Gomez ��~����:��'�D
�,
NOTICE OF CLAIM FORM to the Cit�'b�f�ainot aul, Minnesota
, ...¢� �
"�> _,G,.a�`��.
Minnesota State Statute 466.05 states that "...every person...who claims damages�»i¢ny munzczpalzty...shall cause to be presented to the
governing body of the municipality within 180 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 clarify answers,so provide as
much information as necessary to ezplain 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 OTHER DOCUMENTS TO: CITY CLERK,
15 WEST KELLOGG BL�D, 310 CITY HALL, SAINT PAUL, MN 55102
First Name 1 � �r Middle Initial � Last Name '� Z.
rGr�����
Company or Business Name � 2��2
Are You an Insurance Company? Yes�`.:y' If Yes, Claim Number?
Street Address � � �.� � �,1�� � v _ �, � � !���
^ f
City � ` �� Sta.te �1n Zip Code 5 � � I �
Daytime Phone(�'s�)�����( Cell Phone �� ��Sg�y� Evening Telephone��'�""--'—'
Date of Accident/Injury or Date Discovered D ' 1 Time�(��pm
Please state,in detail,what occurred(happened),and why you axe 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.
Ple check the box(es)that most closely represent the reason for completing this form:
My vehicle was damaged iri 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
❑ Other type of injury—please specify
In order to process your claim you 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 V�II,L 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 far the repairs to your vehicle if the damage exceeds �
$500.00; or the actual bills andlor 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 estima.tes if the damage exceeds $500.00; or the actual bills
and/or receipts for the repairs; detailed list of daxnaged items
O Injtuy claims: medical bills,receipts
O Photographs are always welcome to document and support your claim but will not be returned.
Page 1 of 2—Please complete and return both pages of Claim Form
Failure to complete and return both pages will result in delay in the handling of your claim.
All Claims—please complete this section
Were there witnesses to the incident? Yes No Unlrnown (circle)
Provide their names,addresses and telephone numbers:
Were the police or law enforcement called? Yes No Unlrnown (circle)
If yes,what department or agency? Case#or report#
Where did the accident or injury take place? Provide street address,cross street,intersection,name of park or facility,
closest lanclmark,etc. Please be as detailed as possible. If necessary, attach a diagram.
Please indicate the amount you are seeking in compensation or what you would like the City to do to resolve this cla.im
to your satisfaction.
Vehicle Claims— lease com lete this section ❑ check box if this section does not a l
Your�ehicle: Year O O Make (' � , Model � v Q c..�
License Plate Number �"$ v State '�Color �-�r c�..�
Registered Owner c� ,.- �,v�-c
Driver of Vehi�e ,�
Area Damaged `e ,r v� �
City Vehicle: Year � Ma e Model
License Plate Number State Color
Driver of Vehicle(City Employee's Name) �
Area Damaged
In'ur Claims— lease com lete this section ❑ check box if this section does not a 1
How were you injured� �� w e Y p c�;r�.
What part(s)of your body were injured?
Have you sought medical treatment? es Planning to Seek Treatment(circle)
When did you receive treatment? (provide da.te(s))
Name of Medical Provider(s): � ��c c •
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 form,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 irt prosecution. Date form was completed � � � � \ �
Print the Name of the Person who Completed tlus m: eJ l C/ Y �� �'�
Signature of Person Making the Claim:
Revised February 2011
ABRA Auto Body &Glass - West St Workfile ID: 26e180b8
FederalID: 41-1942823
Paul
Right the First Time...On Time
130 THOMPSON AVE E, West Saint Paul, MN
55118
Phone: (651) 552-7744
FAX: (651) 552-8176
Preliminary Estimate
Customer: GOMEZ, MELBOR 7ob Number:
Written By:Craig Scheffler
Insured: GOMEZ, MELBOR Policy#: Claim#:
Type of Loss: Date of Loss: Days to Repair: 0
Point of Impact: 05 Right Rear
Owner: Inspection Location: Insurance Company:
GOMEZ, MELBOR ABRA Auto Body&Glass-West St Paul CUSTOMER PAY
120 HYACINTH AVE 130 THOMPSON AVE E
ST PAUL,MN 55117 West Saint Paul, MN 55118
(612)775-8441 Evening Repair Facility
(651)552-7744 Business
VEHICLE
Year: 2003 Body Style: 4D UTV VIN: 1GKET165336105116 Mileage In: 136485
Make: GMC Engine: 6-4.2L-FI License: 8586VT Mileage Out:
Model: ENVOY 4X4 SLT XL Production Date: 7/2002 State: MN Vehicle Out:
Color: SILVER Int: Condition: ]ob#:
TRANSMISSION Body Side Moldings Message Center SEATS
Automatic Transmission Dual Mirrors RADIO Leather Seats
4 Wheei Drive Privacy Glass AM Radio Bucket Seats
Overdrive Console/Storage FM Radio 3rd Row Seat
POWER Overhead Console Stereo WHEELS
Power Steering CONVENIENCE Search/Seek Aluminum/Alloy Wheels
Power Brakes Air Conditioning CD Player PAINT
Power Windows Rear Defogger SAFETY Clear Coat Paint
Power Locks Tilt Wheel Anti-Lock Brakes(4) OTHER
Power Driver Seat Cruise Control Driver Air Bag Fog Lamps
Power Passenger Seat Intermittent Wipers Passenger Air Bag Signal Integrated Mirrors
Power Mirrors Keyless Entry 4 Wheel Disc Brakes TRUCK
Heated Mirrors Duai Air Condition Communications System Rear Step Bumper
Memory Package Rear Window Wiper ROOF Trailering Package
DECOR Steering Wheel Controls Luggage/Roof Rack Power Trunk/Tailgate
il/2/2012 3:39:16 PM 029893 Page 1
Preliminary Estimate
Customer: GOMEZ, MELBOR 7ob Number:
Vehicle: 2003 GMC ENVOY 4X4 SLT XL 4D U1V 6-4.2L-FI SILVER
Line Oper Description Part Number Qty Extended Labor Paint
Price$
1 WHEELS
2 ** Repl RECOND RT/Rear Wheel,alloy 9595182 1 289.00 m 0.3
.__. --- --
type 2 w/o tint
_.__. ___.... _w__
_. --. _..�._ � __.
3 ROOF _ _ _�. ,. _.__ ___ _ _.._....-. --
4 R&I RT R&I�uggage rack 0.6
__ _ �_ __,.. __
_ _ __ - _ __._. __
5 PILLARS,ROCKER&FLOOR
6 Repl LT Rocker molding GMC,w/o 15188880 1 436.10 0.4 1.2
Denali front
7 Add for Clear Coat 0.2
___.. __ _ _ __ _ _
_-� -� �-�_.
8 REAR DOOR _ . _ _-
9 R&I RT R&I door assy 1.3
10 Bind RT Door shell w/long wheel base 1.2
GMC
11 R&I RT Belt w'strip w/long wheel base 0.3
GMC
12 * R&I RT Side moiding w/long wheei Q,�
base,w/o chrome w/o DENALI
13 # Rpr 'Clean&Retape Molding 0.3
14 R&I RT Moveable glass GM,w/short 0.5
wheel base dnted
15 * R&I RT Fixed giass GMC,w/long g,�
wheel base privacy
16 R&I RT Handle,outside primed 0.4
17 R&I RT R&I trim panel 0.6
__ � _ .__ _. _ _ _ _ .. _ _ _ _ ___
18 QUARTER PANEL
19 Repi RT Quarter panel w/long wheel 15192231 1 545.46 16.5 3.4
base
20 Add for Clear Coat 1.4
21 RScI RT Qtr glass tinted Incl.
22 # Blnd RT Sail p.g
-----_____ ___----- - --_ ___ ___ _.
23 LIFT GATE _W ___ _ _. _ . _ __ _ - - -__. -----_
24 * Repl LKQ lift gate+30% 89025440 1 650.00 0.8 3.1
25 Overlap Major Adj. Panel -0.4
26 Add for Clear Coat 0.5
27 Add for rear wiper 0.4
28 Refn lift gate underside 1.0
29 * R&I License pocket 9�Z
30 Repi Nameplate"GMC" 15186371 1 35.74 0.2
31 Repl Namepiate"ENVOY" 15123976 1 42.33 0.2
32 R&I Handie 0.4
33 * R&I Lock Q,�
34 R&I Lift gate glass GM,w/rear 1.0
defogger tinted
35 R&I Wiper arm 0.2
11/2/2012 3:39:16 PM 029893 Page 2
Preliminary Estimate
Customer: GOMEZ, MELBOR Job Number:
Vehicle: 2003 GMC ENVOY 4X4 SLT XL 4D UTV 6-4.2L-FI SILVER
36 * R&I Wiper motor m �
37 R&I Upper molding oak 0.3
38 R&I Lower trim panel pewter 0.4
_ _ . _ _
_ _ _
. _ _ _ ___ ____ _ __ _ .
39 REAR LAMPS
40 * Repl LKQ RT Tail lamp assy+30% 15131577 1 117.00 Ip�,
41 Repl RT Applique 88937022 1 69.65 0.1 0.5
42 Add for Clear Coat 0.1
_ _ __ ---
_ ._ _ __ _._ ___ _ __ ._ .
__ __ __..__ -
43 REAR BUMPER
44 0/H rear bumper i,g
45 ** <> Repl RECOND Bumper cover GMC 12335703 1 380.00 Inci. 2.8
46 Overlap Major Non-Adj. Panel _p,2
47 * Add for Clear Coat 0.5
48 Deduct for Rear Bumper R&I -1,Z
49 # Subl '2 Wheel Alignment 1 69.95 X
50 # Repl 'Seam Sealer 1 50.00 X 0.5
51 # Refn 'Car Cover 0.i
52 # Refn 'Corrosion Protection 0.3
53 # Repl 'Flex Additive/Adhesion Promoter 1 8.50 X
54 # 'Hazardous Waste 1 5.00 X
SUBTOTALS 2,698.73 29.0 16.5
ESTIMATE TOTALS
Category Basis Rate Cost�
Parts 2,565.28
Body Labor 29.0 hrs @ $54.00/hr 1,566.00
Paint Labor 16.5 hrs @ $54.00/hr 891.00
Paint Supplies 16.5 hrs @ $34.00/hr 561.00
Miscellaneous 133.45
Subtotal 5,716.73
Sales Tax $2,565.28 @ 7.1250% 182.78
Grand Total 5,899.51
Dedudible 0.00
CUSTOMER PAY 0.00
INSURANCE PAY 5,899.51
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."
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.
11/2/2012 3:39:16 PM 029893 Page 3
Preliminary Estimate
Customer: GOMEZ, MELBOR 7ob Number:
Vehicle: 2003 GMC ENVOY 4X4 SLT XL 4D UTV 6-4.2L-FI SILVER
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide
DR1GN02, CCC Data Date 10/17/2012, 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 (�) 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 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 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 foltowing 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 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.
11/2/2012 3:39:16 PM 029893 Page 4
Preliminary Estimate
Customer: GOMEZ, MELBOR 7ob Number:
Vehicle: 2003 GMC ENVOY 4X4 SLT XL 4D UTV 6-4.2L-FI SILVER
ALTERNATE PARTS SUPPLIERS
Supplier: Keystone-P+A-Minneapolis
Location(s): 3615 MARSHALL STREET NE,MINNEAPOLIS MN 55418 (800)328-1845 (612)789-1919
Line Description Item# Price
45 RECOND Bumper cover GMC GM1100628R $380.00
11/2/2012 3:39:16 PM 029893 Page 5
• OKEEFFES COLLISIOPI �►��e ID: 15d76306
FederalID: 274472577
860 PAYNE AVE, SAINT PAUL, MN 55130
Phone: (651)493-9484
FAX: (651)493-9359
Preliminary Estimate
Customer: Gomez, Melchor �ob Number•
Written By: David O'Keeffe
Insured: Gomez,Melchor Policy#: Claim#:
Type of Loss: Date of Loss: Days to Repair: 0
Pant of Impact:
Owner: Inspectlon Location: Insurance Company:
Gomez,Melchor OKEEFFES COLLISION
120 Hyacinth Ave 860 PAYNE AVE
St. Paul,MN 55117 SAINT PAUL,MN 55130
(612)775-8441 Day Repair Facility
(651)493-9484 Business
VEHICLE
Year: 2003 Body Style: 4D UTV VIN: 1GKEf16S336105116 Mileage In:
Make: GMC Engine: 6-4.2L-FI License: Mileage Out:
Modei: ENVOY 4X4 SLT XL Production Date: State: Vehide Out:
Color: Int: Condition: Job#:
TRANSMISSION Body Side Moldings Message Center SEATS
Automatic Transmission Dual Mirrors RADIO Leather Seats
4 Wheel Drive Privacy Glass AM Radio Bucket Seats
Overdrive Console/Storage FM Radio 3rd Row Seat
POWER Overhead Console Stereo WHEELS
Power Steering CONVENIENCE Search/Seek Aluminum/Alloy Wheels
Power Brakes Air Conditioning CD Player PAINT
Power Windows Rear Defogger SAFETY Clear Coat Paint
Power Locks Tilt Wheel Ma-Lodc Brakes(4) OTHER
Power Driver Seat Guise Control Driver Air Bag Fog Lamps ,
Power Passenger Seat Intermittent Wipers Passenger Air Bag Signal Integrated Mirrors �
Power Mirrors Keyless Entry 4 Wheel Disc Brakes TRUCK
Heated Mirrors Dual Air Condition Communiptioru System Rear Step Bumper
Memory Padcage Rear Window Wiper ROOF Trailering Padcage
DECOR Steering Wheel Controls Luggage/Roof Rack Power Tn�nk/Tailgate
1/21/2013 2:58:08 PM 303923 Page 1
� Preliminary Estimate
Customer: Gomez, Melchor 7ob Number:
Vehide: 2003 GMC ENVOY 4X4 SLT XL 4D UTV 6-4.2L-FI
Line Oper Description Part Number Qty Entended Labor Paint
Price#
1 REAR BUMPER
2 O/H rear bumper i,g
3 * Repl Bumper cover GMC 12335703 1 380.00 Ind. 2.8
4 Add for Clear Coat 1.1
5 REAR LANIPS
6 Repl RT Tail tamp assy 15131577 1 129.93 Ind.
7 REAR DOOR
8 Bind RT Door sheli w/short wheel base 1.2
GMC&Oids
9 R&I RT Belt w'strip w/short wheel 0.3
base
10 R&I RT Rear molding 0.3
11 R8eI RT Applique front p,2
12 Repl RT Nameplate"SlT' 15001733 1 14.40 0.3
13 R&I RT Side molding 0.5
14 R&I RT Moveable glass GM,w/short 0.5
wheel base tinted
15 R&I RT Fixed glass GMC,w/short 0.5
wheel base tinted
16 R&I RT Handle,outside black 0.4
17 R8eI RT R&I trim panel 0.6
18 QUARTER PANEL
19 Repl RT Quarter panel w/long wheel 15192231 1 567.28 16.5 3.4
bdse
20 Add for Gear Coat 1.4
21 Deduct for Rear Bumper R&I -1.2
22 R&I RT Qtr glass GM,w/o GPS, Incl.
w/short wheei base w/o deep bnt
23 LiFT GATE
24 Repl Nameplate"6MC" 15186371 1 37.17 02
25 * Repl LKQ lift gate 89025440 1 650•00 0.8 3.1
26 Overlap Major Adj.Panel -0.4
27 Add for Clear Coat 0.5
28 Repl Nameplate"ENVOY" 15123976 1 44.03 0.2 '
29 Repl Nameplate"XL" 15133077 1 40.22 0.2 ��
30 REAR BODY 8c FLOOR �
31 * Rpr RT Side reinf w/long wheel base �Q 1.2 �
32 # Recon Rt rear wheel 1 289.00
33 # Possible Hidden Damage and 1
Mechanical
SUBTOTALS Z,152.03 23.1 14.3
1/21/2013 2:58:08 PM 303923 Page 2
Preliminary Estimate
Customer: Gomez, Melchor 7ob Number:
Vehide: 2003 GMC ENYOY 4X4 SLT XL 4D UN 6-4.2L-FI
ES'TIMATE TOTALS
Cabegory B�is Raue Cost;
Parts 2,152.03
Body labor 23.1 hrs @ $50.00/hr 1,155.00
Paint Labor 14.3 hrs @ $50.00/hr 715.00
Paint Suppiies 14.3 hrs @ $30.00/hr 429.00
Subtotai 4,451.03
Sales Tax $2,152.03 @ 7.6250% 164.09
Grand Total 4,615.12
Deductible 0.00
CUSTOMER PAY 0.00
INSURANCE PAY 4,615.12
OKeeffes Collision takes great care to ensure every repair we perform meets your satisfacticm.
The labor performed by OKeeffes Collision is guaranteed against any defect in workmanship for as long as you own
your car.
OKeeffes Collision guarantees that for as long as you own your vehicle, OKeeffes Collision will, at its e�cpense, correct
or repair all
defects which are attributabte to defective or faulty workmanship in the repairs stated on the repair invoice, unless
caused by or damaged resumng from unreasonable use, improper maintenance or care of vehicie, and rust and/or
corrosion.
This guarantee rnvers labor only and does not apply to parts, materials or equipment which may be covered by
manufacturer's warranty.
MN ST 60A.955 - A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD
AGAINST
AN iNSURER IS GUILTY�F A CRIME, AND MAY BE PROSECUTED UNDER STATE LAW.
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.
1/21/2013 2:58:08 PM 303923 Page 3
Preliminary Estimate
Customer: Gomez, Melchor 7ob Number:
Vehide: 2003 GMC ENVOY 4X4 SLT XL 4D UTV 6-4.2L-FI
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide
DRiGN02, CCC Data Date 1/17/2013, 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 o�ALT OEM parts may reflect some specif'�c, 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 aftemate 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-0riginal Equipment Manufacturer aftermarket parts are described as AM.
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 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 oomplete 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 wo�ic to be done or parts to
be repaired or repiaced:
SYMBOLS FOLLOWING PART PRICE:
m=MOTOR Mechanical mmponent. s=MOTOR Structural rnmponent. T=Miscellaneous Taxed charge category.
X=Misoellaneous Non-Taxed charge category.
SYMBOLS FOLLOWtNG tABOR:
D=Diagnostic labor category. E=Electricai 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=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 Intemational Certified Part. O/H=Overhaul. Qty=Quantity. Refi=Refinish. Repl=Replace.
R&I=Remove and Install. RScR=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 Fstimatirx�that are not part of the MOTOR �
CRASH ESTIMATING GUIDE:
BAR=Bureau of Automotive Repair. EPA=Environmerrtal Protection Agency. NHTSA= National Highway
Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehide Identification Number.
1/21/2013 2:58:08 PM 303923 Page 4
Accident Report Page 1 of 1
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http://dvslesupport.org/dvsinfo/accidentrecords_2008/Includes_LE/PrintReportIndiv_LE.... 10/23/2012