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Grimm, Emily �`".�_'`'°���.�.,._�'""�.:�:.�,�,� �,5.14 i 4f g �«..�+:, a.... F"'4'..✓6.. 6"C 6n.�' �.r��:R� �'�wmzN���"�i -�.1 �N ap,^ ...a'ca�°a;4 �n'uuuuft"°"Y j.......��.._.�_� �S'�.n�J "�9� wwaa�,�y.,�_ti`m,�� '`""M,� 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 goverriing body of the municipality within /80 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 ctarify 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 �THER DOCUMENTS TO: CITY CLERK, 15 WEST KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102 First Name �Yl`�1� Middle Initial�Last Name U��1`M'M Company or Business Name �� 1�' Are You an Insurance Company? Yes/ io If Yes,Claim Number? Street Address �"lL� �� ��" �v #�%� City f`(;�-P�� �l'��, State M� Zip Code �J�%��� Daytime Phone (=�a r�c - Cell Phone(11�S)Z(v`1 -Z`� �S Evening Telephone (S A'�� - Date of Accident/Injury or Date Discovered ��Za1�Zl�'��" Time �L 'J am/� 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. —��� '��-�c,.C,1�c� �� ��� �c ,\_5 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 �j,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 you need to include conies of all anplicable 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 i O Photographs are always welcome to document and support your claim but will not be returned. ' i Page 1 of 2—Please complete and return both pages of Claim Form ; �I � � Failure to complete and return both pages will result in delay in the handling of your claim. All Claims-nlease comnlete this section Were there witnesses to the incident? Yes No Unkrin�n_ (circle) _..__... . Provide their names, addresses and telephone numbers: Were the police or law enforcement called? Yes No i 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 possible. If necessary, attach a diagram. ��c.� � c�c��r�c,� ���Z��� 1��v.Je��\ �J ��G.C��k�� l�Jz c.r-.2s \.iw�-\v�� 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. '����9 89 ��us ��n� ac:�c���hcn�ti! re�<�rs �e�.(r.�� �a EV✓�C s�-�5�em �Unknc:w�� c'�� -�h�s .,v- , ��- U '�5 � zz��j �t -t� CUm �tz diUC�r,u��t��� .�ieW CIu1M CU� be S'a����c t�0�1hcY�v�1 f�.��irS Ure. y�2ec��• `�'e �1-tucY��y�cfli- �rmc;rc, Vehicle Claims-ulease complete this section ❑ checl�box if this section does not apply �����t1S, Your Vehicle: Year Z��= `t Make 1L�� Model R�o License Plate Number `3`iz E�n�� State fY� � Color �-t1 Registered Owner Cxv;,�T C�+,�mm Driver of Vehicle Cr�r_,�� L-�c���r�nrn Area Damaged ��.�.�cti.�.,_ ti�c,.�, Z r',�.�: Z--�r-z°� , °d E.v�+w� �'�vaS='c� r� City Vehicle: Year Make Model . License Plate Number State Color �j;j�;��% Driver of Vehicle(City Employee's Name) � Area Damaged Iniurv Claims-alease comnlete this section 1�check box if this section does not annlv 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 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 �l I �� l ��'t `"1 Print the Name of the Person who Complet this Form: �rn�'1. �� Signature of Person Making the Claim: i Revised February 2011 � On 4/29/2014 I was driving down Rice St heading north towards highway 36. Between W Hyacinth Ave and Ivy Ave W there was a large and unavoidable pot hole.This area of road I traveled four days a week and the pot holes were becoming increasingly worse each week. It is a well-traveled road and traffic is heavy during the time I drive there. I ended up hitting a rather large pothole on the passenger side of my vehicle. Prior to impact my options were hit a pothole, hit on-coming traffic, or cut off another driver. Upon impact the check engine light immediately came on in my vehicle. I also noticed later that day when I traveled above 55 MPH that my steering wheel now shook. I ended up borrowing a computer scanner and found out my engine light was on due to the EVAP system. I was told the problem could become expensive to fix but was not something�hat required an immediate fix so I chose, at that time, to forego repairs. On 5/31/2014 I brought my vehicle to the Forest Lake BP for a routine oil change and asked that they inspect the front end of my car because the shaking was getting worse.After inspection it was determined that the passenger side sway bar link was damaged and both passenger side rims were dented. One tire was beginning t� b�alge d�le to the rim damage. Due to this I nQeded to replaee two tires to avoid further damage to the suspension. I chose to replace the other two tires at the same time due to the other rim being damaged and to have four even tires.The sway bar link was replaced on 5/31/2014 and the rims were repaired with new tires installed on 6/6/2014. On 6/9/2014 I had Forest Lake BP run a diagnostic on my car to estimate the cost of repairs to the EVAP system.They determined that both the canister purge solenoid and vent solenoid appeared to be functioning properly but needed to be replaced due to the manufacturers recommendations for damage to the EVAP system.Once those are replaced with new parts the system can be further diagnosed to determine if any other parts are not functioning properly due to the pothole damage and then replaced. I feel that it is the City of Saint Paul's responsibility to pay for this as well as the other damages to my car to restore the car to the condition it was in before the incident occurred. I feel that the City of Saint Paul is responsible for the damage done to my vehicle because the area I was driving in is a highly used road and potholes should be repaired promptly to eliminate the risk to the public. In my case the potholes were allowed to grow to a very dangerous size that can and did cause extensive damage to vehicles. Due to this incident I avoid traveling down Rice St because I am afraid of more damage or possibly worse the next time I hit a hazard on the road that is unavoidable. Thank you for your time and consideration in this matter, / " " " �'. :�� � r� �1ri0Uqt ICQ!]e3�oII CIAIm �*" From Im oice#111119 Tire wbr,el weight 3.95 Sway bar link-passenger 39.39 Tire Bslance 20 Stablizer Bar control 35.47 Hazardous Waste SO% i.5 Labor 50%of total 50.23 Ta2c 50%of tatat 3.53 From Invoicc#111206 2 tires Qa 92.86 185.72 Tite Valve stcm 2@ 3.00 6 Tue se�vice 50%of total 30 Repnit 2 rims 220 Whcel Aligament 79.95 Haz�dous Wasbe 50'/0 1.5 Tire Recyck 2�3.15 6.3 Labor 50%of t�tal 77.92 Tax 50%of total 13.66 From Im�oice#111247 Shop Supplies 12.9 Diagnostic 107.5 Hazardous Waste 3 Tax 0.92 Total cost aiready paid for 899.44 I am reque.sting the c�ost of the diagnostic to be paid by the City of Saint Paail ba:suse if the damage had not oacwxed to my vehicte due to the pothole I would not have had to have a diagnostic nm. � I have split c�s betvroen myself and the City of Saint Paul as some ibems were rcplaoed due to wantiag my car to have pazts replaced at the same time rather t6an parts ceplacxd at different times.As you c�see my reques�ed amounts ffie differ�nt than tbe totals on the imoices I have submitbed. Forest I.ake BP Estimate Canister Purge Solenoid 116.75 Shop Supplies 5•� ��r 473 Hazardous Waste 3 T� 8.72 T� 181.45 Tires Plus Estimau Vapor Canister Valve 116.99 I,�r 42.4 Shop Supplies 2.54 T� 8.33 T� 170.26 I would prefer to use the Forest Lake BP for all my service work so I have calculated using their estimate rather than Tires Pius estimate. �c�-C�1 �I C-�ir�� ��'f�`��'u�}� � /U��� . �`1 - ' • - FOREST LAKE BP 8�GOODYEAR . 1367 WEST BROADWAYAVENUE INVOICE . Forest Lake, MN. 55025 111119 ' Phone-651-464-7812 Fax-651-464-2845 Org. Est. #258243 INVOICE Print Date : 05/31/2014 GRIMM, EMILY 2007 Kia - Rio SX- 1.6L, In-Line4 (98CI) 907 8TH ST SW APT 207 Lic#: 392EUN-MN Odometer In : 136820 Forest Lake, MN 55025 Unit#: Home 218-269-2938 --- Mr. Office 651-334-6806 Vin#: KNADE123876200595 Cust ID : 32111 Hat#: Ref# : ��� � f � . ,, ,. � , �.��: , :_ r � >. : - ` =: ',; ....,�_� .,, ,,,,�h,.. ��,....., ,,.,�*.. 4� ,.Y,,,,�; � .,,,��>� ,. , .�, �. ; ;.`_ � ,.� 5W-30 PREMIUM OIL ` $5.00 OFF/$19.99 OIL CHANGE SPECIAL -5.00 F-OL-5W-30 PREMIUM 5.00 1.88 9.40 CHANGE OILAND FILTER, LUBRICATE 11.51 OIL FILTER MP AND PERFORM 16PT INSPECTION OF-21334 1.00 4.08 4.08 LOF-CHECK FRONT TIE ROD/CONTROLARMS ETC...HEARS j CLUNK AND FEELS SHAKE IN TIRE WHEEL WEIGHT TIRE BALANCE 2X2 20.00 TP-AL789 1.00 3.95 � 3.95 ALL WHEELS SHOULD BE RETIGHTEN, 100 MILES AFTER Sway Bar Link-Front Susp INSTALL. 1033441 1.00 39.39 39.39 STABILIZER BAR CONTROL LINK-Remove 70.95 &Replace-Both Sides. Sway Bar Link-Front Susp Hazardous Waste 3.00 1033442 1.00 42.25 42.25 [Recommendations] TRANS SERVICE 8 FLUSH -CHECK ENGINE LIGHT IS ON -TRANSMISSION SERVICE -RIGHT REAR RIM HAS A BEND IN IT -RIGHT REAR TIRE HAS A SMALL BULGE IN IT Org.Estimate a 206.59 Revisions a 0.00 Current Estimate S 2os.5s Labor: 100.46 Parts: 99.07 Sublet: $0.00 Sub: 199.53 Tax: 7.06 Total: 206.59 Bal Due: $206.59 [Payments- ] Warranty 24 Months or 24,000 Miles Part&Labor! Warranty on parts and labor is one year or 12,000 miles whichever comes first.Warranty work has to be performed in our shop&cannot exceed the original cost of repairs. Until paid in full,the amount owing on this repair shall constitute a lien on the motor vehiGe. If collection is ���i�����i�g�ot�ie�,�wis�, I a��ee po���r s�ora�e,and coqe�ctior�co�sts and attomeX's fees. p y p it n i e I.�or� tne .,ve ro uc an ser o,,parts and�a�or an ran ermission to ou a d i or our em lo ees to o erate the vehicle described for the purpose of testing and, �r iiR:ae�t��ee to pay� r nen �e work is compieted o!to pay or ether terms satisSectory to you.Untll aid in ful�@moun!owlnq on this work shall constitute aTl�l@i the metor vehicle.If collectlor is �n J made by suit�r o.P^��sa. ,;ree!o p v storage and coliection costs and reasonable attomey's fees page 1 of 1 Copyright(c)2014 Mitchell Repair Information Company,LLC invhrs 03.182011 JD CUSTOP.4ER y DATE - SIGNATURE /\ . ---- ..-_. .-- . ._--------- - - -- - � - � �V�IPA AU�'OCI��E "PEACE OF MINQ"NATI�NWIDE L!lVil�"E��°A�iR�NTY i �.�_ ��--..__�_._._. ___—_--- — _-_--____�__--__.- ----�---.� Y�:liU I�lalCES �HI5 WARt�ANTY � Thls �nar�ant;� ' ,. ,^�.�e� � _ . n. �>���r ����al N��rch-+se �. � ��., .� ,��,;;,�� w!�c . , r �cr�<„y ou� ���?,< , �_ f•i��r , ,. �uring ihe term of the warrant�,'. Th:s ��tia a��q ,, �� �� .� ��,,,, �. �r��nh ,� so �i,.� :;d �r tre ��F_ � �r���r. �� � ,,,I,�, r, �rmc ,>se �;repei,s on your venicie.;his warranty wi{I �e i�cn�;��s 1,� , :+ -�. . �. � ,"�a� - : �aUat� ; .�, ,;r,.;��.,��� _., � �� re.. !r�r, � ,c,��+�; ai,i!I,o�ir��7 ��r,y�vhera ir ihe United States. 'nIs svai _ , ,- . �v f,cr�.::���;i� N�-.n�r�oti✓e �arrs ��,�a� � � nJ��� � s Frt,i >yees , ._., ;;��;o�:r ���r,�anie5, cr cl,e admmistrator, Ameraan, Inc. -; � , � ; �—�__ . .____�_-.-__ _ _--...._—______�.____.__.�__.___._._�__.___________._ , �__�__.w._.. _ _-- __---- -----. .-- ----------------_—___--_____._ ____.____.___ ._._..___----_.__.�.�— � �nIHAT iS b;�VEREC�B�#THE�1VAkR4N��' 1 Thic vv�i n�,�cc ���e f�I r n,i q �rr,.�;i�and �' -�ces' � ��r� _� ic � � A. A C c�ndi�ic�ii�,r_._a� .a;,. . �:e.,�r�trcl system� � .�,�� , J�'��r;lny systems. � �3 � _ _ ,_r ,_ I i �,_�,� am. � a��-..n� _. � . �_..' ,. . ���ro rPpali_ E�ns.u���',�s���m C�_ t .;s�on ��o�s . ,_ K. Innit�on sysiem � E � �F I s�ti�s*.����'�•s :_ 5.-�er�m ��s�i�pens�7r��zys'.ems,�vheel bearinys, � F t�E.,� or.:; ,�,. ,.,.,�; stc�r,.. :�;i��� on- ';oirt � ;��in'.s '�iait-shat?s 3oo driveshafts. + bua�d ce r u?er�y Pi��,, lc-nq�ne bc � br<,ke arr� `�`v'. Gther mi�or,epa�;s. i s�soer i�r_��nr��i����ters; � � «co�tr< <;ystams. Dea!er „ar;ants t�ir ihr �� ��� r,pa r�� �n� se riees ,�er., �����,�a � ,i�,; ;oe��or ,���I te c� ., 7. _ r� r at,�,�:�__ .� .. .,� r r .:ns!'„p ?or 12 months or 12,000 miles o' use. Nhir�r,c✓r ,,._ �. _ .,u��E�: ir e !�ne d�te of th�� r��a;r and the oc+o�e?�� rr,a�ii a ���, n c�r� ��i, rE,_ai, r_ Th v���r�,n,, is conditioned on the vehicle beir,g subject.,o ����; ' ���rrme ciai .:�E and ��"eiviny reasonable and r�ecES:a�v ma t�.�a��e Ja��ng v� �;rt, ��er��d. Warranty repair costs are covered � up to the cost�*the ongmal repair or service. tni>! _ .. ., , __r � ,��arr_ .�_, t�t �. _. �.iar�� , p:, ���c .�. � ., . , . � � � _ �'��m emadia4 SPrvice work al . ��r �� . . ��e thE ae+a,�'.,, �._�.�ant �i arYi .,i,h�.ui char e to .��, o� � 4�,nd ro vo,. .tc �r ,� � . „ � �, �,,, N� � �y- � F s� 9 u c �h_��,�� F . . �_� °_.. ���.rs � e any previous refun,,,. ._, ,- � � � �--�_-------..---�___ _—�._.�_ �. ___--_---------._—^�__—__—_____--- ' �------------.���----- �_.____..__..���._ __— � � b4NERE YOU CAN UBl'A!N 4VARR�kNTY S�RViC:E � 1-800-452-iVAPA (6272) C If yoa a_ __ _ , �; - . �+ ray t �m i��e d� ���L'ng rapa�nng NAPA RufoGare �, i��� +c ,_ � U�` r.,u��� 1ou� ✓eh�clo to the NAPA AutoCare Cen?er loeation ' , �Nhere �e � ;i P i , ��E i�. necr a i� present your copy �f tt�P r pa�r order ro',he �F a�c if vcu are ru e han 2� m'Ic:s from the original AutoCare facility, then � ycu maw oke ;� .��ic�,r . � ^Fa� ;� pa�t� ,paiinq NAFA AutuC,arc 'a ��ty If yo�� ve"r.le � �i:op�r�ue_ and y�.0 a,e u.; ;tan 25 mdes from the original facility, yeu f may be e�u�iala � �r�rta:r ��vrr;a ar�d�or rer,tal car benefits as d�termine o; tf�e ����-anr-� A�n�m��strrato� If yo� a-�. n�t a��vare oi a participating NAPA AutoCare Center � locatior i ti �, : ., s �ai tY c� ✓�la;r��ity Adminis(ra;or at #t-fs 0 w�� "NFI, ' �,� � a c�C� ,� p,qo i' y �;^ro�ch Sat�.�rday !Eastem Standard Time), { ex.:ludn u���, F �. ?cr v� a�rec� �o� to the neares, ;�aiYicipa[ ,g NAP ��u�a r t , � � ,�c,� : t �.e ar. i�a h�APV, A�toC�re Center locations authorized � to perfo�rr �u�;��,� _ c; Y��� a� .,��str.��v�w�!I oirect you to an autho �z�c�roo .��4�� �C �t �_�__�..._..�—��. _._ ,�� WHAT YOU �v�UST iD0 TO OBTF�iN V/ARRti`N7Y SER�rICE ' Y'ou musi keep a copy uf thYs repair order and presenY it when seeking service under this warranty ,i �,,,a � v Jdor.; �,a G�e�ormed at a participating NAPA AutoCare Center lo�atiori,y�., ,����t tr uorrir.��y 5 a r.riGe o��_��sio� ct'Fi�:�2pa�ctler_ � It �h.�:� �rc �� � "�l i� � . _.�, �, _tr�n y�r_ ir�>a. �ir ���t< .� U�.;rt ��o,, r �hF� v,, an;y . ir,i-;?ra�o� �rr�or?o any sierrarty repair work by calling ; t , ,, � , � �rt 8C� .��_ rJAr _ . ,, ,. .;�. ,<<.:iv! v ,. a. G r ��.y; �r,i; ��o �, ,�, ., ��- „a �,., .. ;r��.�:� p<±y ier ;re �roar�ar,r� serilcP and submit your , cri�inal rr p i � , . st �ep�,� ,;�der t_, ��I �,,or r�.� „ ,,.„ ,,r� �,rit - ���� ca,r, �,_� �!��a, ;�.,�mer,t�s) wi;l be re;u�ned to you as soon as p� i_�t;ca t, ,��.� i �-�v�.r �;n,�_ � �� �—�_____..________ �__�________�_— ------T._�__�----------.�� w ���/h�Ai" 4: �JOT COVERED �Y I iiifi V`JARF�AdVTI' � .. , _ i �y � ,ce y�c� o�der c h� pec i �� � ��; i � amF n�- a�- �-ar�� ��erv���ct, `hls �,v a ,/ will �ot apR�y t y�;; �epaired �eh cia i` li hu., �: r�. . . _ ..- .a mic npr! ...i ar�ir�c i, a!i��dt-�?l Or 'iHfilD@rin. h� + � . � ' � �be her th n the �nq�i t �?r r -�r = ,�'o� ^,; The Deaier's err-ptoy�� 3 i�r_� 7 ,�: c �.: h<,� ,r �ni r , �r��r, r [��s va , r :K p�� e ,: � i� . , z � r�i tai�ed in �his warranty.This warranty do�s not a�� �v � ��,�aE � u,n+ � ey u,n«�e, ,r, ',e �;xvc ,, .�i.� ., ,. ��:s���� „ � .. r., ,, �e.��. T���; �;arranty glves you specific rights, and yo��may al_�"�,��.��! ��r rlg�t. . ich .. , ,��_t�,>_�,.E- f Al!TOfv1t7TIVc RERA�RS EXCL!JDED FFiQM tvARRA�'TY � t y � _ I I V 3i .�ll d06 ^,G I � ,71dC.e �'� 5 ��;xr t ,„ d � ^ �O 1 � v � � ,' r.. � � �� .;� �r n �r� �e �ough the independent Dealer ma� , of er r �r ; i � �!I � r_i �1� n�_ z _ �,�-, �_ ,��E ,� ._ .. _, �� e!y ., .��.,, �a�_ �.,� c[ner s.ich repairs as listed below. � � Au( i� r �. S �,.. 1 � t P�_i - r� �✓a i. ENl i �� /�. H y a R� '- � � .` rt .� nt> ��r� r i .t� c ._ r� ;. II. -f!?!i ,i� HAf : �� N N � ii � ;� >r .,, � c tr � �_ o � tr� s� � �r sar r �i tY E�iEhide or disasse«iby�f ihe sarne. °? B. �1a��t� �rv �nt� „a ;�,rr, ,. ,. ,e� , ���,i ��nnrt t� : re�r_�.v ;�f ti�, h�a�sr��i...0 , , �,���.�i, from thA �_h�cle o� disassembiy oi the same. C ��_. �., , r �� ,�_,���Er�t � ' 111. DRIVr X!F���r � �� �,i ;� A �,v �� � � r-, F��r�,; r.he -��c�.a� ot r?ernd I �.;-�c.,�;d comoo�ier�� rap�:ic,,,�n! c1 the �7rive�axie dif!erential assembly. _, te;�,ra�� > a ,:��: _.�� , � �i . .,. =i 3 N;,Jcn<ea'.- !�'. AUl� � ,:�G'i ` i ,... � .vIN�REF�,fR_ 4_ � _ , �;��,� �sto. „� o„' .._ _ - `i. i 3 s�rel�+ �oa,�3 . v. ccr��,��:��..:r:�a.�v..:�-ic��: NAPA AUTt�CARE"PEACE OF MIND" "�� NATiJF,iJJiC`iEI�JFi�iriANT�!CENTER - -------------.—�_-----�---___—_—____. —�----..e—_�-�-r�OX 1088 v J �__ � AF?VA�A.�OLt1CAQC SD001 J uescr qty amount --- �, �� <CUSTOMER COPY> �n� LABOR 1 155.85 LABOR � � LAKE BP 8�GOODYEAR • W E L --__??�_00 �EST BROADWAY AVENUE INVOICE F O R Sub Total 375.85 orestLake, M N. 55025 111206 ° 1267 N Tax 0.00 1-464-7812 Fax-651-464-2845 Org. Est.#258306 FORESI TOTAL 375 _ 85 651-4f CREDIT $ 375.85 � 00009' MASTERCARD Acct/Card #: XXXXXXXXXXXX9774 Work Completed Date : 06/06/2014 Print Date : 06/06/2014 2007 Kia- Rio- 1.6L, In-Line4(98CI) Auth #: 07733Z Lic#: 392EUN-MN Odometer In : 137059 DE Ref: 3Z576009 _. Resp Code: 000 Unit#: Stan: 0355240133 Vin#: KNADE123876200595 Hat#: Ref# : T „� _ „ .� SITE ID: 9268202 � . . . � � � CUSTOMER COPY DISMOUNT AND MOUNT TIRES AND 0.00 Earn rebates INSTALL VALVE STEMS, NO CHARGE. wi th BP Visa 371.44 TIRES NEED TO BE ROTATED EVERY 9000 MILES. Take app I i cat i on TIRE SERVICE 4 4 60.00 VI� and App I y Today 1a.00 COMPUTERIZED SPIN BALANCE TIRES.ALL WHEELS SHOULD BE RETIGHTEN, 100 MILES AFTER INSTALL. TIRE RECYCLE 12�9`� Au( THANKS , COME AGA I N REPAIR ON TWO 15"BENT RIMS 220.00 Re TWIN CITY RIM REPAIR SAVE DRIVERS REAR TIRE!!!!! St CARWASH EXPIRES IN 14 DAYS COMPUTERIZED WHEELALIGNMENT 79.95 SEE ATTENDANT FOR EXPIRED CODE FRONT S REG# 0002 CSH# 015 DR# O 1 TRAN# 28815 CHECK ENGINE LIGHT ON CODE-P0496 EVAP SYSTEM HIGH � 06/06/14 17:23:31 ST# AB 123 PURG 3.00 Hazardous Waste E W I LIl Dr Y��� [Recommendations j Take app I i cat i on TRANS SERVICE 8 FLUSH and App I y Today -CHECK ENGINE LIGHT IS ON -TRANSMISSION SERVICE l HA NKS , COM E AGA I N -RIGHT REAR RIM HAS A BEND IN IT -RIGHT REAR TIRE HAS A SMALL BULGE IN IT CARWASH EXPIRES IN 14 DAYS SEE ATTENDANT FOR EXPIRED CODE REG# 0002 CSH# 015 DR# O1 TRAN# 28814 06/06/14 17:22�50 ST# AB123 Org.Estimate E 0.00 Revisions S 748.61 Current Estimate S 74$•s� Labor: 155.85 Revision#1,Previous Estimate Amount-0.00,Additional Cost-748.61,Revised Estimate-748.61,Parts:$383.44 Labor:$19285 Sublet$110.00 Taxes&Fees:$6232 Pa�. 383.� Authorized by-GRIMM,EMILY,Dale-6/5/2014,Time-733 AM,Initiated By-Shop S u blet: .p220.�� Sub: 759,29 Tax: ' 27.32 Total: 786.61 Bal Due: $786.61 [Payments- ] Warranty 24 Months or 24,000 Miles Part&Labor! Warranty on parts and labor is one year or 12,000 miles whichever comes first.Warranty work has to be performed in our shop&cannot exceed the original cost of repairs. Until paid in full,the amount owing on this repair shall constitute a lien on the motor vehicle. If collection is made b�r suit or otherwise I agree to Pay storage and collection costs and attorney's fees. Havi__ng auth nty ���..; � _ i ' ,� .�_icts 3� �.�� z ts �nc. abor and gran�permission to you d r your employees to operate the vehicle de bed for the purpose ot testing ��d/or p� 1mp�th f roh rlo II rnll���'nri IS ir�i�tl.U� o U h w� he is c�mo e'ea f IE n f f^t�f�1 in I Int l nalti'n{Ll�`Hm t �jj]e ih�a i.inrk chall nnnctitiitc��n,el made bv s��'s , i=��:�=� + �c.'_�„� rage ana�ollec,�n_osts and reascnable aflomey s`�espa��� Of� Copyright(c)2014 Mitchell Repair Information Company LLC invhrs 03.18 2011 JD CUSTC�e'��ER u --- DATE -------�--.. . _—. cicnicri i[:G A . —_ —. —_—— � `� _ � NAQA AlJT�`JCARE "PEACE OF MIND"NATIONWIDE - � i------- ---.._----_-------- � LVHU MAKES TiiiS WARRA;J7Y � This warraniy is extende� :����ly� ;, ou �h:� �� purchaser, and not io ar:yone wY�o may p��rc!��usE TfliS`�. :1rtV i� -i�7�. � �i,. _ �iEp' , i��.� ... -., iI!'��n �, h-; rr�;�; ,-�.�-ri�,. _n�. ���"�C per tir r�i ,�o . '�- .,. e .�� � '�r „ � pir)��r:1n. ., i _ � � ;�e;,a��r � This'.v�� � ` �< ,�� . .� � ., y _ „� . �,i i i�. i'', ,.� ✓ erl� id > ,_�,.���. �i�.iAP t4 r-:�*�:,r-�� !nGr . ��_--- -----_._. , �------------------ ------- - ------------------ WHaT IS COb'ERED F3YTHE�^lAi�RA! n_ . � ,<� �. � . .._ � a. 4i �c���di �i�r_ 'r�; , n i ,,a:e,,�i t_�I sv� ,.ni�. E ��ir�<:_, �CS'F';?_� _ �4 _,_ rman< r ,__, ,� . _. _� a ro,�< �� , Fn� __��, �rrol; .�.� E �-ac�i:�,� _ < � r � __ ;,�._ u r,�,�. � � �'��tr� � �; boarcf oom�uter sy F mc; �� �irr ������dy bra�:e anC �s;e7�iur r�,n;r � _ .;�'�r r �5ds+e^�,, � ues��� � ��it� t _ ,. �,_a,� ,�,'� _. �i <._ per`���me��� a ti �r.ato .;;i� c., r�,� . �_._ , , < « . �.�h�.�n"�E ����e� r5s r���F< , :.+. ' ic ci.�E ,- tnc r�palr ar � ine oc+.ir�t��� �r;Ur:, �t,, �'hls subjecte� ,'v •. �� �c�-, e ��,� �:;. �:nd �e , , �a�s�r�able arci necc5 n�v � . -:n,.n�.r. � � up to the cost u; �ir ,rig�nai repair or service. � � � .. � . <� ,������� ;�r� i� _ . ,\ �h<<.��,���E _ _ __ .� _ , 4, t.�.r; to . _ , . ._ ., ��eni�r _._._.._.—,-.,-------------- 'v�!H�f�E Yr?�1 CAN G�STAlN V4�HHFAfdTY SER�l�CF • ' �r ,.o��� a, _-. ����. . . _, ..�. , ti�e ��.�Gfi���� ������.rir�� ^J:1F'4 . +-:'_i�.r , . ,.. . . I �.dr�r.. ?�-t .. -.. , .. _ .. , �r� ^.,.;,a :.-,nr. ;�resent your copy o!the i DU,� ,_ ..,_ _ ����c �.,.� n _ � vo� ma , . ,_�hr��q PaA1?o Aa?��;or_ �ac nt�. I! yc�� .�' �._ � �.:�iat ' mc✓ be ci r�ble � .. �;.u� ., - . �.. _.. .. ber�,`��te as a..,c m�ine� _�� �,_- 1,. ,. ; -+�� ..,.�iSt � icca}��� . �n �_ .. .1 � ��a�c � � B,`� �_ .1 � r � exc ,a� .� � ��_ , i�� !r� ��a�e�: F � ,H;r ,. _.�� ._ � � to pe fc��� .. ,. ...�, . �.. , ., . _ �S�.�nu�t� :.i,��o ed��u� . '.1.,�����.,. ... � . . ��.. _ . , ..� -� _ , � , ,-.,. �_----- -� --.._---�--�---�---.__.__-----------------�-------------- �— ----.__._----------_..__.__---------._._---------__-.—.—.._-------_._...------- V�i�"sAT YOU ME.1ST DO TG O�1"�1itd \�i�Fi!�� You must keep a c�4�y oi�h�i.repair ��rd;r and presei�' It when seeking servic2 �,mct::r t}7i, �varran vent�r'�,:ri� , , , � .. �_.�der pr s t�.,s'�o^�a+thls reF,�r��r�r?r- '�r�;e ..F �_ ^! �,, �. � ,:�ion � �. �. �i. , . , y �.;r� � _ ��e , ,� � ��: '�Gi' � �u, !ardf�0�� vJ nr)' Cc�L�t ;,av!nent fr�� „ . ?., r�� ,,, �< � _ � _„ ��c _ _ _ _ � ._. , _. i�;,�; - , � _._ ( � �� � ,�air bv'r.r , � . i I �•------...—.�__ , � ., : I _._------ ---- _----- ----- -_ _- ------__. .- -------- ----- 'JvHAT 'S �lCST COVER[D 6°! Ti-iIS N f � • , ,_ a - ��y 5er�ic ,�ou ;:r�� � i� r p3rf, ,d af �a���e � r" a� ;.��ra � �r i�3. �, ,i � � � I - � -1 S�l .���(1 1t8r2�i� 'ta�pr r nq ih� In � . em�ry_c �i�,�: �;i r �,.;�: ��f lerm i ������� , r �� . � prC � doFS n�.i i�� airy �, .� .ude � .er�,, , �,� �a��lyes ,�. .��e ; .�.�F e���,�, I,;,;,n � you may a s�h a�r� [n�=;r r��ght� vl��c:`�� -� - � i^s:.;;� � AUTOMOTIVE REPAIRS EXCLUDED FROM WARR j ; � i Thi> 3 �y uuE nor , � _� � �„� Y�_� r ,�;i, r_ � n ��d , r � �cy �,i vlar, nty�� even thouyh the indeoendent Deaie m��� � i otfei � i ._ �� - S., . �i�, x =a � r: ��.i���: � , ,_ . . cC t,�rt= and othsr such repairs as Ilsted b2.�,v � 4uton t, _r� ,a . � F �.�u�. , ,�:��,r, � L E=Nr�n:� . A. r 1[;�� �ur..t �.,. � .. , .�iraC�. , c x��:,� . , a i 1 ��'.�� �t(ry. � �� ��. TF1AN.,ti I r;lf 1 HAfJS�x � ,�_� _ �_ " i;. .. _ .c�� ,,�. .,� .. . � �rt � „ i,.,� ..�:r i .n�-� t.n;azi � ��th� c h�;ie� i�isa sen,b?y of tY1e Same. � - E�. � i ,.. - ,,�.-� , .�� _. ., ::n� i _ t�.n� ., '�I�� .t -...,�,, t i -, .�ti<<,.Ip f r� thE �,. .i.iE; or C715c755@I71bly Of th9 gcir'19 � C. � ��,t��.- �1.`Cr � i�'( . ,i,� , l. .u.,, c . II1. URI� _ . L;;��, ;;�� ,_ , ",^;�L�.� �,( � �� � _ , �_ �i c.[+I n? intern�i',y '�ul�nc�t�.�i � ���p�ne:rt5 �:pl<ice�rerit of the diive'��xle ditferentlal eSSemhi;� � r� �y �F �� u . �� � 1: 3 iion rE � .. � IV. i�,UTO Cii �1' PAu� � fGOULD NG�t F'A H: , �+ ��-���� i,'..� � i t�'- , L;. v� � ,_ I � .;GN'��r I �L r i;LE= NAPk AUTOCARE"PEACE OF MIND"' i r+Al"lONWli�k VVARRAN':�Y CEN�lFP � P.O BOx 1CSo I � ,:.�aa�Q cu�..okaao s000i . - i � FOREST LAKE BP 8�GOODYEAR 1367 WEST BROADWAYAVENUE INVOICE Forest Lake, MN. 55025 111247 Phone-651-464-7812 Fax-651-464-2845 Org. Est. #258403 INVOICE Print Date : 06/09/2014 GRIMM, EMILY 2007 Kia- Rio- 1.6L, In-Line4 (98C1) 907 8TH ST SW APT 207 Lic#: 392EUN-MN Odometer In : 137069 Forest Lake, MN 55025 Unit#: Home 218-269-2938 ---Mr. Office 651-334-6806 Vin#: KNADE123876200595 Cust ID : 32111 Hat#: Ref# : �.,.�.e� .....,�4� £ �'���� ���� ; �.... �� . ,. ..� .. ,. �. . .. . ��� ..a.�� �.��... , �.,.�, H..�x�� ���...��Q���u.�..x s,�R# � . � .�:,��w_� � �.. ����_,.��. Shop Supplies 12.90 12.90 DIAGNOSTIC 107.50 Tested both canister purge solenoid and vent solenoid on vehicle. Appears vent solenoid is functioning properly.To begin to fix problem the canister purge solenoid must be replaced and we must re-test both solenads fotlowing installation of new parts. ' P0496 EVAP CODE Hazardous Waste 3.O�J [Recommendations] TRANS SERVICE�F�USH -CHECK ENGINE UGHT IS ON -TRANSMISSION SERVICE -RIGHT REAR RIM HAS A BEND IN IT -RIGHT REAR TIRE HAS A SMALL BULGE IN IT • Org.Estimate a 124.32 Revisions E 0.00 Current Estimate a 124.32 Labor: 110.50 Parts: 12.90 ; Sublet: $0.00 Sub: 123.40 ' Tax: ' 0.92 Total: 124.32 Bal Due: $124.32 [Payments- ] Warranty 24 Months or 24,000 Miles Part&Labor! Warranty on parts and labor is one year or 12,000 miles whichever comes first.Warranty work has to be performed in our shop&cannot exceed the original cost of repairs. Until paid in full,the amount ovving on this repair shall constitute a lien on the motor vehiGe. If collection is made b�r suit or otherwise I a�qree to pay storage and collection costs and attorney's fees. Having auth ity to ic�� '� �.de. �`�e:bove ur�Cucts�nd services.�arts anc iabor and gran,�ermission to you�a�or��our employees to epera!e the vehicie de bed for the purpose of testina r .�i�or in����e te U�y caa tahen!he riork is c�rnoletetl or to oav on other terms satisfactorv to vou.Until oaid in fulH��oi�nt nw1n0 on rhls wnrk shau�onsriture�{�rna mnfnr vehicie If muc.�_�nn is made�y c,iit���cthe^-v,se.'� . .-�;.t�sge a�c1 r:o!iectlon costs and reasonable attomey's fee: Page 1 of 1 Copyright(c)2014 Mitchell Repair Information Company,LLC invhrs 03.18.2011 JD cusroa�E� � SIGNAi�JR� _. ..._ ....__. _... _. .--�- �--- ------ -. _-�------..___�._------�--DEQE----�------�------�----.— .._-- �1APA l�IITOCARE"PEACE O� MIND" NAT80NWID� L1�,�3TED V10ARRANTY � _�_________-------_---._.-�._�____--- � �1H0 IVtAKES THIS WA�iRAN'"✓ ���� � r � iu�e frc�� <� durir.c the term of the warrant;�. � �,� a �� �, r r . �� c �u�iaoe r. an�i � re �r,F nh� r�a� {�� t � �r i y , � 1� �� , : E� �^ � sr .., � E t; + . ,�i ' � ,, � n -u � , i �alr �i� you• veh�cle.This warrant. �ii uE ,�n � c, ,- r. ,., , . :. .. .�... , .,. ,. �� ., .� �r� � , . i�a ;� � .r � ricc:S ,,v��t2ere in the United Stat.,�: � , �,va . . ,. °�-� ,��1,�� _ .�. � --� � , .. %+ � .��ati�, '�,Af�'4 nN r.F� i . „ ,-� ., .�ruenies. � th� administra'or. Ameraan, ,�,,. � � , ,� � � �, \.___._-_._.�_._._------ _._.. ._.____ -_.__.__...-.-----_.__^._-----_.._.._.�.-.__,.___ --..._.---�._-----___,_.__---- _._. _. .__ ---- - _ - - ---__�.------°--------- -- � �_,_ _ __ __- _ . WHAT IS CUVEF��'J RY"�HE I�/ARRAl�lTY , , t- . � .>> nr: � ,�A ,. � r ��,_+r � a .,.r .��i , : �i_ � _::�rt _ �ys, ^.�. t �r��a a �r Gl,:a:�uny systems. � � _ ;�-•c _ , � ectrir_al s:e�n � �, i�:r �� �� � � _. � �a�; ,��v�c ?��r1 r�pair. � Exhaust s�-s'e��� � i;. i`_r-� .. �� _ K I nit on s stem. ` � t. P.�� :-- ���?�� u�r�ens�or�s✓s'.e�is.�ti�heei bearings, � F, '�� + ,.� , �;, � r e � � E r ��;,he� an_ j��nts U�n�nts.Half-shafis and driveshafts. boar�� �n��r i�e sys..m , �� ._ ,rake a�d M. J.ner minor repairs. " Sl S�@nc�. i . i:ll� Pi`, � .��!'.� r Gy51Ht1'�F � �2aiar �.va�ranis ��at 'h< �:��,.� -: �r�� � .;_-. .tu , ; _ � �,�, - , �° �� .,. 'a'�� , ;: ���r� ,��io for 12 months or 12.000 milea o{ ,.>E�, � rhichev� ��:mcs ,t �:����.. ,t,i *�c � ��a.�. �` .'�� , �. ar,. �r. �u�v,,,�,. ��e.,, :, ���;c,ti ���' . .. �r�,�. ..� ��.n,ry Is conditioned on the vehide be!'�� ,i �F;;te. � .__ . - _ �ar�l., n _ � �. _ �� ��rr „_. 1Narranty repair costs are cev�re� � up to the cost�}_'`%,e ur+c;i� ��•e;;air or service. I � � � _ ::., , , ... � - -. ., _,.,. . '1` ..' . . ` ��� r f _�cl �vf4iC2 WOfr �: �-,' I �:`..: . .���: .. . . . ._� ..�.. � . . .�. .'�: . ... :�...;. ._ . �._ "��.' . .'� . , i .. . . ,. �..,. . <. , �..-. ��.: . ,r;..i! ;'� ;t -G '0. :^� _.i'. . ,`:�.,. P 2fkni �' - - , . . ,. , -_. 3.ir�. ,.�U3 dll4 N.,eVIOUS t2'�fiCiS. ..,,, , .,n ..�... � �� ___ -_.- _��� ����� �JU CAN f.36TAlfv WtlPRAl:TY SERV?z,;E • 1 800-d�2 NAFA (62?2) � I` .; a � ��_ ,d '; ��uri��� ��r'.� 4 � � a�r � , ,v'AFA Aut�Cara Center io� t��^ � tir� =ir ,, 1 ar i p esent ti��.•copv ��the r o� � �r ,�. It . � �. .' r �an 2 m e�; !i he c, ,iinai AutcCare fac�iity tn,n � T_,�, � �� iva�rg tiAPA ruto ��re 'ac v f ._ � � � � .'ci , � m E � �� �� �2s �om ihe orig�nal facd�ty �ou '� ' � � h , ,� , = ini =_�rou �f r ��i�.bf �tin� NAPA AutoCare Cen?er i �V �� � , . r� , ��ita � be��e�i+,s as cieterm� �ed � `." _ p`� y Ic�a��oa _ � .���.,sr. ,� ±7e'�,d ar�iy A�ninistrato�at �' 80G 1.:'-���� �> �or� F .-, ' n"�� f�Lr�ay thrc;._h Saturday �Eastem Standard Timej, p ,n - - � t�c r. �;�j oh , � „ , , ��� �., ��o N;,�� A:;'�Care Center!ocations authorized � '�� .. , ..�or �. . ... ._. 1, i ;tr .i���i'. �� y .. �.. ,iuT;,�� �_n .uc �,'1 , . �' . -..,., � . ,.� , ,, , . L—'-�—.`-°-'_'-----.�—°�_ .._�_.___.__..�__��--------'----._------..—.�_'�_---.._.s_p_—._�—�— _._.__.-, __—._.. - .'--.. .--- ---� .. -_.-�---�. ..___..__ . �_�—_�_. . _..._.� _.� ._._ , � � �'vH�T V�U MUS? Dt3 TJ F?B7�iN ti�VARRlaC�TY SEFtdICE � � Yo� mu�t k.,fp r, copy .�S i; is rap�;: vr�kr anr� p�es�nt it w�her seekiny sE-�r+ce �ndar th� ;:arranB� �.� � �.or!. �� „e.r.o�n�d a! a participating NAPA AutoGsre � .u^ter 6�, y� ��c , _._ , .._ ,, ,� _ .: � � iti�r� �,r. r-. ., � �.o�,< � vo�,� �� ,_ � o�,.� ,�_tr_ . . � .,a . , ��_. �r prior �o any '�arranty repair work by callin� �� �, v�� , , ".�� ��� �, . � 8G^ '•I, � � , ��� �.. � r„�r c . � �„ •,- _a�r . m�.; ��„ '..� t s �,va��ar::y service and submit your , 4„� ,, . e-�� a� _= c� , _ ,.:n e�x°� w�i: be retumed te you as soon as or ira! _.. .. . . _ ._� , _ , �. � _ � p aciicab e�,�rh„, ,��1, � �,�� � � . � , � � � \- �___ ------- ._.�_�.__-_—_----- -----_-_°_- -------------°- _____ _-__�_.___.__,_ _.._.__ _.. ___.__...�._. .__ _._____._---------..__.-_.�__- .--._.__._.__ _- -----.___ _� � �'�h;F�7 s� NOT GOVERE�7 �Y THiS �/vARRANTY �, _, 4:;�,� any non-e�:ar�ranty �rvlce you ��,d�r t� Le. �r�er,� ���d at ��z ��.��e !ime as �. �F, ti:?a�,,�ty svrv,ce.�als warra�ty �.vill not apply to your repalred �er:cle if ! � it na� �� � ��� G�; �bnormal usP misuse neoiA�*. accidr.�t alteration or 'tamoeri��q w�th" ihv otner th n ihe nr�n� n<_+' � " n,?!��� . sj.The �c��.'� � „� ,�. , _ ���,._ � +ei�� � r �ty � pr_ t ��� �� i+_ �_ �� in.d in this warranty.This warranty � ces nc i � � � n -�a � dc.n�i �_� i��,., r".� t�',e� .�e�e ;Irr�ia� � < .�_un n . ,t +u. , u�su�, � ;a �nn?y 9ives you specifie rights, and � y�u!ia� ._, �iv _,� �. �qi,�_ .. ��i s� t�,� ��s.ih, { AU�OfuiC)TIVE REPAiRS EXGLtfUE�% FR�J'PJI WARFiA,NTY i ; �hi � snanty d e� no � �e r r r ;r�r ;c � 3: �. '�r E i� ',,, , � + h� VV��-�3rty� e�ei� t`�cugh ?he !ndepondent Dealer�r�,� � ' o;?�r �� �- � , �� _ � r, ��..,,_n�.ni c � - � . .�. _�i_� ,,a�ts �nd ot^�� �uch repairs as listed be ow, � � � ' AUtOr � � �.�...G . � c, �. . ._�,_ . � �. C.�4ri�:�. 3 � P. H y F. �?'i r ., � E,-,_ . _. (�ntr;o u) -I II. TRPtv� ll SI >, TRA���� � ' a ;� ,. �. i � � ;a �, ., sa ���t�, e,r c�e a sus�e. by o;the same. , ' � ,„ n' E 1�.�. , � -n'� „ �e � ei� e u � � � ' �' i', r� .,� _,_ �.axle r,r rhe �eFrle or �isassembly pf the sarc:e. � i_. ,....':bS .�I.1'.,.,�, „ '.c �..�_., .�. Pr�.,,,,., ...� ��� .}h.i f 1`[_ 1 F �� � I � � ,- I � a - ��,��.-� F� ��e �F� �aq��r:r,g the Ea�ovai , irtarna�i� ,�h:icated con���nents o� rop�acement of t�e drive/axle diflerentlal assembly_ ,� - .� ��' r i.,�l 4e�.�. . � __. .� �_.,��c - 3.Rnion sea! ' IV. AI_}T�BOU'f.PAIN r.",10UL��fNu HEPAIR. .,. . _ ,.�. _ _�.te ...,�.;to � �.UG .,SrS. �� .JVI��VI !{.:�{: J��'.{I�.�_C�i P�.9t�A AU70CARE"PEACE t)F MtND" IVL�Tlt7NW�DE WAHftAlJT'Y^ENT�R � t�.Ci.k30X 1 Q�3 - �RVC4L�A.CC,�ORA[3���U001 ___--�----�_.�_-- - �____,� FOREST LAKE BP & GOODYEAR Sub Estimate For Order# 1367 WEST BROADWAYAVENUE Forest Lake, MN. 55025 11�1247 Phone-651-464-7812 Fax-651-464-2845 ESTIMATE FOR SERVICES Cust ID: 32111 Estimate Date : 6/9/2014 GRIMM, EMILY 2007 Kia- Rio- 1.6L,In-Line4 (98C1) 907 8TH ST SW APT 207 Lic# : 392EUN- MN Odometer In: 137069 Forest Lake, MN 55025 Unit#: Home 218-269-2938 --- Mr. Office 651-334-6806 VIN# : KNADE123876200595 t k� ,,�a 3 �,:,; z� �� � �� �"�a ��,�� 3 r^N�".._�: � h�lJ� "�s&�. � �� �� �' . .,�� ., � �i � �� `.'��i 4 Uj r �"��a 1���;�... � .. ,. :., ...�.....3..�� 3. ..�...3.��33�/f'�� a. 3�'�:'.��,G,,,,i,: - 7�Y3 �i�.aa»t� ..�nn �.3�...���W`��3�.3�.i«3Y�3�.n,..,/n !.. ..?:��. �,,,,, ����. ��.3,�.. . ..3.:.. . '•'xi.> . ��. vv�... .. .. ', ��. .... ,..�. _� .,. _ � «_ .._.� , <_.... . . .�. . .. . .. Canister Purge Solenoid - emove 47.30 2283660 1.00 116.75 116.75 Replace-All Applicable Models Tested both canister purge solenoid and vent solenoid on vehicle. Shop Supplies 5�68 Appears vent solenoid is functioning properly.To begin to fix problem the canister purge solenoid must be replaced and we must re-test both solenoids following installation of new parts. Hazardous Waste 3.00 [Recommendations ] TRANS SERVICE&FLUSH -CHECK ENGINE LIGHT IS ON -TRANSMISSION SERVICE -RIGHT REAR RIM HAS A BEND IN IT -RIGHT REAR TIRE HAS A SMALL BULGE IN IT Rev Amnt: 181.45 Parts: 122.43 Labor: 50.30 Tax: 8.72 Total: $ 181.45 I hereby authorize diagnostic repair work to determine the necessary repairs, as well as the items I requested at drop off. I hereby grant you and/or your employees permission to operate the vehicle described for testing and/or inspection. Until paid in full,the amount owing on this repair shall constitute a lien on the motor vehicle. If collection is made by suit or otherwise, I agree to pay storage, and collection costs and attorney's fees.All parts removed will be discarded unless instructed otherwise: Save all PartsU Any vehicle left longer than 10 days may be impounded. Signature Date Time Page 1 of 1 Copyright(c)2014 Mitchell Repair Information Company,LLC esthrs 09.121NKYK QUOTE TIRES PLUS SERVICE ADVISOR: 1660572 979 W BROADWAY AVE 11 CHAD 06/09/2014 FOREST LAKE, MN. 55025-1412 651.464.3312 2007 KIA RIO LX GRIMM, EMILY 1.6L L4 FI GAS 241 4TH ST LIC# 392EUN MN VIN# ALBANY, MN 56307 IN 01/01/70 12:OOAM EST. MILEAGE 0 218.269.2938 Store# 244211 QUOTE Article E�ended Job Description ______ Number T#_Qty __ Part _Labor __ Price _ Total ENGINE SENSORS 159.39 911-808 VAPOR CANISTER VALVE 7016896 1 116.99 116.99 REMOVE & REPLACE PURGE CONTROL SOLENOID 7024449 1 42.40 42.40 Prices valid for 30 days. 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" J����_ as. so tr:e above limita'��� or exdusi:n ma�Y i , � � � � _� ��"���'�� . v�� .- � � I�e _ � . �rict �i �e . � � ^ .