Bill To:


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

Services Rendered To:


David Arista
3148 Juan Circle
Eagle Pass, TX 78852
Policy # 038895594

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-PZ-402-2021-423-A 11/06/2021 11/16/2021 On Receipt O'Donnell V.F.D.

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

    $350.00
    2.75
    $962.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    2.75
    $825.00
  3. 102 Engine Response (Per Hour)

    $350.00
    2.75
    $962.50
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 404 Scene Lighting (Per Hour)

    $75.00
    2.75
    $206.25
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2.75
    $275.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Loop 76 & US Highway 87 - O'Donnell, Texas

Subtotal $3,481.25
Total Due $3,481.25


Updated
November 16, 2021 @ 12:12 pm

Invoice updated by Geoffrey.

Status Update
November 16, 2021 @ 12:13 pm

Status changed: Draft to Pending.

Viewed
July 27, 2022 @ 6:45 pm

Invoice viewed by Karen Smith (KarenS) for the first time.