Bill To:

Progressive County Mutual Insurance
6300 Wilson Mills Rd.
Mayfield, OH 44143

Services Rendered To:

Jonathon Smith
1210 Willis Street
Atlanta, Texas 75551
Policy # 17790225


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    Engine  #1

    $350.00
    2.5
    $875.00

  2. 103 Rescue Response (Per Hour)

    Rescue #1

    $300.00
    2.5
    $750.00

  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    Chief #2

    $150.00
    2.5
    $375.00

  4. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  5. 409 Manpower (Per Hour)

    2 Firefighters x 2.5 Hours = 5 Hours

    $20.00
    5
    $100.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: State Highway 77 West and County Road 2120

Subtotal $2,130.00
Total Due $2,130.00

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
December 31, 2019 @ 5:26 pm

Invoice updated by Karen Smith.

Status Update
December 31, 2019 @ 5:26 pm

Status changed: Draft to Pending.