Bill To:


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

Services Rendered To:


Gregory Greene
802 Hodge Street
Atlanta, Texas 75551
Policy # 919261224

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-2020-0922 09/22/2020 10/02/2020 On Receipt Douglassville V.F.D.

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

    $350.00
    2
    $700.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    2
    $600.00
  3. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  4. 409 Manpower (Per Hour)

    4 x 2 Hours each

    $50.00
    8
    $400.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: State Highway 77 West - Cass County

Subtotal $1,845.00
Total Due $1,845.00
Updated
October 2, 2020 @ 1:55 pm

Invoice updated by Geoffrey.

Status Update
October 2, 2020 @ 1:55 pm

Status changed: Draft to Pending.

Updated
October 2, 2020 @ 1:57 pm

Invoice updated by Geoffrey.

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