Bill To:


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

Services Rendered To:


Skye Williams
800 E. Houston
Linden, TX 75563
POLICY# 968473798

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TX-BY-205-24-410 04/10/2024 04/16/2024 On Receipt Douglassville V.F.D.

Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  2. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  4. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: SH 77 West- Douglasville, TX

    Ordinance Info: Douglassville Volunteer Fire Dept. Resolution

Subtotal $1,000.00
Total Due $1,000.00


Updated
April 16, 2024 @ 1:26 pm

Invoice updated by Geoffrey.

Status Update
April 16, 2024 @ 1:26 pm

Status changed: Draft to Pending.