Lopez �_ ,�,.
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NOTICE OF CLAIM FORM t6�h� ���+of Saint Paul, Minnesota
,
Minnesota State Statute 466.05 states that "...every person...who c��` `��la�s��arry municipality...shall cause to be presented to the
governing body of the municipality within 180 days after the all ge loss or injury is discmered a notice stating the time,place,arrd
' circumstances thereof,�a»d the amourit of compensation or other relief demanded"
Please complete this form in its entirety by clearly typjng or printing your answer to each question. If more space is
needed,attach additional sheets. Please note that you w�l not be contacted by telephone to clarify answers,so provide as
mnch information as necessary to explain your claim,anc�the amount of compensation being requested. You wilt 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,anci both pages completed. If something does not apply,write�N/A'.
SEND COMPLETED FORM AND OTHER DOCUMENTS TO: CITY CLERK, 'I
15 WEST KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102 �
(
First Name y J( ���(�I Middle Initial V Last Name �� (� I
. �— . I
_ Company or Business Name 'I
Are You an Insurance Company? Yes/N�o If Yes,Cl�im Number? i
�^ ,
Street Address�� �i`�� �(a Y` � J �
� ) ,� ) I
City �T '�i� � Sta�e- �►V Zip Code���� !
�
Daytime Phone��.���Cell Phone�) - Evening Telephone(���-� �I
Date of Accident/Injury or Date Discovered � a l " _Time QI '� ���pm
, ; - , . �
Please state,in detail,what occurred(happened),and wh you are submitting a claim.Please indicate wl}y or how you
f el the Ci o ain Paul or its employ s are involved d/or responsibla�far.your d ages. - f�'
. R' Y�? Yl �
/ �
� _ -
Please check the box(es)that most closely represent the�eason for completing this form:
❑ y vehicle was damaged in an accident � My vehicle was damaged during a tow
My vehicle was damaged by a pothole or condition of the stree ❑ My vehicle was damaged by a plow
❑My vehicle was wrongfully towed and/or bckete 0 I was injured on City properly /
�er type of property damage–please specify a �'�g�
❑ Other type of injury-please specify '
i .
In order to process your claim vou need to include coaies of all auulicable documents.
For the claims types listed below,please be sure to include the documents indicated or it will delay the handling of
your claim. Documents WILL NOT be returned and become the property of the City. You are 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 is�ued and a copy of the impound lot receipt ,
O Other property damage claims:two repair esti�nates if the damage exceeds$500.00;or the actual bills
and/or receipts for the repairs;detailed list of dar�►aged items
O Injury claims:medical bills,receipts
O Photographs aze always welcome to documen�and support your claim but will not be retumed.
Page 1 of 2–Please complete and return both pages of Claim Form '
Failure to complete and return both pages wilt resnit in delay in the handling of your claim.
All Claims—ulease complete this section -
Were there witnesses to the incident? es No U o (circle) ..
-� 'Provid theirm s,ad esses an telephonep�n� ! j^ `��
.... �,,' ��,�
Were the police or law enforcement called? Yes No 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,
close 1 dmaz tc. leas e as de 'led as sib . s ,attach a 'a
Please indicate the�ount you are,dseeking; compen tion or what you would like e City to do t re�olve this claim
to your atisfac n. � n D �
Vehicle Claims— lease com lete this section ❑ heck box if this section does not a 1
Your Vehicle: Year o Make ` Model
' License Plate Num e State Co or
Registered Owner
Driver of Vehicle
Area Damaged '�
City Vehicle: Year Make Model '
License Plate Number State Color
Driver of Vehicle(City Employee's Name) *
Area Daxnag�ed � '
�
Iniurv Claims—please complete this section ❑check box if this section does not applv
How were you injured?
�i . .
What part(s)of yo�r body were injured? �"'��a,
�
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 attaclung more pages to this claim form. Number of additional pages +
By signing this for»:,you are stating that all information you have provided is hue and correct to the best
of your knowledge. Unsigned forms will not be processed �
Submitting a false claim can result in prosecution. Date form as completed ����
' W �
Print the Name of the Person who Completed this Form: U n�f"!
� .
Signature of Person Making the,Claim:
Revised�ebruary 2011
,<:�;;
RY'S COLLISION - MAPLEWOOD
2923 MAPLEWOOD DR, SAINT PAUL, MN 55109
Phone: (651) 766-9770, Fax: (651) 766-8660
. . - - . .
Owner: LOPEZ,YURIDIA Insurance: Estimator: Mike Spainhower Vehicle Out:
Job Number: Claim Number:
. Year. 2012 Color. GREY License Plate: 760-JKM Production Date: 2/1/2012
Make: TOYO Body Style: 4D SED State: MN Mileage In: 9,659
Model: COROLLA S Engine: 4-1.8L-FI VIN: SYFBU4EE3CP009097 Condition:
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10/1/2012 2:31:01 PM
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LAMETTRY'S COLLISION - MAPLEWOOD
2923 MAPLEWOOD DR, SAINT PAUL, MN 55109
Phone: (651) 766-9770, Fax: (651) 766-8660
. . - - . �
Owner: LOPEZ,YURIDIA Insurance: Estimator: Mike Spainhower Vehicle Out:
Job Number. Claim Number:
Year. 2012 Color. GREY License Plate: 760-JKM Production Date: 2/1/2012
Make: TOYO Body Style: 4D SED State: MN Mileage In: 9,659
Model: COROLLA S Engine: 4-1.8L-FI VIN: SYFBU4EE3CP009097 Condition:
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10/1/2012 2:31:01 PM Page 2
LAMETTRY'S COLLISION - MAPLEWOOD
2923 MAPLEWOOD DR, SAINT PAUL, MN 55109
Phone: (651) 766-9770, Fax: (651) 766-8660
. . - - . .
Owner. LOPEZ,YURIDIA Insurance: Estimator: Mike Spainhower Vehicle Out:
Job Number: Claim Number: I
Year: 2012 Color: GREY License Plate: 760-]KM Production Date: 2/1/2012
Make: TOYO Body Style: 4D SED State: MN Mileage In: 9,659
Model: COROLLA S Engine: 4-1.8L-FI � VIN: SYFBU4EE3CP009097 Condition:
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10/1/2012 2:31:01 PM Page 3
LAMEITRY'S COLLISION - Workfile ID: 06de48e2
FederalID: 411393089
MAPLEWOOD
"Every Customer Leaves With A Smile"
2923 MAPLEWOOD DR, SAINT PAUL, MN 55109
Phone: (651) 766-9770
FAX: (651) 766-8660
Preliminary Estimate
Customer: LOPEZ,YURIDIA 7ob Number:
Written By: Mike Spainhower
Insured: LOPEZ,YURIDIA Policy#: , Claim #:
Type of Loss: Date of Loss: ! Days to Repair: 0
Point of Impact: 06 Rear
Owner: Inspection Location: Insurance Company:
LOPEZ,YURIDIA LAMETfRY'S COLLISI�ON-MAPLEWOOD
17 WHITE BEAR AVE S 2923 MAPLEWOOD D�
ST PAUL, MN 55106 SAINT PAUL, MN 55109
{612)237-7944 Cellular Repair Faciliry
(651)766-9770 Business -- -
VEHICLE
Year: 2012 Body Style: 4D SED VIN: SYFBU4EE3CP009097 Mileage In: 9659
Make: TOYO Engine: 4-1.8L-FI License: 760-JKM Mileage Out:
Model: COROLLA S Production Date: 2/2012 State: MN Vehicle Out:
Color: GREY Int: BLACK Condition: Job#:
TRANSMISSION Console/Storage FM Radio Bucket Seats
5 Speed Transmission CONVENIENCE Stereo WHEELS
Overdrive Air Conditioning Search/Seek Aluminum/Alloy Wheels
POWER Rear Defogger CD Player PAINT
Power Steering Tilt Wheel Auxiliary Audio Connection Clear Coat Paint
Power Brakes Cruise Control SAFETY OTHER
Powe�Windows Telescopic Wheel Anti-Lock Brakes(4) Traction Control
PoweK Locks Intermittent Wipers Driver Air Bag Stability,Control
Power Mirrors Keyless Entry Passenger Air Bag Fog Lamps
Heat�d Mirrors Steering Wheel Controls Head/Curtain Air Bags Rear Spoiler
Power Trunk/Tailgate Message Center I Front Side Impact Air Bags
DECOR RADIO , SEATS
Dual Mirrors AM Radio Cloth Seats
10/1/2012 2:31:37 PM � 053108 Page 1
Preliminary Estimate
Customer: LOPEZ,YURIDIA 7ob Number:
Vehicle: 2012 TOYO COROLLA S 4D SED 4-1.8L-FI GREY
Line Oper Description Part Number Qty Extended Labor Paint
Price$
1 # **ADDITONAL PARTS AND 1
LABOR MAY BE NEEDED***
2 # ***HIDDEN DAMAGE MAY BE 1
FOUND***
3 REAR BUMPER
4 0/H bumper assy i 1.8
5 ` � � Repl Bumper cover US built 5 5215902978 1 264.33 Incl. 3.0
` 6 � ' Add for Clear Coat `� ' l:Z
7 Add for spoiler 0•4
8 Repl Spoiler center 7689102030 1 415.96 Incl.
9 Repl Prep unprimed bumper 1 0.8
10 Repl Side spoiler retainer center 7539235220 5 8.60
spoiler
11 FRONT BUMPER
12 Repl RT Spoiler 7685102909 1 56.49 0.3 0.6
13 Add for Clear Coat 0.1
14 # ***MAY HAVE TO R&I BUMPER 1
TO INSTALL SPOILER**
15 ** Repl A/M Clips and Fasteners 1 10.00 T
16 # Flex Additive 1 6.00 X
17 # Subl Hazardous Waste Disposal Fee 1 5.00 X
18 # Refn Tint Color 0.5
SUBTOTALS 766.38 2.5 6.2
ESTIMATE TOTALS
Category Basis Rate Cost�
Parts 745.38
Body Labor 2.5 hrs @ $54.00/hr 135.00
Paint Labor ! 6.2 hrs @ $54.00/hr 334.80
Paint Supplies 6.2 hrs @ $38.00/hr 235.60
Body Supplies 2.5 hrs @ $2.00/hr 5.00
Miscellaneous ' 21.00
Subtotal ' 1,476J8
Sales Tax $755.38 @ 7.1250% 53.82
Grand Total ` 1,530.60
Deductible 0.00
CUSTOMER PAY 0.00
INSURANCE PAY 1,530.60
10/1/2012 2:31:37 PM 053108 Page 2
' , i
Preliminary Estimate
Customer: LOPEZ,YURIDIA Job Number:
Vehicle: 2012 TOYO COROLLA S 4D SED 4-1.8L-FI GREY
THIS REPORT IS AND ESTIMATE ONLY, BASED ON OUR INITIAL INSPECTION AND DOES NOT COVER ADDITIONAL
PARTS OR LABOR WHICH MAY BE REQUIRED AFTER THE WORK IS OPENED UP. PART PRICES SUBJECT TO
CHANGE PER THE MANUFACTURER AND AVAILABILITY.
WARRANTY: LIFEfIME AGAINST DEFECTS IN WORKMANSHIP. WARRANTY REPAIRS DONE BY LAMETTRY'S
COLLISION ONLY. NO WARRANTY ON RUST, CORROSION RESISTANCE OR REPLACEMENT RENTAL CARS.
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 �NTENT TO DEFRAUD OR HELPS COMMIT A FRAUD .._ _ _
AGAINST AN I�VSURER dS GUILTY OF A CRIME. ! .:.; i
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide
ARM8428, CCC Data Date 9/17/2012, and the parts seledted 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 prov�ed by or through alternate sources other than the OEM
vehicle dealerships. OPT OEM or ALT OEM parts may re ect some specific, special, or unique pricing or discount.
OPT OEM or ALT OEM parts may include "Blemished" parks 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_AM.
Used parts ar� 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.
�abor operation times listed on the line with the NAGS in�ormation are MOTOR suggested labor operation times.
NAGS labor operation times are not included. Pound sign�(#) items indicate manual entries.
Some 2012 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 symbdls that may be used to describe work to be done or parts to
be repaired or,replaced:
SYMBOL5 FOLLOWING PART PRICE: ,
m=MOTOR Mechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category:
X=Miscellarleous 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=Blend. BOR=6oron steel.
CAPA=Certified Automotive Parts Association. D&R=Discannect and Reconnect. HSS=High Strength Steel.
HYD=Hydroformed Steel. Inc1.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non
k�djacent. 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.
10/1/2012 2:31:37 PM I 053108 Page 3
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, �
Prelimihary Estimate
Customer: LOPEZ,YURIDIA 7ob Number:
Vehicle: 2012 TOYO COROLLA S 4D SED 4-1.8L-FI GREY
Sect=Section. Subl=Sublet. UHS=UItra High Strength 5teel. 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 ESfIMATING GUIDE:
BAR=Bureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway
Transportation and Safety Administration. PDR=Paintles5 Dent Repair. VIN=Vehicle Identification Number.
_ .. _ _ I ,
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10/1/2012 2:31:37 PM �� 053108 Page 4
S a 1ewood drive
�p gODY&G� 2806 M P MN 55109
d,
�w.abraauto.com PhaP1ewoo abrQputo com
Emp���h1Q�AgR• �.aaa.a�2.2v2 Workfile ID: 9413529e
�_� �.aaa.usA. 1ut0 BOdy & G18SS -
FederalID: 41-1942823
Maplewood
Right The First Time...On Time
2806 HIGHWAY 61, MAPLEWOOD, MN 55109
Phone: (651) 483-2145
FAX: (651)483-2509
Prelimiriary Estimate
Customer: Lopez,7udy 7ob Number:
Written B�y: Heather Larson
Insured: Lopez,Judy Policy#: Claim#: .
Type of Loss: Date of Loss: 10/1/2012 12:00:00 PM Days to Repair: 0
Point of Impact: 07 Left Rear
Owner: Inspection Location: Insurance Company:
Lopez,)udy ABRA Auto Body&�lass-Maplewood CUSTOMER PAY
17 White bear ave S. 2806 HIGHWAY 61
St. Paul,MN 55106 MAPLEWOOD, MN 55109
(612)237-7944 Business Repair Facility
(651)483-2145 Business
VEHICLE
Year: 2012 Body Style: 4D SED VIN: SYFBU4EE3CP009097 Mileage In: 1
Make: TOYO Engine: 4-1.8L-FI License: 760-JKM Mileage Out:
Model: COROLLA S Produdion Date: 2/2012 State: MN Vehicle Out:
Color: GREY Int: Condition: Job#:
TRANSMISSION Console/Storage FM Radio Bucket Seats
5 Speed Transmission CONVENIENCE Stereo WHEELS
Overdnve Air Condifioning Search/Seek Aluminum/Alloy Wheels
POWER Rear Defogger CD Player PAINT
Power Steering Tilt Wheel Auxiliary Audio Connection Clear Coat Paint
Power Brakes Cruise Control SAFETY OTHER
Power Windows Telescopic Wheel Anti-Lock Brakes(4) Traction Control
Power Laks Intermittent Wipers Driver Air Bag Stability Control
Power Mirrors Keyless Entry Passenger Air Bag Fog Lamps
Heated Mirrors Steering Wheel Controls Head/Curtain Air Bags Rear Spoiler
Power Trunk/Tailgate Message Center Front Side Impact Air Bags
DECOR RADIO SEATS
Dual Mirrors AM Radio Cloth Seats
10/1/2012 3:02:04 PM 014563 Page 1
'Provi e work 'O�usto 'y"� repmwork
ding p Saf iners-right the flrsf t(
'Achievin p�pce�prote me...on tirpe
9 excAu�,,.�• cting the A,,,,;__
Prelimiriary Estimate
Customer: Lopez,7udy 7ob Number:
Vehicle: 2012 TOYO COI�OLLA S 4D SED 4-1.8L-FI GREY
Line Oper Description Part Number Qty Extended Labor Paint
Price�
1 REAR BUMPER i
2 <> Repl Bumper cover US built S 5215902978 1 264.33 1.5 3.0
3 Add for Clear Coat , 1.2
4 Add for spoiler 0.4 �
5 Repl Spoiler center j 7689102030 1 415.96 Incl. �
6 R&I RT Side spoiler 7689502914 Incl.
7 Repl LT Side retainer i 5215602100 1 38.90 0.1
8 R&I LT Side spoiler 7689602911 Incl.
9 Repl Prep unprimed bumper 1 0.8
10 ** Repl A/M Side spoiler clip 5216102020 5 10.60
11 Repl Bumper cover clip 5216102020 2 4.48
� __ _ _
_...
12 FRONT BUMPER
13 Repl RT Spoiler 7685102909 1 56.49 0.3 0.6 �
14 Overlap Minor Panel -0.2
15 Add for Clear Coat 0.1
16 # Repl �Flex Additive/Adhesion Promoter 1 8.50 X
17 # 'Hazardous Waste 1 5.00 X
18 ** Repl A/M RT Spoiler clip 5216102020 5 10.60 ,
SUBTOTALS 814.86 2.3 5S '
ESTIMATE TOTALS
Category Basis Rate Cost�
Parts 801.36
Body Labor 2.3 hrs @ $54.00/hr 124.20
Paint Labor 5.5 hrs @ $54.00/hr 297.00
Paint Supplies 5.5 hrs @ $34.00/hr 187.00
Miscellaneous 13.50
Subtotal 1,423.06
Sales Tax $801.36 @ 7.1250% 57.10
Grand Total 1,480.16
Deductible 0.00
CUSTOMER PAY I 0.00
INSURANCE PAY 1,480.16
� -
THIS IS A VISUAL INSPECTION ONLY. THERE MAY BE �ADDITIONAL DAMAGE AFfER 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."
�
10/1/2012 3:02:04 PM 014563 Page 2
Preliminary Estimate
Customer: Lopez,7udy �ob Number:
Vehicle: 2012 TOYO COROLLA S 4D SED 4-1.8L-FI GREY
MN ST 60A.955 - A PERSON WHO FILES A CLAIM WITH �NTENT TO DEFRAUD OR HELPS COMMIT A FRAUD
AGAINST AN INSURER IS GUILTY OF A CRIME.
Estimate based on MOTOR CRASH ESTIMATING GUIDE. I Unless otherwise noted all items are derived from the Guide
ARM8428, CCC Data Date 9/17/2012, and the parts sele�ted 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 prov�led by or through alternate sources other than the OEM
vehicle dealerships. OPT OEM or ALT OEM parts may re�lect some specific, special, or unique pricing or discount. i
OPT OEM or ALT OEM parts may include "Blemished" pa� provided by OEM's through OEM vehicle dealerships. �'
Asterisk (*) or pouble Asterisk (**) indicates that the pa 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 pertormed as a separate procedure
from the other panels in the estimate. Non-Original Equipment Manufacturer aftermarket parts are described as AM.
Used parts are described as LKQ, RCY, or USED. Recon�itioned parts are described as Recond. Recored parts are
described as Recore. NAGS Part Numbers and Benchma k Prices are provided by National Auto Glass Specifications.
Labor operation times listed on the line with the NAGS i�formation are MOTOR suggested labor operation times. ;
NAGS labor operation times are not included. Pound sigm (#) items indicate manual entries. ��,
Some 2012 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated
data from the vehicfe manufacturer, labor and parts data from the previous year may be used. The CCC ONE
estimator has a comp►ete list of applicable vehicles. Par�s numbers and prices should be confirmed with the local
dealership. i
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:
i
SYMBOLS FOLLOWING PART PRICE:
m=MOTOR Mechanical component. s=MOTOR Structur�l component. T=Miscellaneous Taxed charge category.
X=Miscellaneous Non-Taxed charge category.
SYMBOLS FOLLOWING LABOR:
D=Diagnostic labor category. E=Electrical �abor category. F=Frame labor category. G=Glass labor category.
M=Mechanical labor category. S=Structural labor categ�ry. (numbers) 1 through 4=User Defined Labor Categories.
i
OTHER SYMBOLS AND ABBREVIATIONS: '
Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. BInd=Blend. BOR=6oron steel.
CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel.
HYD=Hydroformed Steel. Inc1.=Included. LKQ=Like Kii�d and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non
Adjacent. NSF=NSF International Certified Part. O/H=Qverhaul. Qty=Quantity. Refn=Refinish. Repl=Replace.
R&I=Remove and Install. R&R=Remove and Replace. pr=Repair. RT=Right. SAS=Sandwiched Steel.
Sect=Section. Subl=Sublet. UHS=UItra High Strength teel. 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=6ureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway
Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number.
,
10/1/2012 3:02:04 PM I 014563 Page 3
Preliminary Estimate
Customer: Lopez,7udy .7ob Number:
Vehicle: 2012 TOYO COR�OLLA S 4D SED 4-1.8L-FI GREY
ALTERNATE F�ARTS SUPPLIERS
I
Supplier: Kent Automotive
Location(s): 1666 EAST TOUHY AVENUE, DES PLAINES IL 60018 I (847)827-9666 (847)827-1525
Line Description ' Item# Price
10 A/M Side spoiler clip KT11709 $2.12
18 A/M RT Spoiler clip KT11709 $2.12
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10/1/2012 3:02:04 PM 014563 Page 4