Loading...
Weber Nelson R���B�I�� � � I�OV 07 2013 � NOTICE OF CLAIM FORM to the City of Saint Paul, Mi�il�s�6�L��i� Minnesota State Stah�te 466.05 states that "...every person...who claims damages from any municipality...shall cause to be presented to the governing body of the municipaliry within 180 days after the alleged loss or injury is discovered a notice stating the time,place,and circz�mstances thereof,and the amount of compensation or other relief demanded." Please complete this form in its entirety by clearly typing or printing your answer to each question. If more space is needed,attach additional sheets. Please note that you will not be contacted by telephone to clarify answers,so provide as much information as necessary to ea�plain your claim,and the amount of compensation being requested. You will receive a written acknowledgement once your form is received. The process can take up to ten weeks or longer depending on the nature of your claim. This form must be signed,and both pages completed. If something does not apply,write`N/A'. SEND COMPLETED FORM AND OTHER DOCUMENTS TO: CITY CLERK, 15 WEST KELI.OGG BLVD, 310 CITY I3ALL, SAINT PAUL, MN 55102 First Name ��.5..��.,5�.. Middle Initial Last Name^�Q��-- ���C`.3� Company or Business Name �� Are You an Insurance Company? Yes No �If Yes, Claim Number? Street Address ��`�j�— ����-� �-� '� � � City���r�� State, ����U Zip Code ��_� Daytime Phone(���i`�j���ell Phone(�-�=����mng Telephone(___� - Date of Accident/Injury or Date Discovered��-� � ��L-��Time �%- pm' � I emailed the city 4 times (see attached emails) during the summer. I received replies stating that the.block needed trimming (see July 30). The last time I emailed on Oct 1 at 12:52. My neighbors saw the branch on my car on Oct 1 around 4 p.m. The damage to my car was caused by negligence on the part of the City. I asked via email numerous times to have the dead branches removed because they were a danger to people or vehicles. One had fallen prior in June which prompted my initial email; fortunately nothing and no one was underneath it at that time. There was a tree down a block away (see June 25 email) and I asked that the trimmers take care of the issue when they were in the area at that time. No one did anything until I called your office on Oct 1 at 4:15 - after the branch had fallen. Then suddenly your crew was out the next day. I tried to be proactive and prevent potential damage al/summer. The City was only reactive and therefore at fault for the damage to my car. � �.�y v..�u�.i�. wa� ua���a��u uy a potnoie or conaition oi tnc��ree� u iviy vemcie was aama�cu oy a piuw ❑ My vehicle was wrongfully towed and/or ticketed ❑ I was injured on City property �Other type of property damage—please specify--�('� c� �g���;��� -��'�� �;� i���. �--� ❑ Other type of injury—please specify , , In order to process your claim you need to include copies of all apqlicable documents. For the claims types listed below,please be sure to include the documents indicated or it will delay the handling of ' your claim. Documents WILL NOT be returned and become the property of the City. You axe encouraged to keep a � copy for y,purself before submitting your claim form. � Q Property damage claims to a vehicle: two estimates for the repairs to your vehicle if the damage exceeds � $500.00; or the actual bills and/or receipts for the repairs i O Towing claims: legible copies of any ticket issued and a copy of the impound lot receipt O Other property damage claims: two repair estimates if the damage exceeds$500.00; or the actual bills and/or receipts for the repairs; detailed list of damaged items I O Injury claims: medical bills,receipts O Photographs are always welcome to document and support your claim but will not be returned. Page 1 of 2—Please complete and return both pages of Claim Form Failure to complete and return both pages will result in delay in the handling of your claim. All Claims–nlease complete this section �______ Were there witnesses to the incident? Yes / No Unknown ircle) Provide their names, addresses and telephone numbers: ��,�p`�,���� ��1 �`�Ce�,V-��1,�5.c� �q5� ����.�. i��.. f��� �o � ���� --����- �� � � � �re the police or law enforcement called? Yes � Unknown (circle) If yes,what department or agency? Case#or report# Where did the accident or injury take place? Provide street address, cross street, intersection,name of park or facility, closest landmark etc. Please be as detailed as pos ible. If nece sar�attach a diagra . �� �° �t — �.�?..� � � � � � �_ Please indicate the amount you are seeking in compensation or what you would like the City to do to resolve this claim to your satisfaction. ` -. - �� Vehicle Claims–please com�lete this section ❑ check box if this section does not apply Your Vehicle: Year�Make �j�l..v Model `.�a���c'o License Plate Number State�?Color �{�� C� Registered Owner�1�,,,,� �`�,:� � ,Q �s�S c�^—� � Driver of Vehicle Area Damaged `�C_..�t�-,r� City Vehicle: Year Make Model License Plate Number State Color Driver of Vehicle(City Employee's Name) Area Damaged InL rv Claims–please complete this section �check box if this section does not apply How were you injured? What part(s)of your body were injured? Have you sought medical treatment? Yes No Planning to Seek Treatment(circle) When did you receive treatment? (provide date(s)) Name of Medical Provider(s): Address Telephone Did you miss work as a result of your injury? Yes No When did you miss work? (provide date(s)) Name of your Employer: Address Telephone �Check here if you are attaching more pages to this claim form. Number of additional pages�. By signing this form,you are stating that all information you have provided is true and correct to the best of your knowledge. Unsigned forms will not be processec� Submitting a false claim can result in prosecution. Date form was completed ����'� Print the.Name of the Person who Compl t _ Form: '� � �,U.��..t' F ��`r" Signature of Person Making the Cla' � � Revised February 2011 Elaine Weber Nelson From: Elaine Weber Nelson Sent: Tuesclay;June 25,2013 12:04 PM To: 'forestry@ci.stpaul.mn.us' Subject: ash tree Prior and Selby There is an ash tree in front of our house that has several dead branches that are barely hanging on. One fell in the recent storm and I would like to ask that when you have a service come out to remove the huge tree that recently fell at Selby and Wilder,you direct your crew to just east of that and trim the ash. Elaine�'Veber Nelson £'ounc�ation I�irector BHC-Minneapolis 618 East 17`h Street Minneapolis,MN 55404 Office Phone (612)879-2888 Cell Phone (612)578-0767 Elaine.VJeberNelson!c�bhshealih.or� 1 ) 3�f � :�a { i . .. � Yf'� '+r�,.��;� ��� _- � �� 1 Elaine Weber Nelson From: Kruse, Scott(CI-StPaul) <scott.kruse@ci.stpaul.mn.us> Sent: Tuesday,July 30,2013 12:02 PM To: Elaine Weber Nelson Cc: Locke, Shawn (CI-StPaul) Subject: 1957 Selby trim Hello Elaine, Ash pruning will not begin until after September 15Y at the end of the Emerald Ash Boer flight season.Your whole block is in need of pruning, so we would plan on doing the entire block. Thank You Elaine Scott Kruse Forestry Supervisor II City of St Paul Parks& Recreation Department Forestry Unit 651-632-2433 Scott.kruse@ci.stpaul.mn.us - ` Water Trees �I 1 Elaine Weber Nelson From: Elaine Weber Nelson Sent: Tuesday,July 30,°2013 12:10 PM To: 'Kruse, Scott (CI-StPaul)' Subject: RE: 1957 Selby trim Great—thanks for your reply.We'il look forward to it—it seems that the larger trees haven't been trimmed in a while. From: Kruse, Scott(CI-StPaul) [mailto:scott.kruseCa?ci.stpaul.mn.us] Sent: Tuesday, July 30, 2013 12:02 PM To: Elaine Weber Nelson Cc: Locke, Shawn (CI-StPaul) Subject: 1957 Selby trim Hello Elaine, Ash pruning will not begin until after September 15t at the end of the Emerald Ash Boer flight season.Your whole block is in need of pruning,so we would plan on doing the entire block. Thank You Elaine Scott Kruse Forestry Supervisor II City of St Paul Parks& Recreation Department Forestry Unit 651-632-2433 Scott.kruse@ci.stpaul.mn.us ' WaterTrees 1 Elaine Weber Nelson From: Elaine Weber Nelson Sent: Monday, September 23,2013 12:47 PM To: 'Kruse, Scott (CI-StPaul)' Subject: RE: 1957 Selby trim Could you tell me when you plan to trim the 190d block of Selby Ave?Thanks. _._..._.�_..__._._..___ From: Kruse, Scott(CI-StPaul) [mailto:scott.kruseCa�ci.stpaul.mn.us] Sent: Tuesday, July 30, 2013 12:02 PM To: Elaine Weber Nelson Cc: Locke, Shawn (CI-StPaul) Subject: 1957 Selby trim Hello Elaine, Ash pruning will not begin until after September 15t at the end of the Emerald Ash Boer flight season.Your whole block is in need of pruning,so we would plan on doing the entire block. Thank You Elaine i Scott Kruse Forestry Supervisor II City of St Paul Parks& Recreation Department Forestry Unit 651-632-2433 Scott.kruse@ci.stpaul.mn.us Y " WaterTrees 1 Elaine Weber Nelson From: Elaine Weber Nelson Sent: Tuesday, October Ol, 2013 12:52 PM To: 'Kruse, Scott(CI-StPaul)' Subject: RE: 1957 Selby trim Hi Scott—any idea of when your crews will be out trimming?The ash on our boulevard has numerous broken/dead branches—several have come down in high wind weather—this tree a danger to people on the sidewalk/cars on the street.Thanks for an update. Efaine From: Kruse, Scott(CI-StPaul) [mailto:scott.kruseCc�ci.stpaul.mn.us) Sent: Tuesday, July 30, 2013 12:02 PM To: Elaine Weber Nelson Cc: Locke, Shawn (CI-StPaul) Subject: 1957 Selby trim Hello Elaine, Ash pruning will not begin until after September 1St at the end of the Emerald Ash Boer flight season.Your whole block is in need of pruning, so we would plan on doing the entire block. Thank You Elaine Scott Kruse Forestry Supervisor II City of St Paul Parks& Recreation Department Forestry Unit 651-632-2433 � Scott.kruse@ci.stpaul.mn.us r ` Water Trees 1 ��5� � � Y LJ � . i.. r�;r:1�a i�� 3 :;��� u��� � � ;, .� .i� � � � ��! AC 1� ' � �£ 1 I k t;._ e s. P� � � °�j;s��,J ����` ��. . � � ����rF. �������� ���X�# � I�� � ""��`�����' r��.z�� � ���..0 k � �.. � �� r�d 3's��.. � r�,t Y �� a° � �x � �� y f : �`Try��3'.3- Y� � t �fc� �d^. � �,_ai,?�3' ''�° �n��� •..,�i'.. 1�z��, '. t £ y � t£ .xr � .� x�,� � `�J' �- � ��Kd![ v� ; 1 q t „� �� �� Y F '"K`�� '»�y � ����. �g";��'t}K.�fi "Y�J 8 �� �. �`y���*:� ��, �,�`� ; ,����t�,.z £ � �� �� p s � � � ��� }s % ����„, �� a�:/ �' 4�� ` �a,s�`' ,� i �E�k. p �-�" �4i*.*X ��� �'$��. . s- ��� - � '�f o-ti ,�« � r �sa� ,�•; ��' ��� �;��' "`� � ?� g'w t� a ���� �: _ 'a t �t .� a� � :. ��r4 tt ,� ` �� J;t 4}t ������ f � 1 ;�j, b�a�4yR,.y'�,�y�. ,� � 't ;��y� . '�:{ Z�&k �; h� � a { j�'$ �.F�.���E � `� re� s �'}' ,A�y± +. £ & � � M�,3 Y ,S� _�p y3 - .� �+ m.,," �F���,d y k t � V i_,��^ Sh�3� y��� �. y * 3 w �-*�,�s� �`�� � '���.���,"�,w _'�, a i , . �, ,,� 'r: . �� �������.������ ` �h� r � � r �� :�,�; ' % ,r �< .,�'�$t����,�;.���}. � x�� � � � .� T�'•: z ,'�'•,�,� ���` '����8 ���s,5'� _ s h ����� i i .�w' � �n�&� � E°- i � � i'� �'X'� `2. k` F " � Y j ��t+�x i a �-���*r' '+ .. . �w .. � �y x �'��.4 «` E�"^- "t��, ��� C .. ,�-� a i` w��� � <;� ��v �� � � � '��.. "�`����.,,y° : , i ����r ��� . .. . . �.:. � i .�� .�� �e. ��M £ . ' _ ., uk� � !�; ���k F I��1 � �� � . � �' � Y p� . � `�1• �4 '*S��'��'e � � ii �`� � � t y �v.�s. '$� � � : �,�`�"�� ,�S . � i.��� ," ' � . y 4 �i y . . - � . .� S � ':r���' �� � ... � � I �} � a�: .�I'3�.�r�z�.- . � � .' ,:. 5 ��, �s: �' � � ��: � ¢ ,; ��� , �, ���f`� ��`;; a��a� �` _��g u - �+'� , .��;. a.`�.� .. � � � ? ���^r� S� s.�i.a _ . ��{� � ���.' r k t 1J ��:u�w�'� . i � ���� ' ��� X. ..�:"3'$'�R q ,p R A Y 4�'i�Y e�r���,1'� $ e x'�''� ,��c��r ��3,�' ; r�: ,n� ��ti�� �� '"��;. �,t - ,.:.s,� ,'kim'. <. ., . .. � �� :� �� � .�� : ,,�. �. �° �_ , ,, . .• .. �:_. ,� �� ,ti ; .;�;: ��� x�' ���`�����'�,,,���, �r��,���,����.,� _� �i� ��>���`+�� .,,� ` ��- '3 ����� ¢ � # � t _�r� k� �� � � ��������� `��ft F �� � �3��� �� c w ��r „�: � ;.`?�� ; � � � � x��r� � �� � �A`� .. �� �� '� x� �' a v t�.� �r.`�5t- .�� � �� �,.1�.�d''����'�i�`�,y� , ,zJ £�s a � � .. � � � ����,���� �� f� � . g .������� � � �-. i C � :L�-+� i �� � Yl P�^ ��^�''j, k. -�-�•� .: .'�ad . s v.�§�"�,,� �y"' .�S��C A �,$.�� f �<iV+. �t��f ��'�'�a+� ,Y� ,�F � . `�,✓ � � �f �E ���'�����k� ��s��a 4� � � = �� ��;� . p . � �' a.,"�` ry �`'a'�w�..�,.4 � x�,� , ��g� 3£ . � e 3 h y+r�� �"� .� �"� �' � `��:.� .:�' � ' s � .a ?�'�^� , � y�; � �a'. ✓��_ �,° �'f � `",kk����'j"��f*+. 't'.�'��f . �s:i�',P � ` " �. �iC+ �`�'�a�c��"'"t'�t'�s`'�R��}�4:' t t',s" � :-3 ¢�i .+°: r �f �^wtt.� 'r�rF af`' � � $��;t;�� � F�. .. 4 �'_ : . :� . . ��. .. � � r�,•....',...j:..a..,•,,.r�::+..w���^i:�.'- ....-m`^�'o-.�� _.. �: �,.r�,�4,.w�uw...e.�.r«i..'-..... ...w.s�+r. - . ... ��Z .f� �� �.Y`'.. .. r . .,..n : .,� ` . -:�s. .' : � � .�ys �,l"� ' }" $^� ✓�' '�d9n C' ,i .�. �}F. . �, 1 {� � ) �.+. ' �. '�� ��_�'�� S {T �. .. . � :.� a� '.f. �f • �` / p� �� ��.Z � . ��� '��r �� �"� ... �'�. k�� »;?�` �: . .. .. . , ^ _; %3? � n " �o�� ,� .: ��'".+. � � <'1 3 _��"<�r. as,���:w.-. '��z J��ti � '' !�x,�e . � . ; ... "t.�a��t,� � ,s � . t a t i k '%� � �;A : . .. ,r.�. V � �� '``�� h.'s er '� �R ,� �.. ,�=r �, �� e .t� f'�.e�q , � . �'�w . '�: °k., R � . 3��:. ?'� �_.. . . ��*. e 4 9 . _ . � . _ . . . . . " . ., , HIGHLAND AUTOSTAR COLLISION CENTER 2042 WEST 7TH ST. ST. PAUL, MN 55116 OFFICE: 651-699-0340 FAX: 651-699-4953 FED TAX ID#41-1828627 ***PRELIMINARY ESTIMATE*"* 10/25/2013 02:23 PM Owner _ _ Owner: ELAINE WEBBER-NELSON Address: 1957 SELBY AVE WorWDay: Home/Evening: (651)690-4581 City State Zip: Saint Paul, MN 55104 FAX: Inspection Inspection Date: 10/25/2013 02:24 PM Inspection Type: Primary Impact: Hood Secondary Impact: Appraiser Name: JOHN RITTER_JR Appraiser License# : Address: 2042 W7TH ST Work/Day: (651)699-0340 FAX: (651)699-4953 City State Zip: Saint Paul, MN 55116 FAX: Email: JOHNJRC�HIGHLANDAUTO TAR.COM Repairer _ . HIGHLAND AUTOSTAR HIGHLAND AUTOSTAR Repairer: Contact:COLLISION COLLISION Address: 2042 7TH ST W Work/Day: (651)699-0340 City State Zip: ST PAUL, MN 551 1 6-31 07 FAX: (651)699-4953 Email: HA2042C�POPP.NET Vehicle 2006 BMW 325xi STD 4 DR Sedan 6cyl Gasoline 3A 6-Speed Automatic Lic.Plate: 253 LJC Lic State: MN Lic Expire: VIN: WBAVD13506KV04812 Veh Insp#: Mileage Type: Actual Condition: Code: 41313A Ext. Refinish: Two-Stage Int. Refinish: Two-Stage Options 4-Wheel Drive AM/FM CD Player Air Conditioning Aluminum/Alloy Wheels Anti-Lock Brakes Center Console Cruise Control Dual Airbags Dual Zone Auto A/C Fog Lights Head Airbags Headlight Washers Heated Power Mirrors Heated W/S Wiper Washers Intermittent Wipers Keyless Entry System Leather Steering Wheel Lighted Entry System MP3 Player Power Brakes Power poor Locks Power Moonroof Power Steering Power Windows Rain-Sensing W/S Wipers Rear Window Defroster Rem Trunk-UGate Release Page 1 of 4 10/25/2013 0228 PM � 2006 BMW 325xi STD 4 DR Sedan Claim ri: 10/25/2013 02:23 PM Run�FIaUSelf-Seal Tires Side Airbags Stability Cntrl Suspensn Strg Wheel Radio Control Tachometer Telescopic Steering Whl Theft Deterrent System Tilt Steering Wheel Tinted Glass Traction Control System Trip Computer Vinyl Seats Wood Interior Trim Damages Line Op Guide MC Description MFR.Part No. Price ADJ°/a B% Hours R Front Bum�er 1 RI 6 Front Bumper Cover R&I R& I Assembly 1.0 SM Front End Panel And Lamus 2 RI 41 Lens,Headlamp LT R& I Assembly 0.6 SM 3 RI 42 Lens,Headlamp RT R& I Assembly 0.4 SM Front Bodv And Windshield 4 RI 272 Lens,Side Marker LT R& I Assembly 0.1 SM 5 RI 273 Lens,Side Marker RT R& I Assembly 0.1 SM 6 I 83 Panel,Hood Repair 3.0' SM High Strength Steel 7 L 83 13 Panel,Hood Refini�h 4.2 RF 3.0 Surface - 0.6I Two-stage setup 0.6 Two-stage 8 RI 40 MIdg,Hood Front RT R& I Assembly 0.2 SM 9 RI 1527 MIdg,Hood Front LT R& I Assembly 0.2 SM 10 RI 71 Emblem,Hood Panel R& I Assembly 0.2 SM 11 I 103 Fender,Front LT Repair 1.0' SM 12 L 103 Fender,Front LT Refinish 2.2 RF 1.8 Surface 0.4 Two-stage 13 BR 104 Fender,Front RT Blend Refinish 1.1 RF 0.7 Blend 0.4 Two-stage Manual Entries 14 SB HAZARD.WSTE. REM. Sublet Repair $6.00` SM 15 EC COVER CAR EXTERIOR Replace Economy $7.00' SM` 16 L CORROSION PROTECTION Refinish 0.5' RF 17 L FEATHER, PRIME, BLOCK Refinish 1.0' RF 18 L DENIB& BUFF Refinish 0.5` RF 18 Items MC Message 13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE Estimate Total & Entries Other Parts $7.00 Paint Materials $332.50 Parts&Material Total $339.50 Tax on Parts& Material C� 7.625% $25•$9 Labor Rate Replace Repair Hrs Total Hrs ' H rs � � Page 2 of 4 10/25/2013 0228 PM 2006 BMW 325xi STQ 4 DR Sedan Claim#: ' 10/25/2013 0223 PM Sheet Metal(SM) $56.00 2.8 4.0 6.8 $380.80 Mech/Elec(ME) $90.00 Frame(FR) $80.00 Refinish(RF) $56.00 9.5 9.5 $532.00 Paint Materials $35.00 Labor Total 16.3 Hours $912.80 Sublet Repairs $6.00 Gross Total $��284•19 Net Total ���284•�9 Alternate Parts Y/00/00/00/00/00 CUM 00/00/00/00/00 Zip Code: 55116 Default Recycled Parts NOT REQUESTED Audatex Estimating 7.0.019 ES 10/25/2013 02:28 PM REL 7.0.019 DT 10/01/2013 DB 10/15/2013 Copyright(C)2013 Audatex North America, Inc. 2.0 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO-STAGE REFINISH FORMULA. YOU ARE AUTHORIZED TO MAKE THE ABOVE REPAIRS. I UNbERSTAND THAT PAYMENT IN FULL WILL BE DUE UPON RELEASE OF THE VEHICLE. PARTS PRICES ARE SUBJECTO TO INVOICE. I GRANT PERMISSION TO OPERATE MY VEHICLE FOR THE PURPOSE OF TESTING/INSPECTION. HIGHLAND AUTOSTAR IS NOT RESPONSBILE FOR LOSS OR DAMAGE TO THE VEHICLE OR ITS CONTENTSIN CASE OF FIRE,THEFT OR ANY CAUSE BEYOND YOUR CONTROL. AUTHORIZED BY: DATE: THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE PARTS MANUFACTURER OR DISTRIBUTOR RATHER THAN BY THE MANUFACTURER OF YOUR VEHICLE. A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGAINST AN INSURER IS GUILTY OF A CRIME. Op Codes ' = User-Entered Value E = Replace OEM NG= Replace NAGS EC= Replace Economy OE= Replace PXN OE Srpls UE= Replace OE Surplus ET = Partial Replace Labor EP= Replace PXN EU = Replace Recycled TE = Partial Replace Price PM= Replace PXN Reman/Reblt UM= Replace Reman/Rebuilt L = Refinish PC= Replace PXN Reconditioned UC= Replace Reconditioned TT = Two-Tone SB= Sublet Repair N = Additional Labor BR= Blend Refinish I = Repair IT = Partial Repair CG= Chipguard RI = R& I Assembly P = Check AA= Appearance Allowance RP= Related Prior Damage Page 3 of 4 10/25/2013 02:26 PM 2006 BMW 325xi STD 4 DR Sedan Claim#: - 10/25/2013 02:23 PM This report contains proprietary information of Audatex and may not be disclosed to any third party(other than the insured,claimant and others on a need to know basis in order to effectuate the claims process)without Audatex Audatex's prior written consent. a S��?4��:r cw:�rd•;y °�°— Copyright(C)2013 Audatex North America, Inc. Audatex Estimating is a trademark of Audatex North America, Inc. - Page a of 4 10/25/2013 02:28 PM . RAYMOND AUTO BODY� INC. Wor�le ID: fid91234 FederalID: 41-0888257 1075 PIERCE BUTLER RTE, SAINT PAUL, MN ' S5104 Phone: (651) 488-0588 FAX: (651) 488-4794 Preliminary Estimate Customer: NELSON, ELAINE �ob Number: Written By:JOEL SLOMKOWSKI Insured: NELSON, ELAINE Policy#: Claim #: Type of Loss: Date of Loss: Days to Repair: 0 Point of Impact: Owner: Inspection Location: Insurance Company: NELSON, ELAINE RAYMOND AUTO BODY,INC. 1957 SELBY AVENUE 1075 PIERCE BUTLER RTE ST PAUL, MN 55104 SAINT PAUL, MN 55104 (651)690-4581 Other Repair Facility (651)488-0588 Business V�HICLE Year: 2006 Body Style: 4D SED VIN: WBAVD13506KV04842 Mileage In: Make: BMW Engine: 6-3.OL-FI License: Mileage Out: Model: 325XI AWD Production Date: State: Vehicle Out: Color: GRAY Int: Condition: Job#: TRANSMISSION CONVENIENCE Search/Seek Bucket Seats 6 Speed Transmission Air Conditioning CD Player Leather Seats POWER Intermittent Wipers SAFETY WHEELS Power Steering Tilt Wheel Drivers Side Air Bag Aluminum/Alloy Wheels Power Brakes Cruise Control Passenger Air Bag PAINT Power Windows Rear Defogger Anti-Lock Brakes(4) Clear Coat Paint Power Locks Keyless Entry 4 Wheei Disc Brakes OTHER Power Mirrors Steering Wheel Touch Controls Front Side Impact Air Bags Fog Lamps Heated Mirrors Telescopic Wheel Head/Curtain Air Bags Traction Control DECOR RADIO Hands Free Device Stability Control Dual Mirrors AM Radio ROOF Headlamp Washers Console/Storage FM Radio Electric Glass Sunroof Power Trunk/Gate Release Wood Interior Trim Stereo SEATS 10/25/2013 1:23:51 PM 019495 Page 1 Preliminary Estimate Customer: NELSON, ELAINE Job Number: Vehicle: 2006 BMW 325XI AWD 4D SED 6-3.OL-FI GRAY Line Oper Description Part Number Qty Extended Labor Paint Prite$ 1 FENDER 2 * Rpr LT Fender BUFF SCUFF � 9� 3 HOOD 4 R&I R&I hood assy 0•8 5 * Rpr Hood �Q 3.0 6 Add for Clear Coat 1•2 7 R&I RT Front seal outer 0.1 8 R&I LT Front seal outer 0.1 9 * R&I Emblem � 10 Repl Emblem grommet 51141852899 2 3.12 11 FRONT BUMPER&GRILLE 12 * R&I RT Cover � 13 * R&I LT Cover � 14 MISCELLANEOUS OPERATIONS 15 * Repl Cover car/bag 1 � � 16 # Repl Hazardous waste removal 1 3.50 X 17 # Refn Color tint/color match 0.5 18 # Rpr Color sand and buff 0.5 19 # Repl Corrosion protection primer 1 0.3 SUBTOTALS 6.62 8.0 5.7 ESTIMATE TOTALS Category Basis Rate Cost; Parts 3.12 Body Labor 8.0 hrs @ $54.00/hr 432.00 Paint Labor 5.7 hrs @ $54.00/hr 307.80 Paint Supplies 5.7 hrs @ $34.00/hr 193.80 Miscellaneous 3.50 Subtotal 940.22 Sales Tax $ 196.92 @ 7.6250% 15.02 Grand Total 955.24 Deductible 0.00 CUSTOMER PAY 0.00 INSURANCE PAY 955.24 WHILE WE HAVE MADE EVERY EFFORT TO WRITE A COMPREHENSIVE REPORT OF THE VISIBLE DAMAGE TO YOUR VEHICLE, IT IS IMPORTANT TO REMEMBER THAT THIS IS ONLY AN ESTIMATE. THERE ARE A NUMBER OF FACTORS THAT CAN AFFECT THE ACTUAL COST OF REPAIRS, INCLUDING BUT NOT LIMITED TO HIDDEN DAMAGE, PARTS PRICE CHANGES, AND INSURANCE COMPANY INVOLVEMENT. PLEASE CONSIDER THIS WHEN MAKING DECISIONS REGARDING THE REPAIRS TO YOUR VEHICLE. 10/25/2013 1:23:51 PM 019495 Page 2 _ Preliminary Estimate Customer: NELSON, ELAINE 7ob Number: Vehicle: 2006 BMW 325XI AWD 4D SED 6-3.OL-FI GRAY AUTO CLUB INSURANCE ASSOCIATION, MEMBERSELECT INSURANCE COMPANY OR AUTO CLUB GROUP INSURANCE COMPANY (HEREIN INDIVIDUALLY AND COLLECTIVELY REFERRED TO AS ACIA) GUARANTEES THAT IT WILL REPLACE THE QUALITY REPLACEMENT PARTS (PARTS NOT MANUFACTURED BY THE ORIGINAL EQUIPMENT MANUFACTURER) IDENTIFIED ON THE VEHICLE ESTIMATE ASSOCIATED WITH THIS GUARANTEE IF A DEFECT IS DISCOVERED. ACIA FURTHER GUARANTEES THAT THE QUALITY REPLACEMENT PARTS, EXCLUDING GLASS AND MECHANICAL PARTS, ARE CERTIFIED OR VALIDATED TO BE OF OEM QUALITY IN ALL INSTANCES WHEN THIS CERTIFICATION OR VALIDATION IS AVAILABLE FOR THE PART. THIS GUARANTEE IS IN EFFECT FOR AS LONG AS YOU OWN THE REPAIR VEHICLE AND IS NOT TRANSFERABLE TO ANOTHER PARTY AT ANY TIME. THIS GUARANTEE COVERS THE COST OF THE PART, LABOR TO INSTALL, PAINT AND MATERIALS IF REQUIRED, AND REASONABLE RENTAL COST OF A SIMILAR TEMPORARY REPLACEMENT VEHICLE DURING THE REPAIRS. THIS GUARANTEE DOES NOT COVER CLAIMS FOR DIMINUTION IN VALUE OR CONSEQUENTIAL DAMAGES. IF A DEFECT IN A QUALITY REPLACEMENT PART IS DISCOVERED, CONTACT YOUR LOCAL ACIA CLAIMS DEPARTMENT IMMEDIATELY AND ACIA WILL REPLACE THE PART WITH A NEW ORIGINAL EQUIPMENT MANUFACTIJRER PART. IF AN ORIGINAL EQUIPMENT MANUFACTURER PART IS NOT REASONABLY COMMERCIALLY AVAILABLE, ACIA WILL REPLACE THE DEFECTIVE PART WITH ANOTHER QUALITY REPLACEMENT PART. MN ST 60A.955 - A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGAINST AN INSURER IS GUILTY OF A CRIME. 10/25/2013 1:23:51 PM 019495 Page 3 Preliminary Estimate Customer: NELSON, ELAINE Job Number: Vehicle: 2006 BMW 325XI AWD 4D SED 6-3.OL-FI GRAY Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ERE1942, CCC Data Date 10/17/2013, and the parts selected are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk (*) or pouble Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Tilde sign (�) items indicate MOTOR Not-Included Labor operations. The symbol (<>) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non-Original Equipment Manufacturer aftermarket parts are described as Non OEM or A/M. Used parts are described as LKQ, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign (#) items indicate manual entries. Some 2014 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The CCC ONE estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. The following is a list of additional abbreviations or symb�ls that may be used to describe work to be done or parts to be repaired or replaced: SYMBOLS FOLLOWING PART PRICE: m=MOTOR Mechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category. X=Miscellaneous Non-Taxed charge category. SYMBOLS FOLLOWING LABOR: D=Diagnostic labor category. E=Electrical labor category. F=Frame labor category. G=Glass labor category. M=Mechanical labor category. S=Structural labor category. (numbers) 1 through 4=User Defined Labor Categories. OTHER SYMBOLS AND ABBREVIATIONS: Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. BInd=Blend. BOR=Boron steel. CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel. Inc1.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part. 0/H=Overhaul. Qty=Quantity. Refn=Refinish. Repl=Replace. R&I=Remove and Install. R&R=Remove and Replace. Rpr=Repair. RT=Right. SAS=Sandwiched Steel. Sect=Section. Subl=Sublet. UHS=UItra High Strength Steel. N=Note(s) associated with the estimate line. CCC ONE Estimating - A product of CCC Information Services Inc. The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR=Bureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number. 10/25/2013 1:23:51 PM 019495 Page 4