Bill To:

PROGRESSIVE NORTHERN INSURANCE
6300 WILSON MILLS ROAD - W33
MAYFIELD VILLAGE, PA 44143-2182

Services Rendered To:

Terrill Squires
5011 McMasters Bend
Van Buren, Arkansas 72956
Policy # 942727971


Product
Price
Qty
Amount

  1. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.25
    $625.00

  2. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.25
    $625.00

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

    $100.00
    1.25
    $125.00

  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

    5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I-40 Eastbound @ MM 249 - Henryetta, OK

Subtotal $1,625.00
Total Due $1,625.00


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
July 12, 2021 @ 5:11 pm

Invoice updated by Geoffrey.

Status Update
July 12, 2021 @ 5:11 pm

Status changed: Draft to Pending.

Updated
July 12, 2021 @ 5:13 pm

Invoice updated by Geoffrey.

Updated
July 12, 2021 @ 5:14 pm

Invoice updated by Geoffrey.

Updated
July 12, 2021 @ 5:14 pm

Invoice updated by Geoffrey.