 4:32 pm

Status changed: Draft to Pending.

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