Noll � ��l�Cl V CU
MAR 11 2014
NOTICE OF CLAIM FORM to the City of Saint Paul, Minnes�o� CLERK
Minnesota State Statute 466.05 states that"...every person...who claims damages from any municipality...shall cause to be presented to the
governing body of the municipality wethin 180 days after the alleged loss or injury is discovered a notice stating the time,p(ace,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 w�l not be contacted by telephone to clarify answers,so provide as
much information as necessary to explain your daim,and the amount of rnmpensation being requested. Yon 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 T6is 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 ' iddle Initial��: Last Name �lr��l
Company or Business N e �
Are You an Insurance Company? Ye. No�� If Yes,Cl�aim Number? �
��_
Street Address r _�.� ;r < <" �,' � 1;1 C� `"�
City �'r'�" -.. .. State �` C-�..L .��'S'
, Zip Code
'^h �c- ` �, Z`.� �_ �.. � � %.
Daytime Phone(������ �Phone(� J� �- � 1. ,.��vening Telephone(�)����
Date of Accidend Injury or Date Discovered I / IC � Time `� '�'/pm
-� -
Please state,in detail, what occurred(happened),and why you are submitting a claim Please indicate why or how you
feel the City of Saint Paul or its employees are involved and/or responsible for your damages.
���1��� ,� 1��1�1
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 My vehicle was damaged by a plow
�My vehicle was wrongfully towed and/or ticketed ❑ I was injured on City property
❑ Other type of property damage—please specify
❑ Other type of injury—please specify
In order to process your claim vou need to include couies of all auulicable 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 enci�uraged to keep a
copy f�r yourself before submitting your claim form.
Property damage claims ta a vehicle: two estimates for the repairs to your vehicle if the damage exceeds
500.00; or the actual bills andlor receipts for the repairs
O Towing claims: legible copies of any ticket issued and a copy of the impound (ot receipt
O Other property damage claims: two repair estimates if the damage exceeds$500.00;or the actual bills
and/or receipts for the repai�-s;detailed list of damaged itemti
O Injury claims: medical bills, receipts
�tiotoQraphs are always welcome to document and support your claim but will not be retumed.
� �
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—ulease comnlete this section
Were there wimesses to the incident? Yes No Unknown (circle)
Provide their names,addresses and telephone numbers:
Were the police or law enforcement called? Yes No Unlrnown (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�ac� o�facility,
cl�est landmark,etc. PI ase�e as detailed as.,Possible. If necessary,attach a diagram.��(�!� �C�l�'�',�11.1.�
—;=��v�' \���f- � :�� Ct�1 � �����1
Please indicate the amount you are seeking in com nsation or what you would li th ;City to do to reso e � claim
to your sarisfaction. � F �\�,
Yehicle Claims— lease com lete this section ❑ch k box if this section dces not a 1
Your Vehicle: Year '`� �' Make � C " Model - '
License Plate Num State ' Color 1�;.-r'�
Registered Owner _� `
Driver of Vehic� �. ' ° . �
Area D�ma ed � � `�:C�.���- �. . �; , - ; • G7- ' "'`,�,;; '__
City Vehicle: Yearr Make � Model
License Plate Number State Color
Driver of Vehicle(City Employee's Name)
Area Damaged
Iniurv Claims—nlease complete this section �I check box if this section does not avnlv
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 � � l l,��
� � }�,' �'��->>
By signing this form,you are stating that all information you have provided is true and cor�ect to t e 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 Comp e�d� ' Fo •.T��_���� I
+\/�,
Signature of Person Making the Claim: � � ��
Revised February 2011
On the evening of January 18, 2014 my daughter, Rachel Noll, unknowingly
parked her car on a snow route at 2301 Nokomis Avenue. The vehicle was towed
by Bobby & Steve's towing per information provided at the impound lot located
at 1129 Caithlin Street in St. Paul. I arrived at the impound lot with my daughter
Rachel just prior to 3 a.m. the morning of January 19, 2014 to pay the fees and
pick up the vehicle. The forms were signed and we were directed to the remote
fairground lot where the vehicle was parked. We went to the unlit lot, and
provided our form to individual sitting in car, and were to directed to where our
form said car was located. Unfortunately the vehicle was not parked where
indicated and the lot attendant was of no assistance other than directing us to
drive around looking for it. 10 minutes later the vehicle was located. Without
light, and the proximity that the vehicle was parked to others, and the fact it was
now almost 3:30 am we did not inspect the vehicle before leaving the remote lot.
We drove the car home and parked in the driveway. The next morning at 10 am
my daughter left the house and found a dent in the passenger rear door. She
came back into the house and informed us of this information. I immediately
called the impound lot and informed them and they directed me to call the City of
St. Paul. I left a message immediately that day, and was called back the following
day and directed to call another dept. which then directed me to complete this
paperwork. The vehicle was parked in the driveway with a snowbank next to the
passenger side of the vehicle so it was not possible the damage occurred while
parked in driveway but rather when towed or in impound lot.
Two quotes to repair the damage are attached. The 2"d auto body shop indicated
the nature of the damage, no scratch marks, no scrapes, and no paint damage
were consistent with other towing damage they have seen.
� . .: - - �,- _ - -
.,� �.��� ,� �,., c c, ��• 24Q.ti�
- =- �3��. t��°„�t,�.,,��.��:.ribec!a.,.,v�. ��..t�u:,l.
.. ..:. :^YQ^:-a����ther Yf��ie�r:�����t
,:�s�_,...�_�_�.���E�u;�,��V����ie vvas in the custody of the Service Charge: $ 0.00
:�* Saint Paui Police Department. I acknowledge I will repo�
damage andlor any other problems to the impound Lot s#at� �:�ta€L�a��°s: � 2��.�:.'
on this form prior to leaving the impound iot.
Damage and/or other problem:
Police Report made:Yes_No_IF Yes, CN , if NO,Why?
TQ PROTECT YOUR RIGHTS REPORT ANY PROBLEMS/DAMAGE BEFORE LEAVING THE LOT
Signature ���
St. Paui Police Department for
� � Ramsey District Court
RECEIPT
Date/Time: 01/19/2014 02:55 Invoice#: 26207
Vehicle Plate: 872GXA/MN
Payor: OWNER Location Paid: Impound Snow Lot
Citation: Amount:
0900200851 � $ 56.00
Total Amount Paid: $ 56.00
Paid by: CREDIT CARD
KEEP THIS C�PY FOR YOUR RECORDS
OAKDALE COLLISION CENTER ,
1040 GERSHWIN AVENUE
ST. PAUL,MN.55128
PHONE:651-264-0909 FAX:651-264-0910
*"PRELIMINARY ESTIMATE"*
01/31/2014 02:38 PM
..._. .,_..___._____.___.....� -. �
`�_��_.....---_.___...______ _._.__..__�____ ___.._......___.__.._...____�__..____.._..__.___.....__.__..___._.___.____._...._________.__—�`______ .___�
Owner: Lisa Noll
Address: 7572 Upper 23rd St N WorklDay: (651)226-3683
City State Zip: Oakdale,MN 55128 F�=
____ __.._.,
__.___��_ _.__..__.__.___.��__�..__.�.__.._._...___.__—_____._ ,
Inspection _w__�.�____.....�___ '
Inspection Date: 0'�131/2014 02:40 PM Inspection Type:
Inspection Location: OAKDALE COLUSION CENTER CoMact: DON JUEN
Address: 1040 GERSHWIN AVE. Work/Day. (651�6�t-0909x
Oakdalecoliisian@msn.com FAX: (651)264-0910x
City State Zip: OAKDALE,MN 55128 FAX:
Email: Oakdafecollision�msn.00m
Primary Impact: Right Side Secondary Impaet:
Company: OAKDALE COLUSION Appraiser License#:
Corrtact: DON JUEN JR.
Address: 1040 GERSHWIN AVE N Work/Day: (651�264-0909
City Stabe Zip: Oakdale,MN 55128 FAX: (651)264-0910
..___._._�___ ______�___
! Repairer
_.__ _ _._...__. .,_.____ � ---�_.. _.__.____�_____._� �.__.__ _.�_.__�!
Repairer: OAKDALE COLUSION CENTER Contact: DON JUEN
Address: 1040 GERSHWIN AVE. Work/DaY: t65�)264-0909
Oakdalecollision�msn.com FAX: (651)264-0910
City State Zip: OAKDALE,MN 55128 FAX:
Email: Oakdalec�ilision(c�msn.com
_.Vehicle � `
2002 Chrysler Concorde LXi 4 DR Sedan
6cyl Gasoline 3.5
4 Speed Automatic
�ic Expi�e: VIN: 2C3HD36Mb2H177962
Veh Insp#: Mileage Type: Adual
Condition: Code: M2713B
Ext.Refinish: Two-Stage Int Refinish: Two-Stage
Options
AM/FM CD Player Air Conditioning Alarm System
Aluminum/Alloy Wheeis Autornatic Dimming Mirror Budcet Seats
Center Console Climate Control For PJC Cruise Control
Dual Airbags Fo9 Lights Garage Door Ope�er
Intermittent Wipers Keyless Entry System Leather Seats
Leather Steering Wheel Lighted Entry System Power Brakes
Power poor Lodcs Power Drivers Seat Power Mirrws
Power Steering Power Windows Rear Window Defroster
2002 Chtysler Cw�corde LXi 4 DR Sedan
Claim#: 01f3�120'14 02:38 PM
Rem Trunk-UGate Release Strg Wheel Radio Control Tachometer
Tiit Steering Wheel Tinted Glass Trip Computer
Wood Interior Trim
,.._
__�M_.n�.. r.�....�,.�_..__ ..._.. __�.n._,�.�__ -._.�., ._.___�_...f
; Damages ___�1
Line Op Guide MC Description MFR.Part No. Price ADJ% B°k Hours R
St_ri�s And Mouldinas
1 RI 93 Cladding,Rocker Panel RT R 8�I Assembly 0.4 SM
2 RI 95 MIdg,Front Door Side RT R&I Assembly 0.3 SM
3 E 392 01 MIdg,Rear poor Side RT 5018311AA $69.20 0.3 SM
84��
4 BR 341 Panel,Roof Biend Refinish 1.9 RF
1.3 Biend
0.6 Two-stage
5 RI 343 Glass Panel,Roof R&1 Assembly 0.6 SM
Front Doors
6 BR 210 13 Pni,Front Door Outer RT Blend Refinish 2.1 RF
1.0 Blend
0.6 Two-stage setup
0.5 Two-stage
7 RI 247 MIdg,Front Door Scalp RT R&I Assembly 0.8 SM
8 RI 284 Mirror,0uter R/C RT R&I Assembly INC SM
9 RI 228 Handle,Front Door Otr RT R 8�I Assembly 1.2 SM
Rear poors
10 EU 288 Door Assembly,Rear RT Replaoe Recyded $25d.00' +25.OQ 1.8 SM
11 L 288 Door SheIl,Rear RT Refinish 3.6 RF
2.0 SurFace
1.0 Edge
0.6 Two-stage
12 RI 314 MIdg,Rear poor Scalp RT ft&I Assembly 0.5 SM
13 RI 302 lock,Rear poor RT R 8�I Assembly 0.4 SM
14 RI 334 Rod,Rear poor Chedc RT R&I Assembly 0.2 SM
Quarter And Rocker Panel
15 BR 390 Panel,Quarter RT Blend Refinish • 1.4 RF
1.0 Blend
0.4 Two-stage
Rear Bumcer
16 N 566 Rear Bumper Cover R&I Additional Labor 1.3 SM
Rear Bodv.Lamos And Floor Pan
17 RI 534 Taillamp Assembly RT R&I Assembly 0.3 SM
Manual EnMes
1R SB HAZARD.WSTE.REM. Sublet Repair �4.00' SM
'i9 EC COVER CAR EXTERIOR Replace Economy $4.00` SM
1u tC CORROSION PROTECTION Repiace Eoonomy 0.3* RF
St;`
�'r � iKl sr'C vy!!4L�E�lC�i! rt+�fii11�1a �-Jr.
� � r20Pt W�CK GtASS f�efiriish "v.�* Si4�S*
22 Items
N!C !�less3c.s�
2002 Chrysler Cor�cade LXi 4 DR Sedan
Clajm g: 0�l31/2014 0738 PM
01 CALL DEALER FOR EXACT PART#/PRICE
13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE
� Estimate Total&Entries �.�.__��___��.� _.__.�...�__,._ _��__�___...,m_w_.;
Gross Parts $69.20
Other Parts $254•UO
Paint Materials $297.60
Line Item Markup $62.50
Parts$Material Total � $683.30
Tax an Parts 8 Material @ 7.125% $48.69
Labor Rate Replace Repair Hrs Total Hrs
Hrs
Sheet Metat(SM) $52.00 7.4 1.3 8.7 $452.40
Mech/Elec(ME) $80.00
Frame(FR) $71.00
Refinish(RF) $52.00 9.3 9.3 $483.60
Pairrt Materials $32.00
Labor Totai 18.0 Hours $936.00
Subiet Repairs $4-00
Gross Total 51,671.99
Net Total ;�.671•�
Altemate Parts No
?±�!���x Estimating 7.0.123 ES 01/31/2014 02:46 PM RE�7.0.123 DT 01/0112014 DB 01t15/2014
,��.,;s��:�;�j�u13 Audatex Nw�th America,Inc.
i.;�;��:�.�3;�A11u�v TO 7'HIS ESTIMATE BASED ON AUDATEX'S TWO-STAGE REFINISH FORMULA.
�.._.s..�� ..... ..... .��....�...�_..� ,. �..�.. .�,.......�. .. ----- � , e._ _ _ __ ,_ . _
�v�unr9 i�vr4LVV�ei e iv vvi:�+3 a e ez c.__�_v:e�r_-cc����•�• — v _ .. _ . . . - _ _. . . _ . ..
�i.�s�`.j,i���.
----- —�_---- -�,v -��i•: r`'_�p%-n�D R�fiEi� :=1iV T�l� i1SE OF ONE OR MORE CR.ASH PARTS
-
_ _
�f_ S?arstarn�rnnnm�i tlF- �?on!ara QYR!!l�Cml� }l�= L?nnlo�a PlG C�:r�^.l�:c
�—: o e:�::ts.^nc >;i!_ --,e::te�i ii�.^.�E: ._ _ -. ....._. . _._..,
f]I'[- nit!1111 Rt':1tf1�111 ! � T\CUdI/ 1 t - �c3Fti�li SE['�€FAt�
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
'� ����#'�!� Audatex's prior written consent.
a Sradefi�rer�n�
Copyright(C)2013 Audatex North America,inc.
Audatex Esstimating is a trademark of Audatex North America,inc.
0113112014 02:46 PM Page 4 of 4
CENTURY AVENUE COLLISION CENTER
WHERE QUALITY&SERVICE COMES FIRST
2501 CENTURY AVENUE
2 BLOCKS SOUTH OF HWY 36
', PHONE:651-777-6055 FAX: 651-779-9417
,
�•
�''�""PRELIMINARY ESTIMATE"**
_. __ _ 01/31/2014 03:25 PM
__T_.—_..__�,�---___._.__�—� �_
iOwner ..___._.. ---
Owner: LISA NOLL
Address: 4572 UPPER 23RD ST N Work/Day: (651)737-3090
Home/Evening: (651)777-5039
City State Zip: Oakdale, MN 55128 Cell: (651)226-3683
Email: NOLLFAMILY4@MSN.COM
_____�._____.____._.___._.. _ ..— �
� Inspection _ F �__.�_ i
Inspection Date: 01/31/2014 03:24 PM Inspection Type: Drive In
Inspection Location: Century Avenue Collision Contact: Garry Olson
Address: 2501 Division Street North Work/Day: (651)777-6055x
City State Zip: North Saint Paul, MN 55109-3111 Work/Day:
Primary Impact: Right Side Secondary Impact:
Appraiser Name: Garry Olson Appraiser License#:
�_--____._�.-------- -- -- --- --- • �
i Repairer _ _
' ----__._____
Repairer: Century Avenue Collision Contact: Garry Olson
Address: 2501 Division Street North Work/Day: (651)777-6055
City State Zip: North Saint Paul, MN 55109-3111 Work/Day:
---- - -____._ m
�Remarks
_.____._�._F__...__�� �...�__ —.
CHECK INNERS AT TEARDOWN
LKQ CHECKED AAA 651-322-6884, HUGO 651-429-5420, LKQ MN 8664814480
ESTIMATOR WILL NOT APPEAR IN COURT WITHOUT FEES FOR TIME
Vehicle � � ^ �.
2002 Chrysler Concorde LXi 4 DR Sedan
6cyl Gasoline 3.5
4 Speed Automatic
Lic.Plate: 872 GXA Lic State: MN
Lic Expire: 07/2014 VIN: 2C3HD36M02H177962
Prod Date: 02/2002 Mileage: 140,958
Veh Insp#: Mileage Type: Actual
Condition: Code: M2713B
Ext.Color: GOLD Int.Color:
Ext. Refinish: Two-Stage Int. Refinish: Two-Stage
Ext.Paint Code: PKJ Int.Trim Code:
Options
AM/FM CD Player Air Conditioning Alarm System
Aluminum/Alloy Wheels Automatic Dimming Mirror Bucket Seats
Ot/31Y2014 03:34 PM Page 1 of 4
2002 Chrysler Concorde LXi 4 DR Sedan
Claim#: 01/31/2014 03:25 PM
Center Console Climate Control For A/C Cruise Control
Dual Airbags Fog Lights Garage Door Opener
Intermittent Wipers Keyless Entry System Leather Seats
Leather Steering Wheel Lighted Entry System Metallic Paint
Power Brakes Power poor Locks Power Drivers Seat
Power Mirrors Power Moonroof Power Steering
Power Windows Rear Window Defroster Rem Trunk-UGate Release
Strg Wheel Radio Control Tachometer Tilt Steering Wheel
Tinted Glass Trip Computer Wood Interior Trim
Damages � � �
Line Op Guide MC Description MFR.Part No. Price ADJ% B% Hours R
Strines And Mouldinas
' 1 I 93 ^ Cladding,Rocker Panel RT Repair 0.5" SM
2 L 93 13 Cladding,Rocker Panel RT Refinish 1.3 RF
0.6 Surface
0.6 Two-stage setup
0.1 Two-stage
3 RI 93 Cladding,Rocker Panel RT R& I Aissembly 0.4 SM
4 RI 95 MIdg,Front Door Side RT R&i Assembly 0.3 SM
5 E 392 01 MIdg,Rear poor Side RT 5018311AA $69.20 0.3 SM
Front Doors
6 BR 210 Pnl,Front Door Outer RT Blend Refinish 1.3 RF
0.9 Blend
0.4 Two-stage
7 RI 247 MIdg,Front Door Scalp RT R& I Assembly 0.8 SM
8 RI 284 Mirror,0uter R/C RT R& I Assembly INC SM
9 BR 228 Handle,Front Door Otr RT Blend Refinish 0.2 RF
0.1 Blend
0.1 Two-stage
10 RI 228 Handle,Front Door Otr RT R&I Assembly 1.2 SM
Rear poors
11 EU 288 DoorAssembly,Rear RT Replace Recycled $250.00" +25.00 1.8 SM
12 L 288 Door SheIl,Rear RT Refinish 3.6 RF
2.0 Surtace
1.0 Edge
0.6 Two-stage
13 RI 318 W/Strip,RR Door Lower RT R&I Assembly INC SM
14 RI 316 W/Strip Assy,RR Door RT R&I Assembly INC SM
15 RI 314 MIdg,Rear poor Scalp RT R&I Assembly 0.5 SM
16 RI 296 Glass,Rear poor T RT R&I Assembly 0.6 SM
17 RI 334 Rod,Rear poor Check RT R&I Assembly 0.2 SM
18 BR 306 Handle,RR Door Outer RT Blend Refinish 0.2 RF
0.1 Blend
0.1 Two-stage
19 RI 306 Handle,RR Door Outer RT R&I Assembly INC SM
Quarter And Rocker Panel
20 1 390 Panel,Quarter RT Repair 0.5" SM
21 L 390 10 Panel,Quarter RT Refinish 2.5" RF
2.0 Surface
0.5 Two-stage
»PARTIAL PAINT FULL CLEAR
Deck Lid And Back Glass
01/31l2014 03:34 PM Page 2 of 4
2002 Chrysler Concorde LXi 4 DR Sedan
Claim#: 01/31/2014 03:25 PM
22 I 369 Back Glass,Heated Repair 0.3' SM
»LIFT TAPE FOR REFINISH
Rear Body.Lamns And Floor Pan
23 RI 534 Taillamp Assembly RT R& I Assembly 0.3 SM
Manual Entries
24 L Corrosion Protection Refinish 0.3" RF*
25 EC Cover Car Exterior Replace Economy $5.00* SM
26 SB Hazardous Waste Removal Sublet Repair $3.00' SM
27 I CLEAN AND RETAPE MLDG Repair 0.3* SM`
28 I LOOSEN REAR COVER Repair 0.5* SM"
28 Items
MC Message
01 CALL DEALER FOR EXACT PART#/PRICE
10 INCLUDES AUDATEX TIME TO CLEAR ENTIRE PANEL
13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE
(�Estimate Total&Entries � �^
L�__��
Gross Parts $69.20
Other Parts $255.00
Paint Materials $300.80
Line Item Markup $62.50
Parts 8�Material Total $687.50
Tax on Parts 8�Material @ 7.125% $48.98
Labor Rate Replace Repair Hrs Total Hrs
Hrs
Sheet Metal(SM) $52.00 6.4 2.1 8.5 $442.00
Mech/Elec(ME) $80.00
Frame(FR) $80.00
Refinish(RF) $52.00 9.4 9.4 $488.80
Paint Materials $32.00
Labor Total 17.9 Hours $930.80
Sublet Repairs $3.00
Gross Total $1,670.28
Net Total $1,670.28
Alternate Parts Y/00/00/00/00/00 CUM 00/00/00/00/00 Zip Code: 55109 Default
Audatex Estimating 7.0.123 ES 01/31/2014 03:34 PM REL 7.0.123 DT 07/01/2014 DB 01/15/2014
Copyright(C)2013 Audatex North America,Inc.
2.4 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 MAN[JFACTURER OF YOUR MOTOR VEHICLE.
WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE PARTS
01/31/2014 03:34 PM Page 3 of 4
2002 Chrysler Concorde LXi 4 DR Sedan
Claim#: Ot/31l2014 03:25 PM
MAN[7FACTURER OR DISTRIBUTOR RATHER THAN BY THE MANL7FACTURER 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
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.
d Solr�a compan�
Copyright(C)2013 Audatex North America, Inc.
Audatex Estimating is a trademark of Audatex North America, inc.
01/31/2014 03:34 PM Page 4 of 4
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