Bill To:


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

Services Rendered To:


Patsy Franklin
182 Private Rd 8809
Ben Wheeler, TX 75754
POLICY# 969565238

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-WZ-208-23-6061 06/29/2023 07/24/2023 On Receipt Van Zandt Midway V.F.D.

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

    $500.00
    1.75
    $875.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.75
    $350.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1.75
    $350.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  5. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.75
    $175.00
  6. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.75
    $175.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 64 & 4913- Ben Wheeler, TX

    Ordinance Info: Van Zandt-Midway Volunteer Fire Dept. Resolution

Subtotal $2,179.00
Total Due $2,179.00


Updated
July 24, 2023 @ 12:19 pm

Invoice updated by Geoffrey.

Status Update
July 24, 2023 @ 12:19 pm

Status changed: Draft to Pending.