Bill To:


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

Services Rendered To:


Austin Scott
110 Sebastian Lane
Josephine, Texas 75173
Policy # 926240544

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-CN-310-2021-20-A 01/11/2021 01/15/2021 On Receipt Lavon V.F.D.

Product
Price
Qty
Amount
  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1
    $150.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  8. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Highway 78 and Lake Road - Lavon, Texas

    Ordinance Info: City of Lavon, Texas - Resolution NO. 2020-03-01

Subtotal $966.00
Total Due $966.00


Updated
January 14, 2021 @ 6:26 pm

Invoice updated by Geoffrey.

Status Update
January 14, 2021 @ 6:26 pm

Status changed: Draft to Pending.

Updated
January 14, 2021 @ 6:28 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 8:01 am

Invoice viewed by 64.124.8.45 for the first time.