Meseret� —�—
NOTICE OF CLAIM FORM to the City of Saint Paul, Minnesota
Minnesota State Statute 466.05 states that "...every person...who claims damages from any municipaliry...shaU cause to be presented to the
goi�erning body of the municipaliry within 180 days after the alleged loss or injury is discovered a notice stating the time,place,and
circumstances 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 explain 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 KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102
First Name��-�,�'�� `�:�-; ��_ Middle Initial ���Last Name Y" ��'���='�� �'.
Company or Business Name ��I V
�AN �G
Are You an Insurance Company? Yes/No If Yes,Claim Number? �� �n14
StreetAddress II�,�/�r, I_��[:► 1 i (��.�=' C�TY �'I rR/�
� St�ite I'�./� )�„ Zi Code r`
City�, .�� ,F-- �/Y�}'�� �-� �� ( P `�-�-`' 'i--��
�, t �—
Daytime Phone(��)`'�-t;r�Cell Phone((r�)�;�- t ;�Evening Telephone(=�1�--
Date of Accidend Injury or Date Discovered 1'�����i`_� Time `` � am pm
Please state, in detail, what occurred(happened),and why you are submitting a claim. Please indicate why or how you
feel the Cit� of S�int Paul or its �mployees are involved and/or responsible for your damages. �� �; ��� r. _`�' �
�, ) ��. — 'L,
G .i'�� , ,.� „ s � � - � �l � ,.�r,
h �
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�
Please check the box(es)that most closely represent the reason for completing this form:
❑ My vehicle was damaged in an accident ❑ My vehicle was damaged during a tow
❑ My vehicle was damaged by a pothole or condition of the street fd'1�I�y vehicle was damaged by a plow
❑ My vehicle was wrongfully towed and/or ticketed ❑ I was injured on City property
❑ Other type of propeRy damage—please specify
❑ Other type of injury—please specify
In order to process your claim vou need to include couies of all applicable 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 are encouraged to keep a
copy for yourself before submitting your claim form.
O 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
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
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.
:111 Claims-please complete this section -t
���re there witnesses to the incident? Yes 10 ' Unknown (circle)
Pru�ide their names, addresses and telephone numbers:
Were the police or law enforcement called? �Ye� No Unknown (circle)
If yes, what department or agency? �������-- �LAr r'��{- i`�7",�ai Case#or report# t `T��-3T���;'
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 gossible. If necessary,attach a diagram.�'t:.,k S-�'� ;�,���,� ��
C�:�l J-}�G��a��"�� [:�'���c� t.�t1"';t1'�,Y'�\-�l.i f-�l;�k;
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Please indicate the amount you are seeking in compensation or what you would like the City to do to resolve this claim
to your satisfacrion.�-z-`v�, (1'1�-1 �z r -� � ��
Vehicle Claims-please comulete this section ❑ check box if this section does not applv
Your Vehicle: Year � '�'�� �� Make(�,�����i�..�-�Mode1 f'Y'i�,���-�i_4
License Plate Number,�,v�Co-Yf t� u State�_Color 1 t�,r'1
Registered Owner�i�.�j�S,.�,�/�2"��--
Driver of Vehicle !�y i;y�S� i'1Z.1 S�'r-Cl L
Area Damaged �� �`._ . . ,�' �� �� � � � � - � .�� � � �-�� - � ►Y1CCl.t�i�1� �+►�--
CityVehicle: Year 't�ti �" Make —G'i^-� Model - ' " `��
License Plate Number�_"�[� �LJ L� State Color �'Si u
Driver of Vehicle(City Employee's Name) �F?-���,:�f�-�'' �,j�� � ���
Area Damaged .'�
In�ur� Claims-please complete this section c eck box if this section does not applv
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 processed.
Submitting a false claim can result in prosecution. Date form was completed ('.�� .`'�-�'��`�
Print the Name of the Person who Completed this Form: �� � ` '�i r�� ������:'�"�-!"
Signature of Person Making the Claim: �^���,a;�����,�' '1�����--
Revised February 2011
_ _ _ _
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:�cc:dent Report Page 1 of 1
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NMl� �OOIf1� dlNOl REYTNIGI ..�00�[9! [a1WOl RESIWC� �VNUVlR
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� Unit 1 was s/b Asbury at University with stop ry
03 I ` sign. Unit 2 was backing to clear snow from lane �x �
�a�TM a>Unit l. began. turn onto w/b N1 lane.. Unit 1 front O1
Ol N '"' ciqht collided with uit 2 rear left. L1ght damage ;
a,�,,,� , �_ _ �` unit 2 and moderate damage front left unit L. No '. �^��
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police officer Theodore Mackintosh &nbs
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http://dvslesupport.org/dvsinfo/accidentrecords_2008/Includes_LE/PrintReportIndiv_LE.... 12/27/2013
LATUFF BROS., INC.
880 UNIVERSITY AVENUE
ST. PAUL, MINNESOTA 55104
(651)224-2828 FAX: (651)291-0677
FEDERAL ID#41-0777034
"**PRELIMINARY ESTIMATE'*'
12/30/2013 01:45 PM
Owner
Owner: AYWISHE MESERET
Address: 1061 HALL AVE Work/Day:
Cell: (651)890-2311
City State Zip: West Saint Paul, MN 55118 FAX:
--_ ---- —
--
Inspection _!
Inspection Date: 12/30/2013 01:44 PM Inspection Type: Drive In
Inspection Location: Latuff Brothers Inc Contact:
Address: 880 University Ave Work/Day: (651)224-2828x
FAX: (651)291-0677x
City State Zip: Saint Paul, MN 55104 Work/Day:
Email: general@latuffbrothers.com
Primary Impact: Right Front Corner Secondary Impact:
Driveable: Yes Rental Assisted:
Appraiser Name: ROBERT LATUFF Appraiser License#:
Repairer
Repairer: Latuff Brothers Inc Contact:
Address: 880 University Ave Work/Day: (651)224-2828
FAX: (651)291-0677
City State Zip: Saint Paul, MN 55104 Work/Day:
Email: general@latuffbrothers.com
Remarks
CUSTOMER ALREADY REPLACED RT HEADLAMP PRIOR TO ESTIMATE
*'*�**"**'PRELIMINARY ESTIMATE"""�""""""
POSSIBLE ADDITIONAL DAMAGE MAY BE FOUND AFTER TEAR DOWN
Vehicle
1999 Chevrolet Malibu STD 4 DR Sedan
6cyl Gasoline 3.1
4 Speed Automatic
Lic.Plate: SMG491 Lic State: MN
Lic Expire: VIN: 1G1ND52M1X6223820
Prod Date: 04/1999 Miteage:
Veh Insp#: Mileage Type: Actual
Condition: Code: U2633A
Ext. Color: GOLD Int. Color:
Ext. Refinish: Two-Stage Int. Refinish: Two-Stage
Options
12I30/2013 01:50 PM Page 1 of 4
��'!- .. ._�:tai�bu STD 4 DR Sedan
�z��� 12/30/20'13 01:45 PM
AR1 Fh" Stereo Tape Air Conditioning Anti-Lock Brakes
Center Console Cruise Control Digitaf Clock
Dual Airbags Intermittent Wipers Keyless Entry System
Power Brakes Power poor Locks Power Mirrors
Power Steering Power Windows Rear Window Defroster
Rem Trunk-L/Gate Release Tachometer Tilt Steering Wheel
Tinted Glass Velour/Cloth Seats
Damages
Line Op Guide MC Description MFR.Part No. Price ADJ% B% Hours R
Stripes And Mouldinas
1 RI 244 MIdg,Front Door Side RT R 8�I Assembly 0.3 SM
2 RI 261 MIdg,Rear poor Side RT R&I Assembly 0.3 SM
Front Bumper
3 E 6 Cover,Front Bumper 12463112 GM Part $302.27 3.2 SM
4 L 6 13 Cover,Front Bumper Refinish 3.7 RF
2.6 Surface
0.6 Two-stage setup
0.5 Two-stage
Front End Panel And Lamps
5 RI 42 Headlamp Assy,Halogen RT R&I Assembly INC SM
» CUSTOMER ALREADY REPLACED PRIOR TO ESTIMATE
6 E 56 Lamp,Side Marker RT 16`.i22558 GM Part $12.08 INC SM
FroM Bodv And Windshield
7 I 83 Panel,Hood Re�air 2.5' SM
8 L 83 Panel,Hood Refinish 3.5 RF
2.9 Surface
0.6 Two-stage
9 E 104 Fender,Front RT 22602678 GM Part $96.72 2.6 SM
10 L 104 Fender,Front RT Refinish 2.8 RF
1.8 Surface
0.5 Edge
0.5 Two-stage
Front Bodv Interior Sheetmetal
11 E 152 Skirt,lnner Fender RT 22603518 GM Part $48.18 INC SM
12 E 112 Shield,Front Splash RT 22610204 GM Part $29.42 INC SM
Front Doors
13 RI 1910 Speaker,Front Door RT R&I Assembly 0.2 SM
14 EU 208 Door Assembly,Front RT Replace Recycled $390.00' 1.7 SM
15 L 208 Door SheIl,Front RT Refinish 3.5 RF
1.9 Surface
1.0 Edge
0.6 Two-stage
16 RI 240 W/Strip,Belt Outer RT R&I Assembly INC SM
17 RI 218 Mirror,Sport R/C RT R& I Assembly INC SM
18 RI 110 Channel,Front Glass Ru RT R&I Assembly 1.1 SM
19 RI 212 Hinge,Front Door Upr RT R& I Assembly 0.2 SM
20 RI 214 Hinge,Front Door Lwr RT R&I Assembly 0.2 SM
21 RI 283 Rod,Front Door Check RT R& I Assembly 0.2 SM
22 RI 222 Lock,Front Door RT R&I Assembly 0.4 SM
12I30/2013 01:50 PM Page 2 of 4
�9i%r'-�.—e�`."a!�bu STD 4 DR Sedan
_m�s 12/30/2013 01:45 PM
f�8f DOOfS
23 6R 290 Pnl,Rear poor Outer RT Blend Refinish 1.0 RF
0.7 Blend
0.3 Two-stage
2� RI 335 W/Strip,Belt Outer RT R& I Assembly 0.2 SM
25 RI 306 Handle,RR Door Outer RT R& I Assembly 0.6 SM
Manual Entries
26 L M14 Corrosion Protection Refinish 0.3' RF
27 N M17 Cover Car Exterior Additional Labor $7.00" 0.0' RF
28 SB M60 Hazardous Waste Removal Sublet Repair $5.00" SM
29 EC CLEAN AND REBACK SD MLDG Replace Economy $6.00' 0.6' SM`
»2 MLDGS
29 Items
MC Message
13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE
, ._ __—_---- ----
Estimate Total&Entries
Gross Parts $488.67
Other Parts $403.00
Paint Materials $473.60
Parts & Material Total $1,365.27
Tax on Parts&Material @ 7.625% $104.10
Labor Rate Replace Repair Hrs Total Hrs
H rs
Sheet Metal (SM) $52.00 11.8 2.5 14.3 $743.60
Mech/Elec(ME) �85.00
Frame(FR) �'S ��
Refinish(RF) $52.00 14.8 14.8 $769.60
Paint Materials $32.00
LaborTotal 29.1 Hours $1,513.20
Sublet Repairs $5.00
Gross Total $2,987.57
Net Total $2�98�•5�
Alternate Parts No
SPPL Yes Zip Code: 55104 Default
Audatex Estimating 7.0.123 ES 12/30/2013 01:50 PM REL 7.0.123 DT 11/01/2013 DB 12/15/2013
Copyright(C)2013 Audatex North America, Inc.
3.1 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO-STAGE REFINISH FORMULA.
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.
12l30/2013 01�50 PM Page 3 of 4
I I ,
�
. , �
1999 Chevrolet Malibu STD 4 DR Sedan
Claim#: 12130/2013 01:45 PM
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/Rebuiit
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
This report contains proprietary information of Audatex and may not be disclosed to any third party(other than
�;�_°- the insured, daimant and others on a need to know basis in order to effectuate the claims process)without
Aucla�ex Audatex's prior written consent.
., ����.� .: �� �.s
��'a""` ' Copyright(C)2013 Audatex North America, Inc.
Audatex Estimating is a trademark of Audatex North America, Inc.
I
12/30/2013 01:50 PM Page 4 of 4
' ABRA Auto Body & Glass - Midway Workfile ID: c59349a7
FederalID: 41-1852119
Right The First Time...On Time
1190 UNIVERSITY AVE: W, SAINT PAUL, MN 55104
Phone: (651) 645-1563
FAX: (651) 641-6129
Preliminary Estimate
Customer: MESERET, AYWISHE ]ob Number:
Written By: Pat Kearin
Insured: MESERET,AYWISHE Policy #: Claim #: *
Type of Loss: Date of loss: 12/27/2013 12:00:00 PM Days to Repair: 0
Point of Impact: O1 Right Front
Owner: Inspection Location: Insurance Company:
MESERET,AYWISHE ABRA Auto Body&Glass- Midway Unknown Insurance
1061 HALL AVE 1190 UNIVERSITY AVE W
W ST PAUL, MN 55118 SAINT PAUL, MN 55104
(651)890-2311 Business Repair Facility
(651)645-1563 Business
VEHICLE
Year: 1999 Body Style: 4D SED VIN: iG1ND52M1X6223820 Mileage In: 5555555
Make: CHEV Engine: 6-3.1L-FI License: SMG-491 Mileage Out:
Model: MALIBU Production Date: State: MN Vehicle Out:
Cs.;�: BEIGE I�:: Condition: Job #:
TRANSMISSION Body Side Moldings FM Radio Bucket Seats
Automatic Transmission Console/Storage Stereo WHEELS
Overdrive CONVENIENCE SAFETY Wheel Covers
POWER Air Conditioning Drivers Side Air Bag PAINT
Power Steering Intermittent Wipers Passenger Air Bag Clear Coat Paint
Power Brakes Tilt Wheel Anti-Lock Brakes(4) OTHER
DECOR RADIO SEATS Power Trunk/Gate Release
Dual Mirrors AM Radio Cloth Seats
1/2/2014 2:22:10 PM 011906 Page 1
� Preliminary Estimate
Customer: MESERET, AYWISHE Job Number:
Vehicle: 1999 CHEV MALIBU 4D SED 6-3.1L-FI BEIGE
Line Oper Description Part Number Qty Extended Labor Paint
Price$
1 FRONT BUMPER
2 ** <> Repl A/M Bumper cover 12463112 1 257.00 1.4 3.0
3 Add for Clear Coat 1•z
4 GRILLE
5 R&I R&I grille assy Incl.
6 FRONT LAMPS
7 ** Repl A/M CAPA RT Headlamp assy 22618781 1 119.00 0.3
g Aim headlamps 0.5
9 ** Repl A/M RT Side marker lamp 16522558 1 9.00 Incl.
10 HOOD
11 * Rpr Hood 3_0 2.8
12 Overlap Major Non-Adj. Panel -0•2
13 Add for Clear Coat 0.5
14 FENDER
15 ** Repl A/M CAPA RT Fender 22602678 1 82.00 2.6 2.2
16 Overlap Major Adj. Panel -0.4
17 Add for Clear Coat 0.4
lg Add for Edging 0.5
19 Deduct for Overlap -0.3
Zn �• Repl A/M RT Liner extension 22610204 1 23.00 Incl.
�_ •• Repl A/M RT Fender liner 22603518 1 38.00 Incl.
22 WHEELS
23 Repl RT/Front Wheel cover 9593869 1 65.40
24 # Subl �2 Wheel Alignment 1 69.95 X
25 FRONT DOOR
26 * Repl LKQ RT door assy+30% 22708736 1 325.00 2.0 3.0
27 Overlap Major Adj. Panel -0.4
Zg * Add for Clear Coat 0.5
Z9 R&I RT Upper w'strip 0.3
30 R&I RT Door w'strip 0.5
31 R&I RT Applique �'Z
32 * Repl LKQ RT Body side mldg 22594614 1 Incl. 0.3 0.4
33 * Add for Clear Coat 0.1
34 R&I RT Mirror w/o electric 0.3
35 R&I RT Handle,outside white 0.4
36 * R&I RT R&I trim panel Incl.
37 REAR DOOR
3g Blnd RT Outer panel 0'9
39 R&I RT Applique �'Z
40 * R&I RT Belt w'strip inner 0=2
41 R&I RT Handle,outside white 0.4
4Z R&I RT R&I trim panel 0.4
1/2/2014 2:22:10 PM 011906 Page 2
Preliminary Estimate
Customer: MESERET, AYWISHE Job Number:
Vehicle: 1999 CHEV MALIBU 4D SED 6-3.1L-FI BEIGE
43 MISCELLANEOUS OPERATIONS
44 # Refn �Car Cover 0.1
45 # Refn �Corrosion Protection 0.3
46 # Repl �Flex Additive/Adhesion Promoter 1 8.50 T
47 # �Hazardous Waste 1 5.00 X
SUBTOTALS 1,001.85 12.7 14.9
NOTES
Prior Damage Notes:
1
ESTIMATE TOTALS
Category Basis Rate Cost$
Parts 918.40
Body Labor 12.7 hrs @ $54.00/hr 685.80
Paint Labor 14.9 hrs @ $54.00/hr 804.60
Paint Supplies 14.9 hrs @ $34.00/hr 506.60
Miscellaneous 83.45
Subtotal 2,998.85
Sales Tax $ 1,433.50 @ 7.6250% 109.30
Grand Total 3,108.15
Deductible 0.00
CUSTOMER PAY 0.00
INSURANCE PAY 3,108.15
THIS IS A VISUAL INSPECTION ONLY. THERE MAY BE ADDITIONAL DAMAGE AFTER DISASSEMBLY. PARTS ARE
SUBJECT TO INVOICE. THERE ARE NO GUARANTEES ON RUST REPAIRS.
"Minnesota law gives you the right to choose any rental vehicle company, and prohibits me from requiring you to
choose a particular vendor."
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.
1/2/2014 2:22:10 PM 011906 Page 3
Preliminary Estimate
Customer: MESERET, AYWISHE Job Number:
Vehicle: 1999 CHEV MALIBU 4D SED 6-3.1L-FI BEIGE
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide
DE1CP97, CCC Data Date 12/16/2013, 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 symbols that may be used to describe work to be done or parts to
be repaired or replaced:
SYMBOLS FOLLOWING PART PRICE:
m=�10TOR Mechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category.
X=Mixellaneous 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.
1/2/2014 2:22:10 PM 011906 Page 4
' Preliminary Estimate
Customer: MESERET, AYWISHE Job Number:
Vehicle: 1999 CHEV MALIBU 4D SED 6-3.1L-FI BEIGE
ALTERNATE PARTS SUPPLIERS
Supplier: Keystone-Complete-Minneapolis
Location(s): 3615 MARSHALL STREET NE, MINNEAPOLIS MN 55418 (800)328-1845 (612)789-1919
Line Description Item # Price
2 A/M Bumper cover GM1000540PP $257.00
15 A/M CAPA RT Fender GM1241254PP $82.00
21 A/M RT Fender liner GM1249120 $38.00
Supplier: Keystone-P+A-Minneapolis
Location(s): 3615 MARSHALL STREET NE, MINNEAPOLIS MN 55418 (800)328-1845 (612)789-1919
Line Description Item # Price
7 A/M CAPA RT Headlamp assy GM2503154C $ 119.00
9 A/M RT Side marker lamp GM2551171 $9.00
Supplier: Wheelers Auto Body Supply
Location(s): 6150 CLAUDE WAY, INVER GROVE HEIGHTS MN 55076 (866)435-7015 (651)379-0808
Line Description Item # Price
20 A/M RT Liner extension GM1249121 $23.00
1/2/2014 2:22:10 PM 011906 Page 5
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