Bill To:

Progressive County Mutual Insurance
6300 Wilson Mills Rd.
Mayfield, OH 44143

Services Rendered To:

Dale John
1303 FM 1502
Detroit, TX 75436
POLICY# 950668177


Product
Price
Qty
Amount

  1. 106 Battalion/Chief Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  2. 102 Engine Response (Per Hour)

    $350.00
    1.25
    $437.50

  3. 105 Utility Vehicle Response (Per Hour)

    $150.00
    1.25
    $187.50

  4. 218 Cervical Collar (# Used)

    $25.00
    3
    $75.00

  5. 309 Power Tool (# Used)

    $50.00
    3
    $150.00

  6. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00

  7. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  8. 209 Extinguisher (# Used)

    $50.00
    4
    $200.00

  9. 208 Fire Line Tap (Per Foot, Amt Used)

    $0.25
    200
    $50.00

  10. 402 Fire/Police Services (Per Hour)    

    $100.00
    1.25
    $125.00

  11. 204 Flare (# Used)

    $8.00
    8
    $64.00

  12. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00

  13. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00

  14. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  15. 201 Oil Absorbent Material (# Used)

    $35.00
    4
    $140.00

  16. 317 Rescue Struts (# Used)

    $50.00
    1
    $50.00

  17. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    4
    $200.00

  18. 304 SCBA Cylinder (# Used)

    $25.00
    4
    $100.00

  19. 404 Scene Lighting (Per Hour)

    $75.00
    1.25
    $93.75

  20. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  21. 306 Hose Per 50′ (Amt Used)

    $25.00
    2
    $50.00

  22. 408 Air Medical Landing Zone (Used)

    $250.00
    1
    $250.00

  23. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    24. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 6700 E Hwy 82- Gainesville, TX

Subtotal $3,631.25
Total Due $3,631.25


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
January 23, 2023 @ 10:50 am

Invoice updated by Geoffrey.

Status Update
January 23, 2023 @ 10:50 am

Status changed: Draft to Pending.