The URL can be used to link to this page

McMahon Safeco Insurance Company of Indiana Mailing Address: St Louis P O Box 461 � i I ns u ra n ce ru PO Box 461 St Louis,mo 63166 St Louis,MO 63166 Phone: (877)622-5020 A I.iherty Mutual Company (800)332-3226 RE C E s VE p Fa�c: (888)268-8840 April 17,zoia MAY 12 2D1� CITY CLERK City Of St.Paul SUBROGATION NOTICE Our Insured Name: Tammy B Mcmahon Michael R Mcmahon Our Claim Number: 409517355002 Loss Date: February 21,2014 Your Insured: Thomas Jandric Your Claim Number: 2-21-2014 To Whom It May Concern: 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: $1,960.16 Rental: Out-of-pocket: Deductible: $500.00 Salvage: Property Damage TOTAL: $2,460.16 i i CA2060 05/08 Page 2 Tammy B Mcmahon Michael R Mcmahon April 17,2014 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 Departrnent at the mailing address noted above. If you have any questions,please reach out to the subrogation handler Korie White at 800-332-3226 ext. 7678725 or 636-326-8725. She can also be reached via email at Korie.White@Safeco.com. Sincerely, Subro Dept St Louis Safeco Insurance Company of Indiana (877)622-5020 (800)332-3226 Fax: (888)268-8840 c,azoso osioe t�ECEIVED MAY 12 2014 CITY CLERK 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...shall cause to 6e 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 circumstances thereof,and the amount of campensation or other relief demanded." Please complete this form in its entirety by clearly typing or prinNng 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 dces 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 `�' irst Name ��.��f" Middle Initial Last Name�� lLtloY7 Company or Business Name Are You an Insurance Company? Ye /No If Yes,Claim Number?�e n �h.C��!1r('P. Street Address Ju�)0 � � �2 S�kG (� �tx�,�v�t f�1/1,4 (�'��,(o City �-`eV�Vl State(NLd Zip Code��)��2,�0 �yt� Pe hone( �0' ��9 �o�ell Phone( ) - Evening Telephone( ) - Date of Accident/Injury or Date Discovered � �-r�l� Time ��Q �in�/pm Please state,in detail, what occuned(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. To w� Sctlt�lriG Sk- a.0 �Ch Gt�(t ke� � /�AC• 1./�n.�� (�� 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 , smQ�.�i..Jk�,I�u-�d � u✓l�CC.c.�[aed ❑ Other type of injury-please specify In order to process your claim vou need to include copies 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. �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 9 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 comulete this section � Were there witnesses to the incident? Yes No Unknown (circle) Provide their names, addresses and telephone numbers: Were the police or law enforcement called? Ye� No Unknown (circle If yes,what department or agency? Case#or report# $a Where did the accident or injury take place? Provide street address,cross street,intersection,name of park or facility, closes landmark,etc. Please be as detailed as possible. If necessary,attach a diagram. t��l�S I�Ue � Cle�e,t.a�n r��- Please indicate the amount you are seeking in compensation or what you would like the City to do to resolve this claim to ur atisf ction. � ' l�Lo 11P o�, �s� O. lo Vehicle Claims-nlease complete this section ❑ check box if this section does not avnlv Your Vehicle: Year�l� _Make I�o r,da Model C%v v1,G License Plate Number �(�,�L,� State�Color �IEW Registered Owner M Driver of Vehicle i'✓�E Area Damaged S� City Vehicle: Year a'�!/l'� Make �1 U�ICS Model P License Plate Number 101�K,�_ State I t1 Color Ctn� Driver of Vehicle City Employee's Name) '�/lu'✓j�S �/y1i� ��G�12�r�G Area Damaged 4 -�'' Iniurv Claims-please complete this section L�J"check box if this section does not avvlv 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 tB"Check here if you are attaching more pages to this claim form. Number of additional pages�. By signing this fornz,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: t�(�ne I/I,l �� Signature of Person Making the Claim: "��4c�� -� , Revised February 2011 For Customer Support refer to the . + appropriate piatform below: Lex i s N ex� s� OrderPoint 800-934-9698 Orderpoint.su pport@lexisnexis.com Accurint for Insurance 866-277-8407 Accurint.support�i lexisnexis.com Lexis.com REPORT ATTACHED Law Firm accounts 800-543-6862 PAGE COUNT:2 CLIENT : 226570 DIVISION : ADJUST'ER : JOHPRFS CLAIM : 409517355002 TRANSACTION# : 470883931 DATE : 03/30/2014 DAT'E OF LOSS : 02J21/2014 TIME OF LOSS : STREET : CITY : SAINT PAUL COUNTY : RAMSEY STATE : MN INVFSTIGATING AGENCY: ST.PAUL PD REPORT NUMBER : 14034082 REPORT TYPE : Auto Accident PARTY 1 : JENN�ER MCMAHON pARTy 2 : THOMAS JANDRIC PARTY 3 : CAR : MAKE : YEAR : TAG : DRIVER LICENSE : ADDITIONAL INFO : P�LICY#: P�LICY STATE: LDSS KIND: NOTE: THANK YOU FOR YOUR ORDER! Accident Report Page 1 of 1 .. , _ � �wtw�n raom � � 11034082 �1 � � �n.�o,.� �,..,c. wc. a�e ��. °"` ri "' � N N d2 DO 'b0 7t 2 21 014 0756 �p � �ouRa�� o• mrrererai O MwK+iae,� a� �..rL.�_e�* (�� n e,�, i 10 Nilea Ave. � M mrr.w rw�uwrt �n �anca ae�wsa • 62 �w 3Q25 t_• 10 Cleveland St. �i rorra a�.�uo��ra-� awe a.r w.n� �+ aM��r�r�.t tws ew� aamr yyra� O1 R338208041614 t`R� B O1 L36218�170811 t�t D ui aao�t wr.•m�.wn oi�m wrnwa�mtwn saear�es. ..ww� THOMAS Et�lZL JANDRIC 08 29 52 JENNIFER EILEEN MCMAHON 09 24 98 O1 1485 POR?LAND AVE APT Y5 N� 529 Cleveland Ave. f5 N.: 21 � .�r 6512957f�� ' S1�720352/ Q�� O1 ST PAUL 55104 St. Paul 55109 �muo +� �p.arr .��w+ .�..o �ecr wrw� � •n wr..or. wn �uw ,en«s pl :> M 04 04 06 OS N F 4 04 �6 05 N O1 Mb� IM� O�iO TR TOI� IY�Od M��MC�� YI141W� M*Ol 1Ml �6 Mf. W�� IMIrAI 1�i«�M�O �lIMM� �f I[!f OY� O� • , �u � �� 00011 0+��MWI ' IR O�Nl�1MY[ OGWr 02 HONDA L£ASE TRUST N EAN HOLDINGS LLC N• �k ' NMM M01lM fOYlm � N+M pl 2170 POINT BLVD SUITE 100 N: 6929 N LAKEWOOD AVE t�00 �D O1 w.,� en+..m... • n..,.o�e. arc..�.s � 0 O1W 90 EL6IN MN 60223 'tf: 03 TULSA !1N 74117 "�9 • 02 OND� UCL 201 GRY VOLK PTS O1 07� • mw w�� .w n.��w �°oso�. w�ui� mso '� 01 03�' 02 406KLM MN � U2 � 02 61BKRE t41 4 0'� .��.o,. .o�....n ..wre�r �ao...roi ' City of.st. Paul Safeco Z2�16a35� � �.. .wo wa�w. w•�• •�econn�vm�oairaia�rmae va�c�e.seNOO��w.oR�sr�w� �"° c"° � r,K n.� , � � �91lMbql W lW7M1IM iTATf M�ROL MM�rM wCtt�7w.iN w tMAiM1. cowoow�srn�wreR�.�e�auww�ww omwra a�eMVwr��w�..rea�owe�+re es1wru MM�wArY+lllrft � Y�T 0� W NAe 1rt Mlra uct w��sY Anl/CR � . Q� IM�11� �MMIa�1 , u�..ne�aaancso� t7soaa�two� Q1 03 ' F 01 �� Ofi 05 N N' p� Q � � . . . nw .r�r.a r�r� ' �ar� Q� Y�UItl Y1�Y11 � �p� �7 YyYCf1AIOA11�1'I1tlYw W K�� OM'Pf/DIMOOIr1��I�IOR�Y�10�laRi71010�1PYU/�I�Yria KU�L�IWNy11 OPQ .ur. . ww+r�: 01 . . . . 98 . a.�. - V-1 xas travellnq eaat on Nils� J�ve. ta+asd 03 � Cleveland Ss. �V-Z wea atoppeil on NSLes�Ave. 7he �� " .vehicls Rad a drivec and.due .[o a larqe enow 9e � fall, had been stutk. The dciver w�i b�lnq w.mQ �q� a�alsted by a male•rho waa attaapCinQ to puaA Ch �� - �,� � vehicle out o! the s�ov covncod psrkin9 �paC- v' . O1 �d r i approsehed and the dzlver of V-2 opeead her � � 98 • aoor, anC V-1 Otruck the Gooc. V-2 had snor oa . .�tho rindora, �nd t6a portipn af g�aa's thit"vsan't �' � ff. S�, cov�rad by snw, Maa covered by Condeasation/.ta9 K°'�"� .� due co the cold temperscure�. 1'he[e Maa narrow 01 'r" �i: paaaaqe [or V-1 to tcaval thsouqh Cuc to the. w�� Ar.W . �ti ^• large amount of anow. Na cltatlona issued aa ,o� }j � thia vould noC likely have hapDansd aa Decauae of, s�� N • ��T T� �'°`L�� Y•' cha snov[a11. Thia ia a veathar rel�tad uK 06 ._.•�`-'—....'•_��"� �' accident. No lnjuriai. . ,' ,�o,,. O1 U5 d; :�; � � "�8 r", _ . N �'; r p �t. i',� . .. � �°�°„r O L �i �r '•I.p . OAW�/4MYlroriolf� �mtr 1RlqlT��CM a�E11Ewn111 la'x Patrol Officer Ben Lego S91 �)� St Paul PD W O� O�^ . �� http:/lwww.dvslesupport.org/dvsinfo/accideretrecords_2Q08/Includes_LElPrintDVSReportI... 2/22l2014 NAME-Tom Jandric ADDRESS- 1485 PORTLAND AVE SAINT PAUL, MN DOB-8/29/52 VEH/COLOR-not sure, was using a rental unit and not sure which once OWNER- Hertz Maybe DRIVER-yes PASSENGERS-yes Cassandra DATE-2/21/14 I believe so TIME- I think it was around 10 am LOCATION OF ACCIDENT-not sure of the road, Niles/Wtson, something like that DIRECTION OF STREET(S)-inner city street, residential Wetather-snow emergency, I was ticketing people for snow emergencies, roads were getting narrower and narrorower for emergency VEHs only WHAT HAPPENED—We were going east bound and the woman car that I hit,she was trying to get out of parking area and a friend of her's trying to push her out. As I went by INSD opened her door and and slammed on my brakes to stop and slid; hitting her door and jammed it open. I think I was going 2 miles an hour. I did jam the door and sprung the door spring, it could shut but not a jar CLMT was 3-4 feet away from INSD door when it was opened. AIRBAGS-no POI ON YOUR VEH-my right front POI ON OTHER VEH-driver door POST AX TALK-Exchanged insurance and what would be the next steps POLICE-yes TICKETS- no WITNESSES-just the person trying to push out from the side of the road INJURIES-no ALCOHOUDRUGS- no LICENSE RESTRICTIONSD-maybe glasses, had glasses on at the time. DID YOD UNDERSTAND MY QUESTIONS?yes ANYTHING ELSE YOU WOULD LIKE TO ADD?no VERIFICATION-2609753 ABRA Auto Body & Glass - Eden Workfile ID: 672535f8 FederalID: 41-1942823 Prairie Right The First Time...On Time 9020 Aztec Drive, Eden Prairie, MN 55347 Phone: (952)829-5922 FAX: (952)829-5921 Supplement of Record 1 with Summary Customer: MCMAHON, MIKE 7ob Number: Written By:Jessie Buhr,3/25/2014 6:09:36 PM Adjuster: PESEK,JOHN Insured: MCMAHON,MIKE Policy#: Z4160354 Claim#: 409517355002-201 Type of Loss: COLL-Collision Date of Loss: 2/21/2014 9:00:00 AM Days to Repair: 5 Point of Impact: 09 Left T-Bone(Left Side) Owner: Inspection Location: Insurance Company: MCMAHON,MIKE ABRA Auto Body&Glass-Eden Prairie SAFECO INSURANCE COMPANY OF INDIANA 16875 DEWEY COURT 9020 Artec Drive Safeco--PLSA EDEN PRAIRIE,MN 55347 Eden Prairie,MN 55347 PO Box 515097 (651)788-3265 Business Repair Facility Los Angeles,CA 90051 (952)829-5922 Business VEHICLE Year: 2012 Body Style: 4D SED VIN: 19XF62F56CE087126 Mileage In: 18136 Make: HOND Engine: 4-1.8L-FI License: 406KLM Mileage Out: Model: CIVIC LX Produdion Date: 8/2012 State: MN Vehicle Out: Color: GREY Int:GREY Conditlon: Job#: TRANSMISSION CONVENIENCE AM Radio SEATS Automatic Transmission Air Conditioning FM Radio Cloth Seats Overdrive Intermittent Wipers Stereo Bucket Seats POWER Tilt Wheel Search/Seek Reclining/Lounge Seats Power Steering Cruise Conhol CD Player WHEELS Power Brakes Rear Defogger Auxiliary Audio Connection Wheel Covers Power Windows Keyless Entry SAFET1f PAINT Power Locks Alarm Drivers Side Air Bag Clear Coat Paint Power Mirrors Message Center Passenger Air Bag OTHER DECOR Steering Wheel Touch Controls Anti-Lock Brakes(4) Trection Control Dual Mirrors Telescopic Wheel Front Side Impact Air Bags Stability Control Console/Storage RADIO Head/Curtain Air Bags Power Trunk/Gate Release 3/25/2014 6:09:36 PM 026974 Page 1 Supplement of Record 1 with Summary Customer: MCMAHON, MIKE 7ob Number: Vehicle: 2012 HOND CMC LX 4D SED 4-1.8L-FI GREY Line Oper Description Part Number Qty Extended Labor Paint Price� 1 FRONT BUMPER 2 * R&I R&I bumper cover-LOOSEN 1.2 _ _ _ _ _ _ 3 FRONT LAMPS 4 R&I LT R&I headlamp assy 0.3 Note: LABOR:Time is after bumper cover is removed.Time includes R&I/R&R all bulbs and front bumper stiffener. 5 FENDER 6 Repl LT Fender 60261TR6999ZZ 1 203.75 1.4 1.8 Note: FENDER IS BUCKLED AND NEEDS REPLACEMENT.LKQ LOCATED AT RHINE AUTO IN WI.THEY WILL NOT SHIP THIS BECAUSE THEY ARE AFRAID IT WILL GET DAMAGED IN SHIPPING 7 Add for Clear Coat �•� 8 Add for Edging 0.5 9 Add for Ciear Coat 0.1 10 R&I LT Fender liner sedan,US built Incl. DX,LX,HF 11 PILIARS,ROCKER&FLOOR 12 R&I LT Pillar trim US built Incl. ._ _ . _ _ _ 13 FRONT DOOR 14 Repl LT Door shell 67050TROA90ZZ 1 683.52 4.6 3.0 Note:SHELL AND SKIN ARE DAMAGED.LKQ AVAIL AT JANTZ YARD 4 IN WI BUT AT$750.00.THIS IS NOT COST-EFFECTNE 15 Overlap Major Adj. Panel ��•4 16 Add for Clear Coat 0.5 17 Add for mirror �•4 18 Add for power units �•Z 19 R&I LT Water shield incl. 20 R&I LT Belt moiding Incl. 21 R&I LT Piilar molding US built 0•2 22 Repl LT Black out tape US built 67365TR3A01 1 7.50 03 23 R&I LT R&I mirror Incl. 24 R&I LT Moveable glass Honda Incl. w/securiry system 25 R&I LT Handle,outside painted w/o Incl. smart entry urban titaniu Z( Blnd LT Handle,outside painted w/o 0.3 smart entry urban titaniu 27 R&I LT Lock assy w/power 0.3 2g Repl LT Lower hinge 674605DAAOIZZ 1 26.93 0.3 0.3 Z9 Add for Clear Coat 0.1 30 Repl LT Upper hinge US built 674505NEAOIZZ 1 24.58 0.3 0.3 31 Add for Clear Coat 0.1 32 R&I LT Check strap US built 0.3 33 R&I LT R&I trim panel Incl. 34 REAR DOOR 3/25/2014 6:09:36 PM 026974 Page 2 Supplement of Record 1 with Summary Customer: MCMAHON, MIKE �ob Number: Vehicle: 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GREY 35 R&I LT R&I door assy 0.6 Note:REMOVE TO REF ALL PARTS OFF.CLEANER REFINISH WITH NO TAPE LINES 36 Blnd LT Outer panel 1.0 37 R&I LT Water shield 0.1 38 R&I LT Belt molding 0.3 39 R&I LT Handle,outside painted urban 0.4 titaniu 40 R&I LT R&I fim panel 0.4 41 R&I LT Lock assy w/power US built 0.3 42 R&I LT Pillar molding front US built 0.2 43 R&I LT Pillar molding rear US built 0.2 44 R&I LT Check strap US built 0.3 45 # 'Car Cover 1 5.00 T 03 46 # Rpr 'Color,Sand,and Buff 0.5 47 # Repl 'Hazardous Waste 1 3.50 X 48 # SOl Refn 'Gravel Guard 0.5 49 # SOl FINAL BILL 1 SUBTOTALS 954.78 13.4 8.8 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(s): HAIL AND LT RR BUMPER Explained Estimate/Parts(Y/N): YES Name of Customer: MIKE MCMAHON Repair Start Date: 3/21 Part Search:CAR-PART.COM,AAA AUTO,PAM'S AUTO. LKQ NOT COST-EFFECTIVE. Additional Comments:OWNER DECLINED A/M PARTS 1 Final Bill: $2460.16 2 Signed authorization for direction to pay shop:YES 3 Vehicle deiivery date: 3/25 4 Additional supplement comments: 3/25/2014 6:09:36 PM 026974 Page 3 Supplement of Record 1 with Summary Customer: MCMAHON, MIKE 7ob Number: Vehicie:2012 HOND CIVIC LX 4D SED 4-1.8L-FI GREY ESTIMATE TOTALS Category Basis Rate Cost$ Parts 946.28 Parts Discount $946.28 -2.0% -18.93 Body Labor 13.4 hrs @ $52.00/hr 696.80 Paint Labor 8.8 hrs @ $52.00/hr 457.60 Paint Supplies 8.8 hrs @ $32.00/hr 281.60 Miscellaneous 8.50 Subtotal 2,371.85 Sales Tax $1,213.95 @ 7.2750% 88.31 Grand Total 2,460.16 Deductible 500.00 Deductible Credit 0.00 CUSTOMER PAY 500.00 INSURANCE PAY 1,960.16 3/25/2014 6:09:36 PM 026974 Page 4 Supplement of Record 1 with Summary Customer: MCMAHON, MIKE 7ob Number: Vehicle:2012 HOND CIVIC LX 4D SED 4-1.8L-FI GREY SUPPLEMENT SUMMARY Line Oper Description Part Number Qty Extended Labor Paint Price� ti � ...,'�� '� � `��,ti�,�-��k�-.� .< "�� .�'�� . .a. � _ t , w �. � - �.� - ., � . �- �_ ,...� .,� �� ,�,:., ,.__-._., , ._� �_,. a.__z ..k_, 48 # SOl Refn 'Gravel Guard 0.5 49 # SOl FINAL BILL 1 SUBTOTALS 0.00 0.0 0.5 TOTALS SUMMARY Category Basis Rate Cost$ pa� 0.00 Paint Labor 0.5 hrs @ $52.00/hr 26.00 Paint Supplies 0.5 hrs @ $32.00/hr 16.00 Subtotal 42.00 Sales Tax $16.00 @ 7.2750% 1.16 Total Supplement Amount 43.16 NET COST OF SUPPLEMENT 43.16 CUMULATIVE EFFECTS OF SUPPLEMENT(S) EsGmate 2,417.00 ]essie Buhr Supplement SOl 43.16 Jessie Buhr )ob Total: # 2,460.16 CUSTOMER PAY: $ 500.00 INSURANCE PAY: � 1,960.16 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." You may receive a survey asking you about the service you received. If you are unable to rate your experience with this repair facility a "10" at any time during the repair process, please let me know as soon as possible so we may handle any concerns. Your business is very important and our goal is to exceed your expectations at every opportunity. 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. 3/25/2014 6:09:36 PM 026974 Page 5 Supplement of Record 1 with Summary Customer: MCMAHON, MIKE 7ob Number: Vehicle: 2012 HOND CMC LX 4D SED 4-1.8L-FI GREY Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ARG4449, CCC Data Date 3/17/2014, 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 (Altemative 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=Aftermarket part. BInd=6lend. BOR=6oron 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. 3/25/2014 6:09:36 PM 026974 Page 6 Claim Referenceld 409517355002-201 File Name PHOT05 File Date 03/24/2014 - �- Label LT FT Note Owner:MIKE,MCMAHON�Style:2012,HOND,CIVIC LX� Insured:MIKE,MCMAHON�LossDate:02/21/2014� PolicyN umber:Z4160354� ClaimRepresentative:PESEK�S Photo Location ABRA Auto Body 8 Glass-Eden Prair Photo Taken By Jessie Buhr LT FT Estimate Indicator E01 Claim Reference Id 409517355002-201 File Name PHOT02 File Date 03/24/2014 v.-t Label FENDER AND DOOR DAMAGE ��:� .�� k�`..:..,- i.rt �'.`.`; Note Owner:MIKE,MCMAHON�Style:2012,HOND,CIVIC LX� Insured:MIKE,MCMAHON�LossDate:02/21/2014� PolicyNumber:24160354� e� ClaimRepresentative:PESEK�S � � �! Photo Location ABRA Auto Body&Glass-Eden Prair Photo Taken By Jessie Buhr FENDER AND DOOR DAMAGE Estimate Indicator E01 Claim Reference Id 409517355002-201 File Name PH0T09 File Date 03/24/2014 ��°�� Label DOOR GAPS Note Owner:MIKE,MCMAHON)Style:2012,HOND,CIVIC LX� Insured:MIKE,MCMAHON�LossDate:02/2112014� PolicyNumber:Z4160354� ClaimRepresentative:PESEK�S Photo Location ABRA Auto Body 8 Glass-Eden Prair Photo Taken By Jessie Buhr DOOR GAPS Estimate Indicator E01 Claim Reference Id 409517355002-201 File Name PHOT08 File Date 03/24/2014 � Label FENDER AND DOOR DAMAGE r Note Owner:MIKE,MCMAHON�Style:2012,HOND,CIVIC LX� Insured:MIKE,MCMAHON�LossDate:02/21/2014� PolfcyNumber:Z4160354� ClaimRepresentative:PESEK�S Photo Location ABRA Auto Body 8 Glass-Eden Prair Photo Taken By Jessie Buhr FENDER AND DOOR DAMAGE Estimate Indicator E01 (C) SessionC - PASSPORT Wednesday, May 07, 2014 , 7 : 50 :49 AM ACSINQP HIS1 Clm# 13A 14053 513 C/I# OPEN CLAIM C/I# 001 Name MCMAHON MICHAEL R, TAMMY B RS# Tran Clm class Res# Payment amt Stat Tran-date Dr/Ck/Vou# 002 SNGL COLL 001 1, 960 . 16 PRO 03-26-14 850754 Pay period Pye# 008 002 Name ABRA MINNESOTA INC DBA ABRA AUTO to BODY & GLASS LAST SCREEN HIS1 Next screen (Clm# C/I# Pye# RS# )