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Schendel _ i • �tEC�tVED . MAR 0 6 2013 � NOTICE OF CLAIM FORM to the�i�y o�'�aint Paul, Minnesota 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 municipality within 180 days after the alleged loss or injury is discovered a notice stating the time,ptace,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 explain your claim,and the amount of compensation being requested. You will receive a written acknowledgement once your form is received. The prceess can take up to ten weeks or longer depending on the nature of your claim. This form must be signed,and both pages completed. ff something does not apply,write`N/A'. 5END COMPLETED FORM AND OTHER DOCUMENTS TO: CITY CLERK, 15 WEST KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102 First Name ��}-,5 f��l� Middle Initial � Last Name S<<1 L� ��`� Company or Business Name �� Are You an Insurance Company? Yes/ T� If Yes,Claim Number? �'�'� �p �� Street Address �� 3� C�rr�f l�ai�' // �� ,l/' State �� Zip Code 7 S%Z j' Ciry G�'r1' i� e" �, Daytime Phone( ) - Cell Phone(�'�� )7�7- �' j Evening Telephone( ) - Date of Accidend Injury or Date Discovered �`��/3 Time 7 '` " a /pm 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. f� �/r � i�c ,"�i�s Si C� F �c�:c�e fht 7` �"+1 �ih /fJf ��G� �i Nc t C �,f //J f'l v � j �Fd d// 1 �c' �c � / C�/ �oi �ms'f f'f r ff'./�a" ! �' �t'/7��c%� �5�'c Z ��%rys /S /�/%�d<�!� ��41�n �� SG(i ih � L f 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 ❑ Other type of injury—please specify In order to process your claim vou need to include copies of all apnlicable documents. For the claims types listed below,please be sure to include the documents indicated or it will delay the handling of your claim. Documents WILL NOT be returned and become the property of the City. You are encouraged to keep a copy for yourself before submitting your claim form. �Property damage claims to a vehicle: two estimates for the repairs to your vehicle if the damage exceeds $500.00;or the actual bills and/or receipts for the repairs O Towing claims: legible copies of any ticket issued and a copy of the impound lot receipt O Other property damage claims:two repair estimates if the damage exceeds$500.00;or the actual bills and/or receipts for the repairs;detailed list of damaged items O Injury claims: medical bills,receipts O Photographs aze always welcome to document and support your claim but will not be returned. Page 1 of 2—Please complete and return both pages of Claim Form Failure to complete and return both pages will result in delay in the handling of your claim. All Claims—nlease comnlete this section Were there witnesses to the incident? Yes �1 Unknown (circle) Provide their names, addresses and telephone numbers: /�� Were the police or law enforcement called? es`�� No Unknown (circle) ff yes,what department or agency? �;�- ��c��,,1 " �, ��..,,,:�„ i Case#or report# 1 "�C�i"5:�:�'�7 Where did the accident or injury take place? Provide street address,cross street, intersection,name of pazk or facility, closest landmark,etc. Please be as detailed as possible. If necessary,attach a diagram. �U13��- 1�\15�rJ�r /�„,� r �� flh.\J�� .'�✓�i�! . 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.��//�7, b'� Velucle Claims—ulease comnlete this section ❑check box if this section does not applv Your Vehicle: Year r�C.'�c'�c Make C?�.;,.c �- �Model L.r-,«.�n^�_ License Plate Number I✓Y� 6 L�' State "�h Color' �..r-��:.,��-,du Registered Owner L.'��,(4 y /`��r.l�z;'�f 5�!Fs��% Driver of Vehicle ��i`I , f4,r��( .�r Sfr r�� Area Damaged_ 1��•'�r� s.</r {;.ti, i�r�� 7�v C,,:�, 7`- City Vehicle: Year Make /U'k�.c.:1L Model C- r-c:.Y�,i�-c'_ License Plate Number �3�1 (.�(c�, State:+�� Color Driver of Vehicle(City Employee's Name) Oc..vc� P r� �,,,�� ,��, Area Damagedj�C��,a,�-�-�� I�iurv Claims—nlease comnlete this section �j�check box if this section does not applv 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 attaclung more pages to this claim form. Number of additional pages�. By signing this fornt,you are stating that all inforntation 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 3�s��3 Print the Name of We Person who Completecl this orm: \,�'�Yl �'1 Y. A ��k�'U�.v�� Signature of Person Making the Claim: � �� '�� ' ° Revised February 2011 OAKDALE COLLISION CENTER 1040 GERSHWIN AVENUE ST. PAUL,MN.55128 PHONE:651-264-0909 FAX:651-264-0910 "•PRELIMINARY ESTIMATE*** 03/04/2013 03:13 PM ��.______w,______ ��___.__�_�_ _ __.__.____�_________________.__...__.______.�_�__.___._.___.___�_.� _.__.�. � = Owner Owner: Christine Schendel Address: 3639 Gresham Ave N Work/Day: (651)717-8349 City State 2ip: Oakdale, MN 55128 FAX: ,__..____�..-----.---.._._____._____------.�._....______�---_---___.----....__..____�_�__________. _--____.___.._..__-----___�__._____._.__...__.._�.___.___---_..__, ! Inspection ` Inspection Date: 03/04/2013 03:13 PM Inspection Type: Inspection Location: Oakdale Collision Center Contact: City State Zip: Oakdale,MN 55128 FAX: Primary Impact: Left Side Secondary Impact: Company: OAKDALE COLLISION Appraiser License#: Contact: DON JUEN JR. Address: 1040 GERSHWIN AVE N Work/Day: (651)264-0909 City State Zip: Oakdale,MN 55128 FAX: (651)264-0910 . ._ _._. _. _ ', Repairer ' �mT� w�_v. Repairer: OAKDALE COLLISION CENTER � mm� Contact: DON JUEN� Address: 1040 GERSHWIN AVE. Work/Day: (651)264-0909 Oakdalecollision@msn.com FAX: (651)264-0910 City State Zip: OAKDALE, MN 55128 F�� Email: Oakdalecollision@msn.com ____ ._ __._______._._._,..._._.�.. _�_—�.._._.�...__...____._.____.____�_� �Remarks � � . _._. �_._.._ ' *"POSSIBLE HIDDEN DAMAGE NOT SEEN AT TIME OF ESTIMATE"'**' *"'VEHICLE NEEDS TO BE DISASSEMBLED TO DO A COMPLETE ESTIMATE'*" _._____ __ ._.____---.__�.___ _____._.__.��_____ _._�___�__� �Vehicle _�. ��_.��..____ __�._��.�_._._..__.._____. .__._.__.., �._.�__�.,�._,.___.�._._._.�_._. 2000 Buick Le Sabre Limited 4 DR Sedan 6cyl Gasoline 3.8 4 Speed Automatic Lic.Plate: VYA628 Lic State: MN Lic Expire: VIN: 1 G4HR54K9YU263489 Veh Insp#: Mileage Type: Actual Condition: Code: S4343B Ext.Color: Red met. Int.Color: Ext.ReFnish: Two-Stage Int.Refinish: Two-Stage Options AM/FM Stereo Tape Alarm System Aluminum/Alloy Wheels Analog Gauges Anti-Lock Brakes Auto Load Leveling Automatic Dimming Mirror Climate Control For A/C Cruise Control Driver Information Sys Dual Air Conditioning Dual Airbags 03/04/2013 03:25 PM Page 1 of 4 � � � . ' � , 2000 Buick Le Sabre Limited 4 DR Sedan ' Claim#: 03/04/2013 03:13 PM Dual Power Seats Intermittent Wipers Keyless Entry System Lighted Entry System OnStar System Overhead Console Power Brakes Power poor locks Power Mirrors Power Steering Power Windows Rear Window Defroster Rem Trunk-L/Gate Release Side Airbags Split Front Bench'Seat Tachometer Tilt Steering Wheel Tinted Glass Twilight Sentinel Velour/Cloth Seats �_..�_ _..� __�._.._�.__ _.�_..._._______�.__. _ ��-�� ; Damages � _ w______ _._________ ____1 Line Op Guide MC Description MFR.Part No. Price ADJ% B% Hours R 1 N 27 Frt Bumper Cvr Overhau Additional Labor 2.6 SM 2 I 6 Cover,Front Bumper Repair 2.0* SM 3 L 6 13 Cover,Front Bumper Refinish 3.7 RF 2.6 Surface 0.6 Two-stage setup 0.5 Two-stage 4 E 41 01 Headlamp Assy,Halogen LT 19245373 GM Part $412.92 0.3 SM 5 N 973 Headlamps Aim Additional Labor 0.4 SM 6 I 103 Fender,Front LT Repair 1.5' SM 7 L 103 Fender,Front LT Refinish 2.6 RF 2.2 Surface 0.4 Two-stage S RI 452 Emblem,Front Fender LT R&I Assembly 0.2 SM 9 RI 111 Skirt,lnner Fender LT R&I Assembly 0.3 SM 10 L 625 Pillar,Windshie�d LT Refinish 0.6 RF 0.5 Surface 0.1 Two-stage 11 BR 169 Panel,6odyside Otr Upr LT Blend Refinish 0.7 RF 0.5 Blend 0.2 Two-stage 12 RI 180 MIdg,Rocker Panel LT R&I Assembly 0.4 SM 13 I 209 Pnl,Front Door Outer LT Repair 1.5' SM 14 L 209 Pnl,Front Door Outer LT Refinish 2.3 RF 1.9 Surface 0.4 Two-stage 15 RI 446 W/Strip,Frt Door Upr LT R&I Assembly 0.2 SM 16 RI 241 W/Strip,Belt Outer LT R&I Assembly 02 SM 17 I 268 MIdg,Front Door Lower LT Repair 1.0* SM 18 L 268 MIdg,Front Door Lower LT Refinish 0.5 RF 0.4 Surface 0.1 Two-stage : 19 RI 268 MIdg,Front Door Lower LT R&I Assembly 0.4 SM 20 E 229 Mirror,0uter R/C LT 25769728 GM Part $217.62 0.3 SM 21 L 229 Mirror,0uter R/C LT Refinish 0.6 RF 0.5 Surface 0.1 Two-stage 22 RI 227 Handle,Front Door Otr LT R&I Assembly 0.6 SM 23 I 289 Pnl,Rear poor Outer LT Repair 3.0' SM 24 L 289 Pnl,Rear poor Outer LT Refinish 22 RF 1.8 Surface 0.4 Two-stage 25 RI 429 W/Strip,Rear poor LT R&I Assembly 1.6 SM 26 RI 321 W/Strip,Belt Outer LT R&I Assembly 02 SM 27 RI 333 MIdg,Rear poor Lower LT R&I Assembly 0.4 SM 28 I 305 Handle,RR Door Outer LT Repair 1.0' SM 29 L 305 Handle,RR Door Outer LT Refinish 0.4 RF 0.3 Surface 0.1 Two-stage 30 RI 305 Handle,RR Door Outer LT R&I Assembly 0.9 SM Page 2 of 4 03/04/2013 0325 PM I 2000 Buick Le SaWe Limited 4 DR Sedan Claim#: 03/04/2013 03:13 PM 31 I 389 Pane�,Quarter LT Repair 5.5* SM 32 L 389 Panel,Quarter LT Refinish 2.4 RF 2.2 Surface 0.2 Twastage 33 E 397 Door,Fuel Filler LT 25697148 GM Part $71.73 0.3 SM 34 L 397 Door,Fuel Filler LT Refinish 0.3 RF 0.3 Surface INC Twastage 35 E 410 Namepiate,Qtr Panel LT 25648732 GM Part $21.38 0.2 SM 36 RI 533 Taillamp Assembly LT R&I Assembly 0.3 SM 37 N 31 RR Bumper Cvr Ovefiaui Additional Labor 1.4 SM 38 I 566 Cover,Rear Bumper Repair 2.5* SM 39 L 566 Cover,Rear Bumper Refinish 3.2 RF 27 Surface 0.5 Two-stage 40 SB HAZARD.WSTE. REM. Subiet Repair $4.00' SM 41 SB COVER CAR EXTERIOR Sublet Repair $4.00' SM 42 L CORROSION PROTECTION Refinish 0.3* RF 43 SB PINSTRIPES-PAINTED Sublet Repair $100.00' SM 44 SB FLEX ADDITIVE Sublet Repair $4.00' RF 45 L ROPE WINDSHIELD Refinish 0.3' SM* 46 L ROPE BACK GLASS Refinish 0.3' SM* 47 SB CLEAN&RETAPE Sublet Repair $6.00' 0.4' SM 48 RI Lic Plate R&I Assembly 0.2' SM' 49 SB Bumper Repair Kits Sublet Repair $40.00` SM* »Front and rear covers 49 Items MC Message 01 CALL DEALER FOR EXACT PART#/PRICE 13 INC�UDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE �_�___._.____�.____._______._. _� ___..._._.._...�.._ _.._._._.__.�._.____________,.�.�_.�________.__.____. __.__________._. ; Estimate Total 8�Entries _ ,__�T��_________�__.._______._._�_.____.�_._____ ��, Gross Parts $723.65 Palnt Materials $633.60 Parts�Material Totai $1,357.25 Tax On Parts Only @ 7.125% $51.56 Labor Rate Replace Repair Hrs Total Hrs Hrs SheetMetal(SM) $52.00 7.6 22.8 30.4 $1,580.�90 Mech/Elec(ME) $80.00 Frame(FR) $71.00 Refinish(RF) $52.00 19.8 19.8 $1,029.G0 Paint Materials $32.00 Labor Total 50.2 Hours $2,610.40 Sublet Repairs $158.00 Gross Total 54,177.21 Net Total E4,177.21 Altemate Parts No Audatex Estimating 6.0.626 ES 03/04/2013 03:25 PM REL 6.0.626 DT 02/01/2013 DB 03/01/2013 03/04/2073 0325 PM Page 3 of 4 2000 Buick le Sabre Limiled 4 DR Sedan Claim#: 03/04I2013 03:13 PM Copyright(C)2011 Audatex North America, Inc. 3.6 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWOSTAGE REFINISH FORMULA. ESTIMATE CALCULATED USING THE 2.5 HOUR MAXIMUM ALLOWANCE FOR TWO-STAGE REFINISH OF NON-FLEX,EXTERIOR SURFACES. THIS ESTIMATE HAS BEEN PREPRRED BASED ON THE USE OF ONE OR MORE CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE PARTS MANUFACTURER OR DISTRIBUTOR RATHER THAN BY THE MANUFACTURER OF YOUR VEHICLE. A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGAINST AN INSURER IS GUILTY OF A CRIME. Op Codes ' = User-Entered Value E = Replace OEM NG= Replace NAGS EC= Replace Economy OE= Replace PXN OE Srpls UE= Replace OE Surplus ET= Partial Replace Labor EP= Replace PXN EU = Replace Recycled TE = Partial Repiace Pnce PM= Replace PXN Reman/Reblt UM= Replace Reman/Rebuilt L = Refinish PC= Replace PXN Reconditioned UC= Replace Reconditioned TT = Two-Tone SB= Sublet Repair N = Additional Labor BR= Blend Refinish I = Repair IT = Partial Repair CG= Chipguard RI = R 8 I Assembly P = Check AA= Appearance Allowance RP= Related Prior Damage This report contains proprietary information of Audatex and may not be disclosed to any third party(other than /M�'''"�' the insured, claimant and others on a need to know basis in order to effectuate the claims process)without � ��x' Audatex's prior written consent. i Sdara r�npanY Copyright(C)2011 Audatex North America,Inc. Audatex Estimating is a trademark of Audatex North America, Inc. 03/04/2013 03:25 PM . Page 4 of 4 - ' CENTURY AVENUE COLLISION CENTER WHERE QUALITY & SERVICE COMES FIRST 2501 CENTURY AVENUE 2 BLOCKS SOUTH OF HWY 36 PHONE: 651-777-6055 FAX: 651-779-9417 CD LOG NO 21219-1 DATE 03/04/13 SHOP: CENTURY AVENUE COLLISION INSP DATE: 03/04/13 ADDRESS : 2501 N0. DIVISION ST CONTACT: GARRY CITY STATE: NORTH ST PAUL, MN PHONE 1 : (651) 777-6055 ZIP: 55109- FAX: (651) 779-9417 OWNER: SCHENDEL, CHRISTINE HOME PHONE: (651) 717-8349 ADDRESS : 3639 GRESHAM AVE N CITY STATE: OAKDALE, MN ZIP: 55128 INSURED: CITY OF ST PAUL TYPE OF LOSS: /DRV POINT OF IMPACT: 5 LIC# : VYA 628 STATE: MN VIN: 1G4HR54K9YU263489 BODY COLOR: MAROON MILEAGE: 182 , 022 CONDITION: ACCTNG CTL# : PROD.DATE: 02/00 PAINT CODE: *=USER-ENTERED VALUE E=REPLACE OEM NG=REPLACE NAGS EC=REPLACE ECONOMY UE=REPLACE OE SURPLUS UC=RECONDITIONED PRT UM=REMAN/REBUILT PRT EU=REPLACE SALVAGE EP=REPLACE PXN OE=REPLACE PXN OE SRPLS PC=PXN RECONDITIONED PM=PXN REMAN/REBUILT TE=PARTL REPL PRICE ET=PARTL REPL LABOR IT=PARTIAL REPAIR I=REPAIR L=REFINISH BR=BLEND REFINISH TT=TWO-TONE CG=CHIPGUARD SB=SUBLET N=ADDITIONAL LABOR RI=R&I ASSEMBLY P=CHECK AA=APPEAR ALLOWANCE RP=RELATED PRIOR UP=UNRELATED PRIOR ORIGINAL ESTIMATE CHECK INNERS AT TEARDOWN ESTIMATOR WILL NOT APPEAR IN COURT TO TESTIFY ON THIS ESTIMATE WITHOUT A FEE PAID FOR HIS SERVICES AND TIME. 2000 BUICK LE SABRE LIMITED 4DOOR SEDAN 6CYL GASOLINE 3 . 8 CODE: 54343B/A OPTNS A/24LGIS OPTIONS : TWO-STAGE - EXTERIOR SURFACES TWO-STAGE - INTERIOR SURFACES REMOTE KEYLESS ENTRY SYSTEM CLIMATE CONTROLLED A/C ALARM SYSTEM FRONT SIDE IMPACT AIRBAGS OP GDE MC DESCRIPTION MFG.PART N0. PRICE AJ� B� HOURS R -- --- -- ----------- ------------ ----- --- -- ----- - N 0027 FRT BUMPER CVR OVERHAU ADDNL LABOR OPERA 2 . 6 1 PAGE 1 03/04/13 2000 'BUICK LE SABRE LIMITED 4DOOR SEDAN � .CD LOG NO 21219-1 i I 0006 COVER, FRONT BUMPER REPAIR 1 . 0*1 L 0006 13 COVER, FRONT BUMPER REFINISH 3 . 7 4 2 . 6 SURFACE 0 . 6 Two STAGE SETUP ' 0 . 5 TWO STAGE E 1364 RET, FRT BUMPER COVER MULTI-PART GM PAR 13 . 30 INC 1 R10041 HEADLAMP ASSY,HALOG LT R&I ASSEMBLY 0 .3 1 I 0103 FENDER, FRONT LT REPAIR 2 . 0*1 L 0103 FENDER, FRONT LT REFINISH 2 . 6 4 2 . 2 SURFACE 0 . 4 TWO STAGE E 0452 EMBLEM, FRONT FENDER LT 25713251 GM PART 35 . 68 0 .2 1 RI0180 MLDG, ROCKER PANEL LT R&I ASSEMBLY 0 . 4 1 I 0209 PNL, FRONT DOOR OUTE LT REPAIR 1 . 5*1 L 0209 PNL, FRONT DOOR OUTE LT REFINISH 2 . 3 4 1 . 9 SURFACE 0 . 4 TWO STAGE R10446 W/STRIP,FRT DOOR UP LT R&I ASSEMBLY 0 .2 1 R10241 W/STRIP, BELT OUTER LT R&I ASSEMBLY 0 . 5 1 I 0268 MLDG, FRONT DOOR LOW LT REPAIR 0 . 5*1 R10268 MLDG, FRONT DOOR LOW LT R&I ASSEMBLY 0 . 4 1 L 0268 MLDG, FRONT DOOR LOW LT REFINISH 0 . 5 4 0 . 4 SURFACE 0 . 1 TWO STAGE E 0431 # MIRROR, OUTER R/C LT 25658311 GM PART 430 . 95 INC 1 # = 01, 02 L 0431 MIRROR,OUTER R/C LT REFINISH 0 . 5 4 0 . 5 SURFACE INC TWO STAGE R10227 HANDLE, FRONT DOOR 0 LT R&I ASSEMBLY 0 . 6 1 BR0227 HANDLE, FRONT DOOR 0 LT BLEND REFINISH 0 .2 4 0 . 1 BLEND 0 . 1 TWO STAGE I 0289 PNL, REAR DOOR OUTER LT REPAIR 3 . 5*1 L 0289 PNL,REAR DOOR OUTER LT REFINISH 2 . 2 4 1 . 8 SURFACE 0 . 4 TWO STAGE R10321 W/STRIP, BELT OUTER LT R&I ASSEMBLY INC 1 R10333 MLDG, REAR DOOR LOWE LT R&I ASSEMBLY 0 . 4 1 BR0333 MLDG, REAR DOOR LOWE LT BLEND REFINISH 0 . 3 4 0 .2 BLEND 0 . 1 TWO STAGE R10317 VENT GLS ASSEMBLY, R LT R&I ASSEMBLY 1 . 5 1 I 0305 HANDLE, RR DOOR OUTE LT REPAIR 1 . 0*1 R10305 HANDLE,RR DOOR OUTE LT R&I ASSEMBLY 0 . 9 1 L 0305 HANDLE, RR DOOR OUTE LT REFINISH 0 . 4 4 0 . 3 SURFACE 0 . 1 TWO STAGE I 0371 MLDG ASSY, BACK GLASS REPAIR 0 .3*1 LIFTTAPE FOR REFINISHING IT0365 PANEL, QUARTER LT LABOR/PAR.TL REPAI 12 . 0*1 L 0365 PANEL, QUARTER LT REFINISH 2 . 5 4 PAGE 2 03/04/13 �000 BUICK LE SABRE LIMITED 4DOOR SEDAN .CD LOG NO 21219-1 2 .2 SURFACE 0 .3 TWO STAGE E 0397 DOOR, FUEL FILLER LT 25697148 GM PART 67 . 03 0 . 3 1 L 0397 DOOR, FUEL FILLER LT REFINISH 0 .3 4 0 . 3 SURFACE INC TWO STAGE R10407 POCKET, FUEL FILLER LT R&I ASSEMBLY 0 . 4 1 E 0410 NAMEPLATE, QTR PANEL LT 25648732 GM PART 20 . 57 0 . 2 1 N 0031 RR BUMPER CVR OVERHAUL ADDNL LABOR OPER.A 0 . 6 1 I 0566 COVER,REAR BUMPER REPAIR 1 . 5*1 L 0566 COVER, REAR BUMPER REFINISH 3 .2 4 2 . 7 SURFACE 0 . 5 TWO STAGE E 1341 RET,REAR BUMPER COVER MULTI-PART GM PAR 6 . 20 1 . 1 1 E 1344 RET, REAR BUMPER COV LT MULTI-PART GM PAR 7 . 98 0 . 1 1 E 1345 RET,REAR BUMPER COV RT MULTI-PART GM PAR 7 . 98 0 . 1 1 ECM03 FLEX ADDITIVE ECONOMY PART 8 . 00* *4* L M06 PINSTRIPES-PAINTED REFINISH 1 . 5*4* L M14 CORROSION PROTECTION REFINISH 0 . 4*4* ECM17 COVER CAR EXTERIOR ECONOMY PART 5 . 00* 0 . 3*1* SBM60 HAZARD. WSTE. REM. SUBLET REPAIR 3 . 00* *1* 47 ITEMS MC MESSAGE (S) 01 CALL DEALER FOR EXACT PART NUMBER / PRICE 02 PART NO. DISCONTINUED, CALL DEALER FOR EXACT PART NO 13 INCLUDES 0 . 6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE FINAL CALCULATIONS & ENTRIES GROSS PARTS 589 . 69 OTHER PARTS 13 . 00 PAINT MATERIAL 659 .20 PARTS & MATERIAL TOTAL 1, 261 . 89 TAX ON PARTS @ 7 . 125� 42 . 94 LABOR RATE REPLACE HRS REPAIR HRS 1-SHEET METAL 52 . 00 7 . 9 26 . 5 1, 788 . 80 2-MECH/ELEC 80 . 00 3-FRAME 80 . 00 4-REFINISH 52 . 00 20 . 6 1, 071 .20 5-PAINT MATERIAL 32 . 00 LABOR TOTAL 2 , 860 . 00 SUBLET REPAIRS 3 . 00 TOWING STOR.AGE GROSS TOTAL 4, 167 . 83 NET TOTAL 4, 167 . 83 SHOPLINK U8264 ES CD LOG 21219-1 DATE 03/04/13 02 :34 : 47PM R6 .37 CD 01/13 PXN: Y/00/00/00/00/00 CUM 00/00/00/00/00 GEOCODE 55109 PAGE 3 03/04/13 �000 "BUICK LE SABRE LIMITED 4DOOR SEDAN CD LOG NO 21219-1 HOST LOG (C) 1998 - 2008 AUDATEX NORTH AMERICA, INC. 3 . 5 HRS WERE ADDED TO THIS EST. BASED ON AUDATEX TWO-STAGE REFINISH FORML7LA. AUDATEX TWO-STAGE EXTERIOR THRESHOLD OF 2 . 5 HOURS WAS CALCULATED IN THIS ESTIMATE. -------------------------------------------------------------------------- THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE PARTS MANUFACTURER OR DISTRIBUTOR RATHER TH�,N BY THE MANUFACTURER OF YOUR VEHICLE. A PERSON WHO FILES A CLAIM WITH INTENT `T'O DEFR.AUD OR HELPS COMMIT A FR.AUD AGAINST AN INSURER IS GUILTY OF A CRIME. PAGE 4 03/04/13 � Michael G. McAlpine Pofic•e Officc�� I POLICE DEPARTMENT �.�� ,.,,,':, � CITY OF SAINT PAUL 367 Grove Streer ,��K��y;�, Snint Paul,MN SSII// '�;- -• 6nice,Nnil:651-266-900,0�� ,Nnil Rox�Y:7/286 ctvst � � U'� � 0�3� If you have any yuesliuns rc�ardin�,)uur repurL call: Saint P•rul Pulice Rccurds ll��i116>11266-5700 ,_,. ,; _....1: ..� ::;-:'r �•:�,:- ,:,.-a., .��.�-: . , __�.,� - - 'x9g�-�� .. _ ;,: . � ��'�w..�.`` . u�!"+y.. ;-� - �� - - � �:�:. �,4 f;x= $� � � �� }. �� *�� - � � - �� . x�.: �� L '�' .�: "- i �� i� I� ' ._i�,,. ' _ - I`li i�y .'. ��. ev, Ry 4 � ��°' Ji: � �A a !;. xt.:_ "5� x ��,, �.w �� , ��`�� r�� _ ?r - _ . _. .. -_ F�:-�<:.-� ¢ _-�-. R�_:x`�..: �.t,.� . .. .. x , n � ti. �� ._ .��=r.. ; . .. , .ns.-. __!t.. ..n. -,� .-�.:. _:.. . � .