Bill To:


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

Services Rendered To:


Starlight Church of God
898 MCR 3612 Rd
Jefferson, TX 75657
POLICY# 974358439


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

    $500.00
    1.25
    $625.00
  2. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    1
    $2.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  5. 330 Backboard (# Used)

    $25.00
    1
    $25.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 4238 US 59- Marshall, TX

Subtotal $1,277.00
Total Due $1,277.00


Updated
March 14, 2024 @ 4:20 pm

Invoice updated by Geoffrey.

Status Update
March 14, 2024 @ 4:20 pm

Status changed: Draft to Pending.

Updated
March 14, 2024 @ 4:21 pm

Invoice updated by Geoffrey.

Viewed
March 15, 2024 @ 3:14 pm

Invoice viewed by Ken Kramer (kkramer) for the first time.