Wheelock �� i
���I��'� ;
. � �.; . ��� �� �o��
N(�TICE OF CLAIM FORM to th��i�y��Paul, Minnesota
:t�irnrermu Sknr Sru�u�t,t66.O�rarter�h�n "...trrrr fx rsotr...�rhn��Iuirqs dur�xr�rr%ru�x�nrr inurricrExrlirv...rhull euu re�o he presrr:reJ ro rhe
.�orern.ir..�h<xl�•n/'�he uiu�=ic•i�xrlir�•�,�i�trin/,l'0 d<n'r u�rer�(ie ullr�rd lvrs or ir.jur��ir dir�orre•rd u rniiee cr<r�ir.=g rhr rime,plu�•r,urtt!
eirruixsKUti es thereoJ:u�td!(tc'�t�nvur!!o(i nntprrsulinr�or orlt<'r re(1e���fr�ntr�t�!<'d,°
Please cornplete ttus form in its enti ret��bc clearl}�t}ping or printtng���x�r ans�cer to each questicHi. If rnore space is
neecled.attach ackiitia�al sheets. E'lease nc�te ttmt r�<w H•ill not he cont�eted b}�telept��e to clarify ans���ers,so pro��ide as
much inforn�ation as necessar��to e.q�lain��a�r c4�irn,atx!the atmwnt of ccMnpens:�ticx�beinr requestE�cl. ti'ou��itl recei�e��
«•rltten aek[x�«'leclrerne��t once��a�r fornt is reeei��ecl. The prcx�ess can take up to ten w'eeks or longer depe�xiing a�the
nature of��cwr elaim. This forrn rnust be si�tecl,a�xl both pages eompleted. If sornething cbes not apply.«'rite`N/�'.
SEND COMPLETED FQRNI AND OTHER DUC;i?MENTS TO: CITY CLERK,
15 'EST KELLOGG FLVD, 31Q CITY HALL, SAINT PAL1L, MN 55102
r
Fii�t Name �� Mi�tdle [nitiul [.u�t Nunx �l� .�
Cump��n� ur Bu:ines:Namc.
�re You an [n:�n�ince Cump,�n�'' Y�. Nu [i'y'e:,Cluim Nun�t�er'?
Sh•eet AJdre;: � ��- _
Citv �- 1 lt.(,�, Stute l`"���I "T_ip CoJe ��<<�
Uuytim� Ph��ne l�i�-�V 1�Cell Phone! 1�_- Evenin�� Telephone '�i�l���!Z'
D.�te ufAcrident/ [nj�n� orD.ne Di�o�ereJ��(� � t�j Time J %� .�n pm
Ple�i�:tute.in Jet.�il.��hut�hcurceil (h.l(1f)C fll'[�j.Fllll��i h� �`OU ure:uhmitting .�claint. Plea� indicate��hy ur hin� you
t�eel the City uf S.iint P�iul or it:�atlu�loVee:u'e in�'��Ived �►nd/or re:pomihle ti�r your d��it�a��e..
(7t C7 �
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P lil�l'.III�CI��Ill �Or(t�l Illill IIRI�( 4'I111�I�` fC.�)fC�III IIIC 1'�il�llll fl)I'CQIII'>ICUf1L CI11� Fornr.
-1y �rhi4le�i•u: d�imuge.tl in un uccitlent ❑ My vehicle��a: �lunt.iged clu►'in,�a tow
1�9� tehicle tt,�:d,ima�'ed bV .i ����thole or conclition of the:treet ❑ 1�4v vehicle��'.i; duitl.ireJ b� u plo��'
❑ hly �'efticle��ua ��re�n��full� tu�ced�,nJ/c,r ticketeJ ❑ [�+`a:injtu'ed on Cit� prupeit��
❑Olher ty(�e uP��CO��eit� dunlu,�e— plea�r: :pecify —
❑(�thc:rtv��e ot inju�l —E�ie.�:�:��ecif�y—
In order to process vour claim You need to include copies of att appticabte documents.
Foc the claim:type:Ii;teJ bele»�. ple.�.:e he�ure to incluJe the Jcxument:inJicateil ur it will delay the han�ling of
vour claim. U�kument:��'IL[.NOT t,e ��eturneJ und hec�,n� the propert� ut the City. Yuu ure enco�u�a��eJ to keep,i
c��p� f�,r��,u��elt before:ubmitting your�luim fe,rm. �
O Prupeit� d�in����e clainl�C��.i vehiCle: t��'t�e�til»tUe:for Ihe I�.�?t�lr:[u volu'�ehlcle if Ihe d'.Itll���Y< exCeed�
ti>OQ.OQ: orthe acuiul hilla:and/�}r re��eipt:t�or the repuir�
O Tottin�'cluinl:: le«ihle�o(iie:of un�' ticket i:�ieJ �tnd ,�copy ot�the impuuncl lut recei�?t
O Ckher pruperty J�im.i��e cluim:: t��o rep.iir c�tii�t�ue: if the damage etceed;`;��00.00:or the.�ctu.�l hill�
unJ/ur receipt:tor the repuin:clet.�iled li:t uf d.imu��ed item:
O Injury cluim:: mcili��ul bill:, receiE�t>
O Photo�,i.�ph:.iiz cila.iy>��elconte tu d�x:ument �u��:up��oit yuur claim but��•ill not be returneJ.
Pag� ! of 2—Please complete and return both pa�es of Ctaim Form
Failure to complete and return both pages H�111 result in dela}•In the handiing of�•our claim.
All Ciaims-please contplete this secdon
Vb'ere there ��itne:�;t�,the incicient' Ye: N�� C�nknm�n (circle)
Pro�iJe their min�e:. .iildre�:e:�in�! telephune numher�:
1��'e��e the pulice or la�� enForcen�ent c,illed'? Ye: No Unkno�en �i�rle)
If re:.��'hut dep�iitment or u,�ency'? Cu�e#or reput4# ��1�' a��
V4'here aiil th� acciclent ur inju�� t�ike pl.K:e'? Pro�ide :treet .idJre::,cru:::treet. interectiun. nume of p�irk or f��ility.
l'�llk� �illll�lllill'�. C:�l. ��C21�1'hC'. il�l�t�ill�Cl� il��lO�,�lEl�t.. �f OC-l'C\�ill'�`. i�t�ill'� il/jli�t�lilfl]. ���'�
_ 1'Iy3� ���Gl�� , . �, �usll
Ple��� inilicute the anx�unt y��u .ire:eeking in •ontpen�;ition or��hat you �ruulii lik�the City to�I��to re:ol�e thi•cluim
t u vuln'�ul i�f�uct iun. �
,(,C '�' �-.
\�ehlcle Claims- leasc com lete this se ion � O check hox ifthi��ctian Joe� nut u>>Iv
Yuur Vehicic: Ycur_�R9��k�' Mudel
[.icen� Plate Number Stute Cc�lor (rYl/li��
Regi;tereil O�vner
Driver of Vehicle
Areu D�inki��e�l
c�c� v�n����: v�:�,�� ��o t I�t,�ke Mo�t� x.0
[_icen�e Ptute Number Stute,�l�Colur
Dri�eruf�VehiclelCit� Empluyee':N.ime) ! - � ��N
.�reu Dunki��ed /�1�+�-
In ur��Claims- lease com lete this sectlon ❑check hox if thi��t°ction il��e�nut u>>Iv
Ho�� tt'<re you injured'>
W'h�u purtf:l uf�yuur bucly �+ere inj�n'eJ'>
Huve y��u �,u��ht meJicul tr�ahnent'? 1'e: No Pl�mning tu Seek Tre,itnxnt Iciiile)
��'hen Clid yuu recei�'e [re,Unlenc'? 1(?rovide dute(:I1
N.�mr o1�h9eJi�<d Pr�,�i�ler(:i:
AdJre:; Telephone—
DiJ you nti::��urk u•u re:ult of yotn�injury'? Yr• N��
��'hen did}ou mi:: �rork'' Ipro�iJe Jatel�ll
Numc uf�aur Emplo�er: —
Acldre:: Teleph��ne _
�C'heck here if�'ou are attaching more pagc:s to this clalm form. Number of addltional pages�.
�
R�� signi�rg tl�is form, y�ou are stati�ig tlrat nll iirformatioir you Ircrve provided is true a�rd correct to the hest
of�tour knowle�fge. I;irsigired for�trs will�tot bP�rocessect.
.SI(h/)l(lf1ll�p f!lISP CI[71171 <'lll! I'PSllI![!1 �COSPf[lll0lt. Uate fornt��as completed � � �� ' �
Print the Name of the Person�F�ho Completed thls Form: ' ` C'v`"��'�� ���
Signature ofPerson Atahing the Claim: � �""
{tc�i.ccl f cfvuir� _'c i I I
. - ,Accident Report Page 1 of 1
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Officer Jason Giampolo 425
http://www.dvslesupport.org/dvsinfo/accidentrecords_2008/Includes_LE/PrintReportIndiv... 7/22/2013
� AUTO SERVICE �
�� &BODY RE
� PAIR �K.
" 851-�
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����� � AUTO SERVICE & BODY Workfile ID:
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"�`� � REPAIR CF
���
t�st 22�.��� � ST W, SAINT PAUL, MN 55102
������ ; Phone: (651) 222-4458
FAX. (651) 224-8640
Preliminary Estimate
Customer: WHEELOCK-KA]ER, MARIANNE
Written By: DAN DREELAN
Insured: Policy#: Claim#: 13-147089
Type of Loss: Liabiliry Date of Loss: Days to Repair: 0
Point of Impact: 12 Front
Owner: Inspection Locati On: Insurance Company:
WHEELOCK-KA]ER,MARIANNE BONFE'S AUTO SERVICE&BODY
REPAIR_CF
1722 PINHURST 380 7TH ST W
ST.PAUL,MN 55116 SAINT PAUL,MN 55102
(651)690-1518 Evening Repair Facility
(651)222-4458 Business
VEHICLE
Year: 2008 Body Style: 4D UN VIN: JTED541AX82049471 Mileage In:
Make: TOYO Engine: 6-3.5L-FI License: stk358 Mileage Out:
Model: HIGHIANDER 4X2 Production Date: 2/2008 State: MN Vehicle Out ,
Color. GREY Int: Black/tan Condition: Job#: ,
�
TRANSMISSION Overhead Console Stereo SEATS
Automatic Transmission CONVENIENCE Search/Seek Cloth Seats
Werdrive Air Conditioning CD Player 3rd Row Seat
POWER Intermittent Wipers Auxiliary Audio Connection Captain Chairs(2)
Power Steering
Tilt Wheel SAFETY WHEELS
Power Brakes Cruise Control Drivers Side Air Bag Aluminum/Alloy Wheels
Power Windows
Rear Defogger Passenger Air Bag PAINT
Power Locks Keyless Entry Anti-Lock Brakes(4) Clear Coat Paint
Power Mirrors
Rear Window Wiper 4 Wheel Disc Brakes OTHER
DECOR Telescopic Wheel Traction Control Rear Spoiler
Dual Mirrors RADIO Stability Control
Privacy Glass AM Radio Front Side Impact Air Bags
Console/Storage FM Radio Head/Curtain Air Bags
7/23/2013 3:02:38 PM
013793 Page 1
COL�S= MECHANicA�
- • gRAKES
�
I
Preliminary Estimate
Customer: WHEELOCK=KAJER, MARIANNE
Vehicle: 2008 TOYO HIGHLANDER 4X2 4D UTV 6-3.5L-FI GREY
Line Oper Description Part Number Qty Extended Labor Paint
Price�
1 FRONT BUMPER
Z <> Repl Bumper cover 521190E911 1 278.91 2.p 2,g
NOTE: PARTS: Component comes unprimed from OEM. Preparation is required. See ADD IF REQUIRED operation.
LABOR:Time includes R8eI/R&R grille and hole covers.
3 Add for Clear Coat i.l
4 Repl Prep unprimed bumper 1 0.7
5 R&I RT Lamp cover w/o fog lamps Incl.
w/o tow prep
6 R&I LT Lamp cover w/o fog lamps I Incl.
w/o tow prep
7 * R&I License bracket �
__ _- -__ __ __- _ -_ _ - - __ _
8 GRILLE
9 R&I Grille assy Base Incl.
- --- -- -- --...- ---__ -- _- _ -- _ _--_ ---- _ _ --- - - -- _ ._ _ _
10 RADIATOR SUPPORT
11 R&I Front shield 0,2
12 # Repl FLIX ADDITIVE 1 7.00 T
13 # Repl HAZARDOUS WASTE REMOVAL I 1 7.00 T
14 # Refn TINT COLOR TO SECURE PAINT 1.0
MATCH
15 # PART PRICES SUBJECT TO 1
INVOICE
16 # ****POSSIBLE HIDDEN DAMAGE 1
*****
SUBTOTALS 292.91 2.4 5.6
NOTES
Estimate Notes:
�Rental vehicle will be required, 2-3 day repair,rentat car about$35.00 per day
ESTIMATE TOTALS
Category Basis Rate Cost�
Parts 278.91
Body Labor 2.4 hrs @ $56.00/hr 134.40
Paint Labor 5.6 hrs @ $56.00/hr 313.60
Paint Supplies 5.6 hrs @ $35.00/hr 196.00
Body Supplies 2.0 hrs @ $3.00/hr 6.00
ST . PAUL Miscellaneous 14.00
POLICE
651-266-5700 subtotal 942.91
Sales Tax $494.91 @ 7.6250% 37.74
DATE 07 23/2013 TUE TIME 14:37 Grand Total �0-65
NONADD # 336600 (��`��S ��,�
NONADD # 13147089 � - ,�/'
ACCIDENTS $1.25 �{,LL`�.� w''`���
TOTAL $1.25
CASH $1,25 �� c3 1`�'k-�� '
CLERK 1 076315 00000
7/"t3/2U13 3:UG::i� ``�� �� �'�� � ( • Ztj 013793 Page 2
s�L � � � � �
�� l��- I�t�l��� ��'' ��� `, ��.
�
Preliminary Estimate
Customer: WHEELOCK-KA]ER, MARIANNE
Vehicle: 2008 TOYO HIGHLANDER 4X2 4D UTV 6-3.5L-FI GREY
******************************************************************************
THIS IS A VISUAL ESTIMATE ONLY.
ADDTTIONAL DAMAGE MAY BE FOUND AFTER TEAR DOWN OF VEHICLE.
NO GUARANTEE ON RUST WORK.
******************************************************************************
MINNESOTA FRAUD WARNING
A person who submits an application or files a claim with intent to defraud or helps commit a fraud against an
insurer is guilty of a crime.
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. �
�
I
I
7/23/2013 3:02:38 PM 013793 Page 3
• Preliminary Estimate
Customer: WHEELOCK-KA7ER, MARIANNE
Vehicle: 2008 TOYO HIGHLANDER 4X2 4D UTV 6-3.5L-FI GREY
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide
ARM8438, CCC Data Date 7/17/2013, 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 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 Nurr�bers 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 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 symt�ols 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 categpry. (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=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. 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: I
BAR=Bureau of Automotive Repair. EPA=Environmental!Protection Agency. NHTSA= National Highway
Transportation and Safety Administration. PDR=Paintle�s Dent Repair. VIN=Vehicle Identification Number.
7/23/2013 3:02:38 PM 013793 Page 4
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COLLLSION CENTER John �tt Jr.
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- � Phone 65 - 40 ID AUTOSTAR COLLISION CENTER
" . 53 2042 WEST 7TH ST.
2042 W.7th St. .��` �fi`Ji� " . _ . m
St.Paul,MN 55116-3107 www.lughlandautostar.com ST. PAUL, MN 55116
:651-699-0340 FAX: 651-699-4953
FED TAX ID#41-1828627
*** PRELIMINARY ESTIMATE**'
07/24/2013 01:47 PM
Owner
Owner: MARIANNE WHEELOCK-KAJER
Address: 1722 PINEHURST AVE Work/Day:
Home/Evening: (651)690-1518
City State Zip: Saint Paul, MN 55116 I FAX:
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Inspection �
Inspection Date: 07/24/2013 01:47 PM Inspection Type:
Primary Impact: Left Front Corner Secondary Impact:
Appraiser Name: JOHN RITTER_JR I Appraiser License# :
Address: 2042 W7TH ST Work/Day: (651)699-0340
FAX: (651)699-4953
City State Zip: Saint Paul, MN 55116 FAX:
Email: JOHNJRC�HIGHLANDAUTOSTAR.COM
Repairer
HIGHLAND AUTOSTAR Contact:
Repairer:COLLISION
Address: 2042 7TH ST W Work/Day: (651)699-0340
City State Zip: ST PAUL, MN 55116-3107 FAX: (651)699-4953
Email: HA2042@POPP.NET
Vehicle
2008 Toyota Highlander STD 4 DR Wagon i
6cyl Gasoline 3.5 !
5 Speed Automatic
Lic.Plate: STK 358 Lic State: MN
VIN: JTEDS41 AX82049471
Lic Expire: Mileage Type: Actual
Veh Insp# : Code: Y6533A
Condition: � Int.Color:
Ext.Color: GREY Int. Refinish: Two-Stage
Ext.Refinish: Two-Stage
Options
Air Conditioning Aluminum/Alloy Wheels
AM/FM CD Player gucket Seats Center Console
Anti-Lock Brakes Head Airbags
Cruise Control Dual Airbags
Keyless Entry System Lighted Entry System
Intermittent Wipers Power Brakes
MP3 Player Overhead Console Power Steering
Power poor Locks Power Mirrors Rear Spoiler
Power Windows Privacy Glass Side Airbags
Rear Window Defroster Rear Window Wiper/Washer
Page 1 of 3
p7/24/2013 01:50 PM
2008 Toyota Highlander STD 4 DF Wagon
Claim p:
07/24/2013 01:47 PM
Stability Cntrl Suspensn Tachometer Tilt&Telescopic Steer
Tinted Glass Traction Control System Velour/Cloth Seats
Damages
Line Op Guide MC Description MFR.Part No. Price ADJ% B% Hours R
Front Bum�er
1 E 6 46 Cover,Front Bumper 521190E911 $278.91 1.7 SM
2 L 6 13 Cover,Front Bumper Refinish 3.7 RF
2.6 Surface
0.6 Two-stage setup
0.5 Two-stage
3 L 405 Prep Raw Frt Bmpr Cvr Refinis� 0.5 RF
0.5 urface
4 BR 641 Cover,Tow Hook Access LT Blend Refinish 0.1 RF
0.1 Blend
Eront Bodv Interior Sheetmetal
5 RI 797 Cover,Engine Front R& I A$sembly INC ME
I
Manual Entries
6 SB HAZARD. WSTE. REM. Sublet Fiepair $6.00' SM
7 L COLOR TINT Refinisfl 0.5' RF
8 EC FLEX ADDITIVE Replace Economy $6.00' SM'
9 RI LICENSE R& I Assembly 0.2' SM'
9 Items
MC Message
13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE
46 PRINTABLE ALTERNATE PARTS COMPARE
Estimate Total& Entries
Gross Parts $278.91
Other Parts $6.00
Paint Materials $168.00
Parts& Material Total I $452.91
Tax on Parts& Material @ 7.625% $34.53
Labor Rate Replace Repair Hrs Total Hrs
Hrs
Sheet Metal(SM) $56.00 1.9 1.9 $106.40
Mech/Elec(ME) $90.00 II
Frame(FR) $80.00
Refinish (RF) $56.00 4.8 I 4.8 $268.80
Paint Materials $35.00
Labor Total 6.7 Hours $37520
Sublet Repairs $6.00
Gross Total $868.64 �
Net Total $868.64
Alternate Parts Y/01/00/00/01/01 CUM 01/00/00/01/01 Zip Code: 55116 Default � � ( r ,�s /�'� f� ,_�f �
Recycled Parts NOT REQUESTED `��� � / k �
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07/24/2013 01:50 PM Page 2 of 3
. , I,
2008 Toyota Highlander$TD 4 DR Wagon �
Claim fl: � . � 07/24/2013 01:47 PM
Audatex Estimating 7.0.019 ES 07/24/2013 01:50 PM REL 7.0.019 DT 07/01/2013 DB 07/15/2013
Copyright(C)2013 Audatex North America, Inc.
1.1 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO-STAGE REFINISH FORMULA.
YOU ARE AUTHORIZED TO MAKE THE ABOVE REPAIRS. I UNDERSTAND THAT PAYMENT IN FULL WILL BE DUE UPON RELEASE
OF
THE VEHICLE. PARTS PRICES ARE SUBJECTO TO INVOICE. I GRANT PERMISSION TO OPERATE MY VEHICLE FOR THE PURPOSE
OF
TESTING/ INSPECTION. HIGHLAND AUTOSTAR IS NOT RESPIONSBILE FOR LOSS OR DAMAGE TO THE VEHICLE OR ITS
CONTENTSIN I
CASE OF FIRE,THEFT OR ANY CAUSE BEYOND YOUR CONTROL. AUTHORIZED
BY: DATE:
THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE CRASH PARTS
SUPPLIED BY A SOURCE OTHER THAN THE MANU�ACTURER OF YOUR MOTOR VEHICLE.
WARRANTIES APPLICABLE TO THESE REPLACEME T 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 Replace Price 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 I IT = Partial Repair
CG= Chipguard RI = R& I Assembly P = Check
AA= Appearance Allowance RP= Related Priqr Damage
I
This report contains proprietary information of Audatex and may not be disclosed to any third party (other than
the insured, claimant and others on a need to know basis in order to effectuate the claims process)without
j������l� Audatex's prior written consent.
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:�Su1e����.�er�psa•;��
Copyright(C)2013 Audatex N rth America, Inc.
Audatex Estimating is a tradema k of Audatex North America, Inc.
i
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07/24/2013 01:50 PM Page 3 of 3