Bill To:

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

Services Rendered To:

Angela Salinas
Policy# 929273429


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00

  2. 104 Tanker Response (Per Hour)

    $300.00
    1
    $300.00

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

    $150.00
    1
    $150.00

  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. 804 Cleanup / Scene Stablization (Response Fee)

    $250.00
    1
    $250.00

    6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Liberty School Rd & Sandy Beach Rd. Azle, TX 76020

Subtotal $1,300.00
Total Due $1,300.00

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
September 29, 2019 @ 3:39 pm

Invoice updated by Karen Smith.

Status Update
September 29, 2019 @ 3:39 pm

Status changed: Draft to Pending.

Updated
September 29, 2019 @ 3:40 pm

Invoice updated by Karen Smith.