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Tusa, Colleen r , _ . REC�i�,�� : JUL:0 9 2014 � NOTICE OF CLAIM FORM to the City of Saint Paul, Minr�� C��,�.�� 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 municipaliry within 180 days after the a[leged loss or injury is discovered a notiee stating the time,place,and circumstances thereof,and the amourit of compensation or other relief demanded." Please complete this form in its entirety by clearly typing or printing your answer to each question. If more space'is needed,attach additional sheets. Please note that you will not be contacted by telephone to clarify answers,so provide as much information as necessary to explain your claim,and the amount of compensation being requested. You will receive a written acknowledgement once your form is received. The process can take up to ten weeks or longer depending on the nature of your claim, 1'his 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 �ELLOGG BLVD, 310 CITY HALL, SAINT PAYTL, MN 55102 n � • First Name l'�'Ie-�� Middle Initial�Last Name �.1�5�/ ' , Company ar Business Nam� N�A Are You an Insurance Company? Yes/�o If Yes,Claim Number? Street Address��,-�'rinA hQ'�Cl..� ��Q.�P , . I e�ty ` ��i �° State 1 Y 1� Zip Code:3 5�� Z � Daytime Phone(�)�- 6�61 Cell Phone(�?s f)3.i 3-/�Evening Telephone(f�?O��2� Date of Accidend Injury or Date Discovered �O�l k��1 � Time �3 o am pm _ 4y,�t'`� . � �.. . . �. . � . � . . � �J��,� .. Please state,in de,� :what occurred(happened),and why you are subrnitting a claim.Please indicate wh fiow you feel th�U ' f'!�'di�Paul or its e ployees aze involved and/or responsible for your dar,l�ges. ' �`�-e-�- � i e�'2• �i Ic�.� � r G�.+ 54 .Q � � ��• !'a S � � s �,a � ` -e_ c.,��.''.�f e_�-e �k — O— 8 . � t C . e�.��C. ��;_�•.,. �tx,s.,,�. � �, -- �r c: �1 �„�a.�� 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 D Other type of injury—please specify In order to process your claim vou need to include conies of all anolicable documents. For the claims types listed below,please be sure to include the documents indicated or it will delay th�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 � $500.00;or ttie actual bills and/or receipis for the repairs � O Towing claims: legible copies of any ticket issued and a copy of the impound lot receipt O Other property damage claims: two repair estimates if the dama$e exceeds$500.00;or the actual bills and/or receipts for the repairs;detailed list of damaged items O Injury claims: medical bills,receipts O Photographs aze always welcome to document and support qour claim but will not be retuined. Page Z of 2—Please complete and return both pages of Claim F'orm 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 � U wn (circle) Provide their names,addresses and telephone num rs: �-��e�- C-�i-n`e ` ��° �`'`"��0�` '� r�6-ir�` -�-�.�2 ��.��`C� ' �� Were the police or law enforcement call d?p 1'es No Unlmown (circle) °L '� ff yes,what department or agency?�� - T G-t�-� Case#or report#�� "'�g� � � . •. Wh�re did the accident or injury take place? Provide street address,cross street,intersection,name of park or facility, closest landmark,etc. Please be as detai1�d as possible. If necessary,attach a 'a a}n. � �'� - � r.i e �,r� 1�-�i 1� '�2 5'�':�' r � `, , Please indicate the amo nt you�re seekin in compensation r what you would like the Ci to do to reso ve this claim to your satisfac ' n. �' lc�-�.- � i fi `Vehicle Claims— lease com lete this section ❑ check box if this section does not a 1 Your Vehicle: Yeaz 3� �'� Make a.�/ Model � License Plate Number �' ��' � State�► ,�Color 5i Ve�r Registered Owner 2-v� u.5�� Driver of Vehicle � nr� S� S o h Area Damaged o P.✓ — a 5 �' � City Vehicle: Year Make Model '�^ v�"' . 2 License Plate Number �i 3�, � State 1� Color w • Driver of Vehicle(City Employee's Name) Q— �� Area Damaged � �� iniurv Claims nlease comnlete this secdon �check box if this section does nct avulv How were you injured? 1 O_ What part(s)of your body were injured? , Have you sought medical treatment? Yes .�� Planning to Seek Treatment(circle) When did you receive treatment? (provide date(s)) Name af Medical Provider(s): Address Telephone Did you miss work as a result of your injury? Yes ,d�o` When did you miss work? (provide date(s)) Name of yodr Employer: n�� f • �- Address Telephone 5 I -7 3" ��O� � �j�Check here if you are attaching more pages to this claim form. Number of additional pag � �' �\ � � , �' , By signing this form,you are staling that all information you have provided is true and correct e best � I.� of your knowledge. Unsigned forms will not be processed. , g�,�"e7f � �e�- ' ri�Submitting a false claim can result in prosecution. Date form was completed �0�� `O�� 1 .� /� � � Print the Name of the Person who Completed this Form: `-c��Q� � �'�'S� �IV�� Signature of Person Maldng the Claim: � �'l�l.v`-�-- I � Revised February 2011 �y I � �� l � �� E� �� as�� ' � i � • • Pride,Professionalism & Partnership � L. MERCADO Police O�cer . POLICE DEPARTMENT CITY OF SAIlVT PAUL 367 Grove Street Voict Mail:651-266-900U ext 71299 Sainr Paul,MN 55/0l linda.mercado@ci.stpaul.mrt.us � �N� ��ao-� R 3 [f you have questions regarding your report,call: , � Saint Paul Politt Records Jnit (651)266-57W � . • , Revised June, 2004 INCIDENT REPORT CENTER C DATE TIME: i DETAILS OF INCIDENT: ,; . �. ��,,- c� � �'L� � � �`F ve��.,..�� , ��-�P �x�--� ��j � o�l t �2�-dZ t�� ; Z_e_.e�- �eC�.�((� `s� � ��'c� trL� w+rn�� pc�S�� s��e � -�� 1�� e k� .� i � , 1 -2�1'S�.�E�• < s �3�E...�'' � Police action: Po�� C�Q� How timel was the Police res anse? N/A Officer's Name - � ��,C�� Badge# Report# . _ � _ _ V�� What follow up action are you taking? - � _ r �� Syt.`-�--e,7 ?�S t;�-�'��..��._ (��YN �(�y�t�N � ;w��51�C _ �- e � � � (.'y�i`�"""" �' � 1 •�C"�'�'�C . (`�� (� � PEOPLE INVOLVED Name Address ' Phone A e %4(� �'� � . s��ay � (os - y3 _ S3 �� t�e.I' � I S ' �� S . � • � - 3 -��'G� 5. /�- -t �s►t ' 3�1! WITNESSES - Name . Address Phone A e i ; I All staff on duty at time: �jQ;, G ' � � Name of staff filin re ort: ' � � �,'' �S G:�Div�A-RECREATION SERVICES�RECREATION CENTERS�F'ormslIncident Report�BLANK. DO NOT SAVE OVER.doc Page 1 of 1 �� , . ..,�� ' � '� I r,._ � . .. .. �...: ""�' � x�� . ,.,as.�`��. E - ,. � -. , ;,...,...{-,.„�v��. � � .. . ,�;'.- ..:- � '.. . ._ _ Y� � � l. � . . ._ , . . � ' _ �G� w �. \ ' - � . � � � ' � .- � .. . . . ,. . � � � , ^ � . . . . � �� r 7 ,�-_ �. _ �, .� . . s . , -� 4 .��. � � � • , ' � .. . � � �':. • . _ , . . .. �� _ . , � � ' , ..:� -:-. 31 . _ � i • . c _ _ . ' . ��'!$ 1� . ... , . . 'eip . , . ajrAr� �,.o. . -°,--r`.: _ � � � . , .. . � .. .,.. .. . .. ` � ' � �. -� r . _ .,. . • .,....,. �k � � � , L- . _ .,. � �� .. . . + .• �1 . . �� • � .. � ' • (.'. �{ � �'' �,/ .•. * ' • � i � � � � �� . � , � � * ' • � � r � �� _ .. . .��.\1 ' :i} . 1 f . . .y' . .. ;� . , , . _ � . 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M�i • � , S . . ~ 1 ,. �I�. '� � • , • BEARTOWN AUTO BODY� INC. Workfile ID: 09fe7d70 FederalID: 41-1642045 2034 FLORENCE ST., WHITE BEAR LAKE, MN State ID: 26-20756 55110 Phone: (651)426-9368 � FAX: (651)426-6323 Preliminary Estimate � Customer:Tusa,Tom ]ob Number: Written By:JODIE SAX Insured: Tusa,Tom Policy#: Claim#: Type of Loss: Date of Loss: Days to Repair: 0 Point of Impact: Owner: Inspection Location: Inwrance Company: Tusa,Tom BEARTOWN AUTO BODY,INC. (651)434-4534 Business 2034 FLORENCE ST. WHITE BEAR LAKE,MN 55110 Repair Facility (651)426-9368 Business � , VEHICLE Year: 2007 Body Sryle: 4D SED VIN: 2G2WP552471139130 Mileage In: Make: PONT Engine: 6-3.8L-FI License: Mileage Out: Model: GRAND PRIX Production Date: State: Vehicle Out: Color: Int: Condition: Job#: - TRANSMISSION Dual Mirrors Message Center Communicatlons System Automatic Transmission � Body Side Moldings RADIO Hands Free Device � Overdrive Console/Storage AM Radio SEATS POWER CONVENIENCE FM Radio Clotfi Seats Power Steering Air Conditioning Stereo Budcet Seats Power Brakes Intermittent Wipers Search/Seek WHEELS Power Windows Tilt Wheel CD Player Aluminum/Alloy Wheels Power Locks Cruise Control SAFETY PAINT Power Mirrors Rear Defogger Drivers Side Air Bag Clear Coat Paint Power Driver Seat Keyless Entry Passenger Air Bag OTHER DECOR Alarm 4 Wheel Disc&akes Rear Spoiler � f 6/27/2014 1:16:35 PM 073517 Page 1 PDF created with pdfFactory Pro trial version www;pdffactory.com I � ( � . . d Preliminary Estimate Customer:Tusa,Tom 7ob Number: Vehicle: 2007 PONT GRAND PRIX 4D SED 6-3.Si-FI � Line Oper Description Part Number Qty Extended Labor. Paint Price; 1 FRONT BUMPER — 2 ** Repl RECOND Bumper cover 12335942 1 421.00 1.8 3.0 3 Add for Clear Coat 1•Z 4 # OEM-FLIX ADDITIVE 1 4.00 T � 5 # HAZARDOUS WASTE 1 3.00 X SUBTOTALS 428.00 1.8 4.2 ESTIMATE TOTALS Category Basis Rate Cost; pa� 421.00 Body Labor 1.8 hrs @ $54.00/hr 97.20 Paint Labor 4.2 hrs @ $54.00/hr 226.80 Paint Supplies 4.2 hrs @ $32.00/hr 134.40 ` Miscellaneous 7.00 Subtotal 886.40 Sales Tax $559.40 @ 7.1250% 39.86 Grand Total 926.26 Dedudible 0.00 CUSTOMER PAY 0.00 INSURANCE PAY. 926.26 / **WE ALSO DO MECHANICAL WORK** THIS REPORT IS AN ESTIMATE ONLY, BASED ON OUR INITIAL INSPECTION AND DOES NOT ACCOUNT FOR HIDDEN OR UNSEEN DAMAGE. PARTS PRICES MAY VARY AND ARE SUBJECT TO INVOICE FROM SUPPLIERS. WARRANTY: LIFETIME AGAINST DEFECTS IN WORKMANSHIP. WARRANTY REPAIRS DONE BY BEARTOWN AUTO BODY ONLY. NO GUARANTEE ON RUST REPAIR OR CORROSION RESISTANCE. OUR ESTIMATED COMPLETION TiME DOES NOT INCLUDE INSURANCE OR PARTS DELAYS THAT WE MAY EXPERIENCE. 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. 6/27/2014 1:16:35 PM 073517 Page 2 PDF created with pdfFactory Pro trial version www;pdffactorYcom Preliminary Estimate Customer:Tusa,Tom )ob Number: Vehicle: 2007 PONT GRAND PRIX 4D SED 6-3.8L-FI Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide DR1FD04, CCC Data Date 6/16/2014, 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 altemate 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 ve�iicles 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. O/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 ofi the MOTOR CRASH ESTIMATING GUIDE: � BAR=6ureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway ' Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number. 6/27/2014 1:16:35 PM ' 073517 Page 3 PDF created with pdfFactory Pro trial version www�pdffactoy.com � I � Preliminary Estimate j Customer:Tusa,Tom �ob Number: Vehide: 2007 PONT GRAND PRIX 4D SED 6-3.8L-FI ALTERNATE PARTS SUPPLIERS Line Supplier Description Price 2 Keystone-Insurance-A-I�inneapolis #GM1000698R $421.00 �3615 MARSHALL STREET NE RECOND Bumper cover � MINNEAPOLIS MN 55418 �, (800)328-1845 (612)789-1919 - � 6/27/2014 1:16:35 PM 073517 Page 4 PDF created with pdfFactory Pro trial version www.pdffactory.com i AutoNation Collision Center workfile�ID:-.._� 8af9274a _. .- Federaf I6:"� �--='�� 41-0609970 White_Bear Lake �,=- 1493 COUNTY ROAD E E, WHITE BEAR L��KE, MN 55110 i �'r1�°/ �C..� � � '. Phone: (651) 288-6262 i'�� 'L--',. �� Preliminary Estimate ;� � �� Customer: TUSA,TOM � . / 4, S Numberc Written B :Gnd Tuttle `/�`�� , Y Y Insured: TUSA,TOM Policy#: Gaim #: , Type of Loss: Date of Loss: Days fo Repair: _0.- Point of Impad: 12 Front , � � Owner: Inspection Location: Insurance Compa�y: TUSA,TOM AutoNation Collision Center White_Bear Lake 746 PENNINGTON PLACE 1493 COUNTY ROAD E E VADNAIS HEIGHTS,MN 55127 WHITE BEAR LAKE, MN 55110 (651)434-4534 CeU � Repair Faality (651)288-6262 Business VEHICLE Year: 2007 Body Style: 4D SED VIN: 2G2WP552471139130 Mileage In: 150000 Make: PONT Engine: 6-3.8L-Fi License: 197KKV Mileage Out: Model: GRAND PRIX Produdion Date: 9/2006 State: MN Vehicle Out: ' Color. SILVER Int: Condition: Job#: TRANSMISSION Dual Mirrors Message Center Communications System Automatic Transmission Body Side Moldings RADIO Hands FreP Device Overdrive , Console/Storage AM Radio , SEATS POWER CONVENIENCE FM Radio Cloth Seats Power Steering Air Conditioning Stereo Bucket Seats Power Brakes Intermittent Wipers Search/Seek WHEELS Power Windows Tilt Wheel CD Player Aluminum/Alloy Wheels Power Locks • Cruise Control SAFE7'Y ' PAINT Power Mirrors , Rear Defogger Drivers Side Air Bag Gear Coat Paint Power Driver Seat Keyless Entry Passenger Air Bag OTHER DECOR Alarm 4 Wheel Disc&akes Rear Spoiler `' A�toNation . Collision Center Clndy L TWrtk AutoNation Collision Center Estimator White Bear Lake 3191 Fanum Road � White Bear Lake,MN 55110 � 651-288-6262 Main ' 651488-6273 Direct 651-484-3537 Fax TuttIeC�AutoNation.com . 7/1/2014 1:35:35 PM � 065151 www.AutoNation.com . j Prelirr�inary Estimate Customer: TUSA,TOM 7ob Number: Vehicle: 2007 PONT GRAN�PRIX 4D SED 6-3.8L-FI SILVER Line Oper Description Part Number Qty Extended Labor Paint Price; 1 FRONT BUMPER 2 R&I License bracket �•z 3 0/H bumper assy 2•3 4 ** Repl A/M Bumper cover 12335942 1 421.00 Incl. 3.0 5 Add for Clear Coat • ' 1•2 6 R&I Lower panel Incl. 7 GRILLE g R&I RT Griile w/o special edition � Incl. 9 R&I LT Grille w/o special edition Incl. 10 FRONT LAMPS 11 R&I RT R&I headlamp assy one side IncL 12 R&I. LT R&I headlamp assy one side Incl. . 13 R&I RT Fog lamp assy Incl. 14 R&I LT Fog lamp assy � IncL � 15 Repl Aim headlamps 1 0.5 16 Repl Aim fog lamps 1 0.3 � 17 # Repi Flex additive ` � 1 5.00 � 18 # Subl HAZARDOUS WASTE FEE 1 5.00 X 19 # POSSIBLE HIDDEN DAMAGE 1 20 # PARTS PRICE PER INVOICE 1 SUBTOTALS 431.00 3.3 4.2 ESTIMATE TOTALS Category • Basis Rate Cost$ Parts 426.00 . �Y�� 3.3 hrs @ $54.00/hr 178.20 Paint Labor 4.2 hrs @ $54:00/hr 226.80 Paint Supplies 4.2 hrs @ $34.00/hr 142.80 Miscellaneous 5.00 Subtotal 978'80 Sales Tax $568.80 @ 7.1250% 40.53 Grand Total 1,019.33 Dedudible 0.00 CUSTOMER PAY 0.00 INSURANCE PAY 1,019.33 _ • � 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. 7/1/2014 1:35:35 PM 065151 . Page 2 . � Preliminary Estimate Customer:TUSA,TOM 7ob Number: Vehide: 2007 PONT GRAND PRD(4D SED 6-3.8L-FI SILVER Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide DRiFD04, CCC Data Date 6/16/2014, 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 (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk (*) or pouble Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Tilde sign (N) 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 sigri (#) 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 abbrevietions or symbots that may be used to describe work to be done or parts to be repaired or replaced: SYMBOLS FOLLOWING PART PRICE: m=MOTOR ��lechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category. X=Miscellaneous Non-Taxed charge category. SYMB�LS FOLLOWING LABOR: D=Diagnostic iabor 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 Categcries. OTHER SYMBOLS AND ABBREVIATIONS: � � Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. BInd=6lend. BOR=Boron steel. CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel: Inc1.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part. 0/H=Overhaul. Qty=Quantity. Refn=Refinish. Repl=Replace. R&I=Remove and Ir�stall. 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�CC Informetion Services Inc. , The following is a lis� of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: ` BAR=Bureau of Automotive R'�pair. EPA=Environmental Protection Agency. NHTSA= National Highway . Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number. 7/1/2014 1:35:35 PM 065151 Page 3 I Preliminary Estimate / , Customer: TUSA,TOM 7ob Number: Vehicle: 2007 PONT GRAND PRIX 4D SED 6-3.8L-FI SILVER ALTERNATE PARTS SUPPLIERS Supplier: Keystone-Insurance-A-Minneapolis LocaGon(s): 3615 MARSHALL STREET NE,MINNEAPOLIS MN 55418 (800)328-1845 (612)789-1919 Line Description Item# Price 4 A/M Bumper cover • GM1000698 $421.00 , , , . • 7/1/2014 1:35:35 PM 065151 Page 4