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Yannarelli LMG 4/3/2014 11 :32 :51 AM PACE 1/017 Fax Server Safeco Insurance Company of Indiana Mailing Address: � � 3' '' P O.Box 515097 Los AngelesSCA 9005I-5097 « � ��'"'��' �'��t` Los Angeles,CA 90051-SU97 ;4....:c'f�: `�t:.....':�<,;;i°�. ?t� Phone: (800)332-3226 . . . Fax: (888)268-8840 Apri13, 2014 RECEIVED Minnesota Dept Of Transportation APR 0 3 2014 City Clerks Office 310 City Hall 15 Kellogg Blvd CITY CLERK Saint Paul,MN 55102 Attn: Sandra SUBROGATION NOT[CE Our Insured Name: Richard P Yannarelli Our Claim Number: 395578055033 Loss Date: January 18, 2014 Your Insured: Justin Charles Knabe Your Claim Number: 1046 Dear Minnesota Dept Of Transportation: We have completed our investigation of the above loss.Our investigation indicates that your insured is liable for the damages to our insured's property.Under our insured's policy,we have become legally subrogated to the right of our insured to recover from your policyholder.As such, we are seeking reimbursement from you for the damages we paid out on behalf of our insured. Enclosed please find the documentation that will support the claim. Collision: $3,101.12 Rental: $349.88 Deductible: $500.00 Property Damage TOTAL: $3,951.00 Please issue your check payable to Safeco Insurance Company of Indiana,Attn: Subrogation Cashier,PO Box 461,St.Louis,MO 63166. Please direct all future subrogation correspondence to the Subrogation Department at the mailing address noted above. If you have any questions,please reach out to the subrogation handler Jason Slager at 800-332-3226 ext. 7678673 or 636-326-8673. He can also be reached via email at Jason.Sla�erC�safeco.com. cnaoso a�os LMG 4/3/2014 11 : 32 : 51 AM PAGE 2/017 Fax Server Page 2 Richard P Yannarelll Apnl 3,2014 c,aaoso avos LMG 4/3/2014 11 : 32 : 51 AM PAGE 3/017 Fax Server HEPPNER'S AUTO BODY (Downtown) Nlorkfile ID: c772692a 395 E. 7TH ST.,SAINT PAUL, MN 55101 Phone; (651)224-5644 FAX: (651)224-6042 Supplement of Record 2 with Summary Customer: YANNARELLI, RICHARD P 7ob Number: 15767 Written By: Grant Almeida, 1/31/2014 8:13:15 AM Adjuster: MOORE,QUTANA,(317)509-4030 Business Insured: YANNARELLi, RICMARD P Policy#: X5562126 Claim#: 395578055033-201 Type of Loss: COLL-Collision Date of Loss: 1/18/2014 1:00:00 PM Days to Repair: 7 Point of Impad: il Left Front Owner: Inspcction Location: Insuranae Company: YANNARELII, RICHARD P HEPPNER'S AUTO BODY(Downtown) SAFECO INSURANCE COMPANY OF INDIANA 66 9TH ST E 395 E.7TH ST. PLSA SAINT PAUL,MN 55101-4700 SAINT PAUL, MN 55101 P.O. BOX 515097 (651)224-1867 Evening Repair Facility LOS ANGELES,CA 90051 (651)771-5596 Day (651)224-5644 Business (317)509-4030 Business VEHICLE Year: 2004 Body Style: 4D UN VIN: 1]4GW48544C297931 Mileage In: 121298 Make: JEEP Engine: 6-4.Ol-FI License: VC]454 Mileage Out: Model: GRAND CHEROKEE 4X4 Production Date: 11/2003 State: MN Vehicle Out: LAREDO Color: red Int: Condition: ]ob #: 15767 TRANSMISSION DECOR RADIO Luggage/Roof Rack Automatic Trensmission Dual Mirrors AM Radio SEATS Overdrive Body Side Moldings FM Radio Cloth Seats 4 Wheel Drive Privacy Glass Stereo Bucket Seats POWER Console/Storage CD Player WHEELS Power Steering CONVENIENCE SAFETY Aluminum/Alloy Wheels Pawer Brekes Air Conditioning Drrvers Side Alr Bag PAINT Power Windows Intermittent Wipers Passenger Air Bag Clear Coat Paint Power Locks Tilt Wheel Anti-Lock Brakes(4) Power Mirrors Cruise Control 4 Wheel Disc Brekes Power Driver Seat Rear Window Wiper ROOF 1/31/2014 8:13:18 AM 070412 Page 1 LMG 4/3/2014 11 :32 :51 AM PAGE 4/017 Fax Server Supplement of Record 2 with Summary Customer: YANNARELLI,RICHARD P ]ob Number: 15767 Vehicle: 2004 JEEP GRAND CHEROKEE 4X4 LAREDO 4D UN 6-4.OL-FI red Line Oper Description Part Number Qty Extended Labor Paint Price$ 1 FRONT BUMPER 2 0/H bumper assy 1.6 3 Repl Bumper cover Laredo,Sport SJF8IZSPAC 1 280.00 Incl. textured gray,w/o fog iamps NOTE: NO LKQ PART AT THIS TIME PER CARRIE 1-866-483-4472 4 R&I License brecket 0.2 ................................................................................................................................................................................................................................................ S GRILLE 6 ** Repl A/M AQRP Grille Laredo,Sport 68039844AA 1 233.00 Incl. 1.2 primed NOTE: NO LKQ AT THIS TIME PER CARRIE 1-866-483-4472 7 Add for Clear Coat 0.5 __. _.... . _. ., _ _ _ 8 FRONT LAMPS 9 ** 501 Repl A/M AQRP LT Headlamp assy 55155129A7 1 152.00 n�,l. Laredo,Sport from 1-14-02 10 Aim headlamps 0.5 11 * 501 Repl LKQ Mount panel+25% 55156753AD 1 218.75 1.6 NOTE: LABOR:Time is after bumper rnver is removed.Time includes R&I/R&R headlamp assemblies and grille. .............................................................................................................................................................................................................................................................. 12 HOOD 13 Blnd Hood 1.4 14 R&I Insulator 0.3 15 Repl Nameplate"]eep"chrome 55155622AB 1 52.35 0.2 16 FENDER 17 * Repl LKQ LT fender assy+25% 55135901AC 1 106.25 1.9 2.0 18 Overlap Major Adj.Panel '0•4 19 Add for Clear Coat 0.3 20 * SO1 Repl LT Lower cladding Laredo argent 5FR17ZSPAC 1 74.25 0.2 Q,Q 21 SO1 Repl LT Fender liner 55136229AD 1 56.35 0.3 22 Repl Medallion driver side"TRNL 55157106AA 1 39.45 0.2 RATED 4x9" 23 * SOl Rpr LT Apron panel s 9,Q 1.0 24 * 501 Rpr LT Side panel s 4_0 1.0 25 SO1 Overlap Major Non-Adj.Panel '�•z 26 tf 501 Rpr BODY PULL LT INNER FENDER 1.0 AND APRON ............................................................................................................................................................................................................................................................ 27 PILLARS,ROCKER&FLOOR 28 SO1 R&I LT Rocker molding brow�stone ............................................................................................................................................................................................................................................................ 29 ENGINE 30 501 R&I Body m 0.5 __ _ NOTE:time is for air box cleaner for repair to It apron 31 WINDSHIELD 32 SOS R&I Reservoir �•$ .......................................................................................................................................................................................................................................... 33 FRONT DOOR 34 * SOl Rpr LT Outer panel �, Z'3 1/31/2014 8:13:18 AM 070412 Page 2 LMG 4/3/2014 11 :32 :51 AM PAGE 5/017 Fax Server Supplement of Record 2 with Summary Customer: YANNARELLI,RICHARD P ]ob Number: 15767 Vehicle:2004 JEEP GRAND CHEROKEE 4X4 LAREDO 4D UN 6-4.OL-FI red 35 501 Overlap Major Adj.Pane� -0.4 36 501 Add for Clear Coat 0.4 37 R&I LT Beft w'strip outer 0.3 38 R&I LT Lower cladding Laredo,Sport 0.4 deep slate 39 * SO1 Repl LT Nameplate"Grand Cherokee" 55155621AB 1 56.60 0.2 chrome 40 R&I LT Mirror heated GTM code 0.3 41 R&I LT Door glass]eep 0.5 42 " R&I LT Run channel � 43 R&I LT Handle,outside Laredo,Sport 0.3 black 44 R&I LT R&I trim panel 0.4 45 # �CoverVehicle 1 8.00 0.3 46 # Repl 'Corrosion Protection 1 B.00 0.2 47 # �Hazardous Waste Disposal Fee 1 3.50 48 # POSSIBLE HIDDEN DAMAGE 1 49 # NEEDS TEAR DOWN 1 50 * SOl Repl LT Lower cladding Laredo,Sport SFR2IZSPAF 1 252.00 0.4 Q.,.Q argent SUBTOTALS 1,542.50 22.2 9.1 NOTES Estimate Notes: FOR ANY SUPPLEMENT APPROVAL OR QUESTIONS REGARDING THIS ESTIMATE,PLEASE CONTACT THE MIDWEST PACE SUPPORT DESK AT 317-509-4030,OR VIA E-MAIL MWPACE@SAFECO.COM. Prior damage area:YES SCRATCHES DOWN RT SIDE AND LT FRONT DOOR AND HOOD Explained estimate/parts:YES Name of CustomerYANNARELLI, RICHARD P Repair scheduled YES Repair start date:l/21/14 Part search:LKQ,AAA,KEYSTONE Additional Coments:CUSTOMER DROP VEHICLE AT SHOP FOR REPAIRS Customer approves aftermarket parts?YES Additional supplement comments: NO A/M OR GOOD LKQ LOWER CLADDINGS PER CARRIE @ LKQ CORP 1-866-483-4472 Final bill YES FINAL BILL Signed authorization for direction to pay shop YES Vehicle delivery date:l/30/14 Additional supplement comments:VEHICLE IS DONE AND GONE 1/31/2014 6:13:18 AM 070412 Page 3 LMG 4/3/2014 11 : 32 : 51 AM PAGE 6/017 Fax Server Supplement of Record 2 with Summary Customer: YANNARELLI,RICHARD P 7ob Number: 15767 Vehicle: 2004 JEEP GRAND CHEROKEE 4X4 LAREDO 4D UN 6-4.OL-FI red ESTIMATE TOTALS Category Basis Rate Cost� Pa rts 1,542.50 Body Labor 22.2 hrs @ $ 52.00/hr 1,154.40 Paint Labor 9.1 hrs @ $ 52.00/hr 473.20 Paint Supplies 9.1 hrs @ $32.00/hr 291.20 Subtotal 3,461.30 Sales Tax $1,833.70 @ 7.6250�/0 139.82 Grand Total 3,601.12 Dedudible 500.00 Deductible Credit 0.00 CUSTOMER PAY 5�•� INSURANCE PAY 3,101.12 1/31/2014 8:13:18 AM 070412 Page 4 LMG 4/3/2014 11 : 32 :81 AM PAGE 7/017 Fax Server Supplement of Record 2 with Summary Customer:YANNARELLI,RICHARD P ]ob Number: 15767 Vehicle: 2004 JEEP GRAND CHEROKEE 4X4 LAREDO 4D UN 6-4.OL-FI red TOTALS SUMMARY Category Basis Rate Cost$ Parts 0.00 Subtotal 0.00 CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate 2,010.67 Grant Almeida Supplement 501 1,590.45 Grant Almeida Supplement 502 0.00 Grent Almeida )ob Total: � 3,6�3.12 CUSTOMER PAY: � 50�.00 INSURANCE PAY: � 3,10�.12 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. The Insurer guarantees that it will replace the Quality Replacement Parts(parts not manufactured by the Original Equipment Manufacture or Non New-OEM parts that are manufactured by the Original Equipment Manufacturer) identified on this estimate if a defect is discovered. The Insurer further guarantees that the parts are C.A.P,A (Certified Automotive Parts Association)certified when applicable. This guarantee will be in effect for as long as you own the vehicle described in this estimate, 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 cost of a temporary replacement vehicle during the repairs. This guarantee does not cover consequential damages. If a defect in a Quality Replacement Part is discovered, contact your local representative immediately and we will replace the part with a new Original Equipment Manufacturer Part. 1/31/2014 8:13:18 AM 070412 Page 5 LMG 4/3/2014 11 :32 :51 AM PAGE 8/017 Fax Server Supplement of Record 2 with Summary Customer: YANNARELLI, RICHARD P ]ob Number: 15767 Vehicle: 2004 JEEP GRAND CHEROKEE 4X4 LAREDO 4D UN 6-4.OL-FI red Estimate based on MOTOR CRASH ESTIMAIING GUIDE. Unless otherwise noted all items are derived from the Guide DE3WA99, CCC Data Date 1/17/2014, 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 (Afternative 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=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=Afterma�ket part. BInd=Blend. BOR=6oron steel. CAPA=Cer[ified 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. 1/31/2014 8:13:18 AM 070412 Page 6 LMG 4/3/2014 11 :32 :51 AM PAGE 9/017 Fax Server Supplement of Record 2 with Summary Custotner: YANNARELLI,RICHARD P lob Number: 15767 Vehicle: 2004 JEEP GRAND CHEROKEE 4X4 IAREDO 4D UN 6-4.OL-FI red ALTERNATE PARTS SUPPLIERS Supplier: KELLY'S AUTO PARTS ARA Location(s): 1814 NW 7TH ST., FARIBAULT MN 55021 JEREMY (507)334-7035 Line Description Item # Price 11 LKQ Mount panel+25% 8949 $125.00 Supplier: LKQ-ZONE 1 LocaYan(s): , 99999 (866)557-2677 Line Description Item# Price 17 LKQ LT fender assy+25% $FQ561 $ 105.00 Supplier: Keystone-Sate-AQRP-A Locatan(s): 3615 MARSHALL STREET NE, MINNEAPOLIS MN 55418 (800)328-1845 (612)789-1919 Line Dacription Item# Price 6 A/M AQRP Grille Laredo,Sport primed CH1200301 $233.00 9 A/M AQRP LT Headlamp assy Laredo,Sport from 1-14-02 CH2502138 $152.00 1/31/2014 8:13:18 AM 070412 Page 7 LMG 4/3/2014 11 : 32 : 51 AM PAGE 10/017 Fax Server � ��' �� Refltal Company: Enterprise Rent-A-Car � � �'a�� YOUR RENTAL CLAIMS HANDLER Invaice: 1�34 D95�67� .................................................................................................................................................................................................................................................. Bill To: SAF77P6 RENTAL DETAIL: YOUR RENTAL CL.�IMS HANDLER Rental Period: 01121!2C14 tc C1;30l2014(10 days} ATTN.MARKI PERKINS ERaC Billed Period: 01/21/2014 to 01/3Q/2014{10 days) P.O. BOX 515097 LOS APJGELES,CA 900515097 Descriptian Rate Amount RENTER INFORMATION: 1C DAYS @ �28.72 $287 2G Renter: YANNARELLI,RICHARD 1 SURCHARGE% 14.2G $40 78 Address. E6 EAST�TH ST 1 SALES TAX �7.62 $21 90 ST. PAU�. MN 55101A700 Homs Phone: (651) ?71-5596 Total Gha�yes: g349.88 Office Phone: L�ts Amount Recelv�d: $0 00 Total Amount Due: 53�9.88 RENTAL INFORMATION: ReMal Branch Location: ENTERPRISE RENT-a-CAR!1934) 395 EAST 7TH STREET SAINT PAUL, b1N 5510124�0 ADDITIONAL CIAIM INFORMATION: Claim Number: 395578055d33 Claim Type Insured Vehicle Condition: Non-Driveable Date Of Loss: Q1/18/2014 Insured Name: YANNARELLI,RICHARD Owners Vehide: 2004 JEEP GRAND P.ACIFIC Time Escalated: Letter Sent: Ap�ointment Date: 01011900 Daie Escalated: Labor Hours Per Day: Labor Hours Per Day:0.00 Pclicy Limit Reached Date: Policy Number:X0556212c C!I'-i: 1 Lcss Siate: MN Involved Cust ID: 0330000001 Coverage:Collision(COLL) PACE Shop ID: Follo�v Up Date: Total amount as of date above.O.GO Follcw Up Reason: titarketinc�Company: Safeco Inspeciion ctiannel: PACE Date Assigned to TL Repair Facility: HEPPNER'S COLLISION/GLAS-7TH ST ST. Pr1UL, MN 55101 (E51) 224-5i;44 VEHICLES RENTED: Effective Oat� Tlme Year Make Model VIN NUI� e 01l21/2014 10:�2 AM 2014 CHEV CAPT 3GNAL4EK7ES581727 B69 LMG 4/3/2014 11 : 32 : 51 AM PAGE 11/017 Fax Server �\��,�`� �$��a\,��\ Please R°lurn?Ms Portion with Remittance Make Paymerrt To: Total Charges: �349.88 ENTERPRISE RENT-A-GAR(1999) Less Amount Received: �aQ.06 27?5 BLUE V�.�ATERS RD Totai Amount Due........... 5349.88 EAGAN, MN 551 21 1 439 P�ease Irc:�.;ae o�your Check: Federai ID: 26-454855� Invoice:1934 D959679 LMG 4/3/2014 11 : 32 :511 AM PACE 12/017 Fax Server Policy Number: X5562126 Date of Loss: January 18,2014 Claim Number: 395578055033 Policy Holder Name: Richard P Yannarelli Payment Recap for damages paid on behalf of our insured(s),Richard P Yannarelli as of April 03,2014: Transaction Claim Amount Date Start End Payee Name Class Paid Date Date Payment COLL $3,101.12 113U14 HAB INC DBA HEPPNERS AUTO BODY Payment COLL $349.88 2/3/14 OU2U14 OU30/14 ENTERPRISE LOU RENT-A-CAR Total Payments: $3,451.00 LMG 4/3/2014 11 : 32 : 51 AM PAGE 13/017 Fax Server Claim Reterence Id 395578055033-201 File Name PH0T02 File Date 01/21/2014 ; � Label FRONT END :� j ��. .�� I � �;:�� Note Owner:RICHARD P,YANNARELLI \�\��....... Style:2004,JEEP,GRAND CHEROKEE 4X4 LAREDO� ::::_>s>:>::>_::>::: :;��::�; Insured:RICHARD P,YANNARELU� . �:'�`<�:::::: \ ?;�:\••::,,.` LossDate:01/18/2014� PolicyNumber:X5562 �, ''`'� '� ,`� :..... �,� � \�..... � `� �,,`.;;;,;,�:•:.::\� �,;�\,,v„';��'' ��i:::::\c�.. ^,�\ �,��::� Photo Lceation HEPPNER'S AUTO BODY(Downtown) . ..,;" :.� \��: ;� \\�\\��;;;;;��:;<: Photo Taken B Grant Almeida Y FRONT END Estimate Indicator E01 LMG 4/3/2014 11 : 32 :51 AM PAGE 14/017 Fax Server Claim Reference Id 395578055033-201 File Name PH0T01 File Dffie 01/21/2014 "'��'"" \ �\� \ '� Label BROKEN GRILLE ASSY. �� Note Owner:RICHARD P YANNARELLI� ��`�� ` ` �' .::� � \��. ��' y JEEP GRAND CHEROKEE 4X4 LAREDO� ��:: St Ie:2004, , \:�:::::� ��., , �.:;.,:;;;,: Insured:RICHARD P,YANNARELLI� ��\�\ "\\��`�� : ` LossDate:01/18/2014) PolicyNumber:X5562 � � �`�\�;::: � :� ;;<\��?::;;;:�� ;;\;;;�\��; Photo Location HEPPNER'S AUTO BODY(Downtown) ��. ��.> ��o\ ;:,,:� \�„ ,, ,,,�\� \\ .: Photo Taken By Grant Almeida BROKEN GRILLE ASSY. Estimffie Indicator E01 LMG 4/3/2014 11 : 32 : 51 AM PACE 15/017 Fax Server Claim Reference Id 395578055033-201 File Name PH0T06 File Date 01/21/2014 '��`;1\\��\\\ ` Label CRACKED FRONT GRILLE Note Owner:RICHARD P,YANNARELU� Style:2004,JEEP,GRAND CHEROKEE 4X4 LAREDO� Insured:RICHARD P,YANNARELLI� �........ LossDate:01/18/2014�PolicyNumber:X5562 Photo Location HEPPNER'S AUTO BODY(Downtown) ;;:;:,� �:;� Phato Taken By Grant Almeida CRACKED FRONT GRILLE Estimate Indicator E01 LMG 4/3/2014 11 : 32 : 51 AM PACE 16/017 Fax Server For Customer Support refer to the • • appropriate platform below: L��`I ��,`I �✓� OrderPoint 800-934-9698 Orderpoint.support@lexisnexis.com Accurint for Insurance 866-277-8407 Accunnt.support@lexisnexis.com Lexis.com REPORT ATTACHED Law Firm accounts 800-543-6862 PAGE COUNT:2 CLIENT : 226570 DIVISION : ADNSTER : ANGYOU CLAIM : 395578055033 TRANSACTION# : 4(i4133721 T�ATF. � 02J05/2014 DATE OF LOSS : Ol/18/2014 TIME OF LOSS : 01:00 PM STREET : 9TH&JACKSON CITY : SAINT PAUL COUNTY : RAMSEY STATE : MN INVESTIGATING AGENCY : MN HP REPORT NUMBER : P.EPOP.T TYPE : Auto Accident PARTY 1 : RICHARD YANNARELLI PARTY 2 : CHARLES NSTIN KNABE PARTY 3 : CAR : GRAND CHEROKEE MAKE : JEEP YEAR : 2004 TAG : VCJ454 DRIVER LICENSE : ADDITIONAL INFO : Pf_1LICY#� POLICY STATE: LOSS KIND: NOTE : THANK YOU FOR YOUR ORDER! 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O1 10 � �� :m.snrc a� �an.su��.ar wmn O1 FOREST LAKE 55025 � ST_PAUL 55101 O1 �pp� C Ey5 !Q �1f [OYI ��f�t MYO LlCt eY!F�' ;� !kx lOO� f�s[FCI1 unw: Fff,i �wsCV �COwD O1 �:• M . �9 04 06 OS N E-Y;`� M �f�4 "�09 06 OS N O1 YCM T!�E OtlL '�'lE IO��GSI 1M1�lA� �MYIW2EY�MQ �MMLYfEi �YOl 1�'R OM/G noE iA 'lV AMifPd�� WMJ4NCf8YMR MM�NMFP N 98 N5� 98 N; po�q ��`�� 98 �`.' 98 N; �',J'*,�� _.._..._..:_ _ -�-----_._.._.. .........._..._._......................._._._.,_......__.1........•..._.__......_...___.. . ..._....____.�....__.__.._._ .. . ._. __..___.... HOf1/ �vf��4F i ON1Li1MK �K OCM O1 MINN DEPT OF TRANSPORTATION. N tRICHARD PATRICK YANNARELLY N O1 YtMM �yltt5 � �OMCO �.�OO�tlf IOw[0 Nw1Ye 31 6000 MINNEHAHA AV S N � 66 E 9TH ST N 03 KNUiL f/�v.!'A�E.11 � AR1�4 11M[.t I U�'.Sl��t� Nl�i. �wfCT KMYSF 13 ST PAUL, MN 55111 "lC'; O1 � ST PAUL, MN 55101 `"1V 07 O1 IYG�UC Yu( 1tAR� tM f.�11.M .WM! 11m6 l UN p�610C 03 EORD TK 95 ONG �{ JEEP GCH F004 RED O1 % K��KIHC�M1 NqIrM(�jM YWi�lv OMGfN M�E/ 6��E4 vliwilEG W��w:�NL��3 �aar.wW�Nrn t P.�tE� ST�[0 r[ARN[G "'n�' O3 O1 ET0177 MN 019 O1 � O1 } VCJ454 MN 019 O1 O1 �a�,,.�, .xK..,,�,� r, .�,�h;,�.,:� ��,.,.,.�� SELF INSURED 1046 j SAFECO X5562126 """°OD "^"'^ ° "�"'0"' �OMD�� i ACCIOENT pNOIVE�A COMMERCUIL MOTOR VEMI[�E,SCNOOL BUS,OR MFAD l7wR7 BV3 �� n k� ~�� 111� RK • �F � O6 I Y� pEMEMYERTON071FYTMElTATEPATROL�rpulnOunOnMS1697�7�nd/WASt��. OO��tMCYV[IIQfMMCR�.MO'd�WIKflMN1E OO/NY1�M IGOMEAGMIVFItEM�f�).w(1�Y�I:v��ww.l OOiMYU MSiMi4�M1!�[StFT �M/ T�GttfK . 9� M'f YS �f�MG ELCT IuYV IV�qr TNW90tf �y� WSEewCE N!1wNi� � �OM[� O� �MSEMYC2 TMN�itO � 001�w a� u�i[FIKC w"'�� 0�� K ...._.._.__._..'.... _._..................... ...... ....�� WWfLD1�EMViIFLLONIA:MMl� IOpMUO101K110YM0EC�MWFFt�NOR i IOYtlWM�.�OMJR�nN10d�AlONpGMYFY61 :41 �.� •I•••• '1 Oht[ ,�nv .. rw.rrvr. 1 .. . . ..... ..... ... .. ..... . .. ... . -. �1 •� ��..... oa�aw -t . 01 `; V1 IS SNOWPlOW TRAVELING NORTN ON JACKSON SREET �*; _.. � Q3 � ri GOING THROUGH INTERSECTION OF 9TH �STREET. D1 ��. ��t� �� _,,.��.�, yf SLOWS AS.THERE. IS..A PEDESTRIAN IN INTtiRSF;I"'TION. 01 O1 "►'u�' +l � DIDNT WANT TO THROW SNOW OVER HIM. D1 STATES V2 p,�„� -}�� I �J -COMING WB ON 9TH S'fNtET�SLIO��FOR ABOU? 20FT INTO °""'� N�, �t s� INYERSECTION BEFORE�STRIKING THE MTDDLE OF , 09 ,.,.u.vt I SNOWPLOW � 4�,.,�Q f'. � :. . 9g � ��y. - - . L `� D2 STATES XE HAD GREEN LIGHT�AND PI.OW�RAN LICHT �� 7 ,� AND.HIT HIS.VEHICLE. . . . .. . . .... __ .. , . . ,�`TnO�� ; _ — _ ° — a�-: e-- s O1 �e .��r =i£Y � . . . � '...,.E., y �� i� � �1' '.� NO INJURIES, NO PICS, NO TOWS. �" - - � ::: a�cr. � �f'. ucH. 0 S j'} � __ . :: - . . _. ... . . . ..... ma+s a: � ' O1 03 �? I aor �o��c !t? _... .... . ,��:1 �� ; �i: �t; �, �:€ - � ;F Y �� ., �.�.» ;�� ;:� . . . f wo,M ..t ,�, a� 05 ,... O L ,� `�� ' . _ _ -- . _ , . . . _ . .�e+c. mm�a��a. �C'�su�aw�wu.��c¢r �,^�^M~��^°��'°°^°°°• State Patrol 4460 p�w.� O��• NONE BLAKE CEDEASTROM 925