Bill To:

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

Services Rendered To:

JCR Ready Mix
10506 Palamino Trail
Houston, Texas 77095
Policy # 03959875-4


Product
Price
Qty
Amount

  1. 103 Rescue Response (Per Hour)

    $300.00
    3.25
    $975.00

  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    3.25
    $812.50

  3. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    4. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Vacek Road & Vacek Meadows Blvd - Richmond, Texas

Subtotal $2,037.50
Total Due $2,037.50


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
December 20, 2021 @ 4:22 pm

Invoice updated by Geoffrey.

Status Update
December 20, 2021 @ 4:22 pm

Status changed: Draft to Pending.

Updated
December 20, 2021 @ 4:23 pm

Invoice updated by Geoffrey.