Bill To:

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

Services Rendered To:

Forrest Ward
Lawton, OK 73507
POLICY# 959155558


Product
Price
Qty
Amount

  1. 102 Engine Response (Per Hour)

    $500.00
    1.25
    $625.00

  2. 102 Engine Response (Per Hour)

    $500.00
    1.25
    $625.00

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

    $500.00
    1.25
    $625.00

  4. 218 Cervical Collar (# Used)

    $25.00
    1
    $25.00

  5. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00

  6. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00

  7. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00

  8. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00

  9. 201 Oil Absorbent Material (# Used)

    $35.00
    1
    $35.00

  10. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  11. 207 Wetting Agent (Amt Used)

    $25.00
    1
    $25.00

  12. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00

  13. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    14. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I44 MM 44.5- Lawton, OK

Subtotal $2,721.00
Total Due $2,721.00


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
April 3, 2023 @ 1:41 pm

Invoice updated by Geoffrey.

Status Update
April 3, 2023 @ 1:41 pm

Status changed: Draft to Pending.