Bill To:


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

Services Rendered To:


Daniel Davidson
12115 Highway East
Eldridge, MO 65463
Policy # 11626723

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
MO-05-307-2021-0129 05/22/2021 07/17/2021 On Receipt Eldridge V.F.D.

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00
  2. 106 Battalion/Chief Vehicle Response (Per Hour)

    $500.00
    1.5
    $750.00
  3. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00
  4. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  6. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.5
    $150.00
  7. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 17037 Highway East - Eldridge, MO

Subtotal $2,208.00
Total Due $2,208.00


Updated
July 17, 2021 @ 3:57 pm

Invoice updated by Geoffrey.

Status Update
July 17, 2021 @ 3:57 pm

Status changed: Draft to Pending.

Updated
July 17, 2021 @ 3:59 pm

Invoice updated by Geoffrey.

Viewed
October 23, 2022 @ 1:55 am

Invoice viewed by 64.124.8.43 for the first time.

Viewed
November 12, 2023 @ 7:42 am

Invoice viewed by 47.72.217.253 for the first time.