Bill To:


PROGRESSIVE CLAIMS*
PO Box 94670
Cleveland, OH 44101

Services Rendered To:


Kaemon Richmer
9801 NW Madachie
Lawton, OK 73507
POLICY# 970335264

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-16-016-24-135 05/21/2024 06/11/2024 On Receipt Wichita Mountain Estates

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

    $500.00
    1
    $500.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  3. 106 Battalion/Chief Vehicle Response (Per Hour)

    $200.00
    1
    $200.00
  4. 303 SCBA Breathing Apparatus (# Used)

    $50.00
    1
    $50.00
  5. 304 SCBA Cylinder (# Used)

    $25.00
    1
    $25.00
  6. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00
  7. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  9. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 9801 NW Madachie- Lawton, OK

    Ordinance Info: Wichita Mountain Estates Resolution- 1-1-23

Subtotal $1,400.00
Total Due $1,400.00


Updated
June 11, 2024 @ 3:48 pm

Invoice updated by Geoffrey.

Status Update
June 11, 2024 @ 3:48 pm

Status changed: Draft to Pending.

Updated
June 11, 2024 @ 3:49 pm

Invoice updated by Geoffrey.