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Home My WebLink About00-03185 ",~y,_,.,~. ,o_~, .~"_ .~ n_'" , "~__---""",,,,~__._', '~^" 0 I. ~"" ~--'''''-'j SEAN C. LIMRIC, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO.OO- siPS CIVILT~ CIVIL ACTION - LAW ROBERT J. WOOD and ELAINE S. WOOD, Defendants JURY TRIAL DEMANDED NOTICE TO DEFEND YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 800-990-9108 NOTICIA LE RAN DEMANDADO A USTED EN LA CORTE. si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente (20) dias de pla~o al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita 0 en persona 0 por abogado y archivar en la corte en forma escrita sus defensas 0 sus objeciones alas demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso 0 notificacion y por cualquier queja 0 alivio que es pedido en la peticion de demanda. lJsted puede perder dinero 0 sus propiedades 0 otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTE. SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGlJAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 880-990-9108 11< "- ,,' '-'-~,-' --- d '- ,,.. ~-' -",-__".., ~ I SEAN C. LIMRIC, Plaintiff v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 00 _ 31 ~ r{" CIVIL ROBERT J. WOOD and ELAINE S. WOOD, Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED COMPLAINT 1. Plaintiff, Sean C. Limric, is an adult individual residing at 317 Third street, Summerdale, Cumberland County, Pennsylvania 17093. 2. Defendant, Robert J. Wood, is an adult individual residing at 111 Hummel Street, Apartment 3, Lemoyne, PA 17043. 3. Defendant, Elaine S. Wood, is an adult individual residing at 111 Hummel Street, Apartment 3, Lemoyne, PA 17043. 4. The facts and circumstances, hereinafter related, took place on August 5, 1999 at approximately 6: 00 p. m. in the 1200 block of State Street in Lemoyne, Cumberland County, Pennsylvania. 5. At all times relevant hereto, Plaintiff was the owner and operator of a 1997 Volkswagon Jetta, Pennsylvania registration BTL 3408. 6. At all times relevant hereto, Defendant, Elaine S. Wood, was the owner of a Plymouth Neon, Pennsylvania registration BMT 0707. 7. At all times relevant hereto, Defendant, Robert J. Wood, was operating the Defendant's vehicle east on State Street. IJ1 ._~ ~'" -,~ "''"-,-....-~,--,;-- .","- - ' 8. At the time and place aforesaid, Plaintiff was lawfully operating his vehicle west bound on state street, approaching the entrance to the West Shore Plaza. 9. As the Plaintiff's vehicle approached the entrance to the West Shore Plaza, Defendant, Robert J. Wood, turned his vehicle left immediately in front of the Plaintiff's vehicle causing the damages to the Plaintiff's vehicle as more fully set forth below. 10. As a result of the aforesaid accident, the Plaintiff's vehicle sustained damage in the amount of Five Thousand Seven Hundred Seventy and 48/100 ($5,778.48) Dollars and a claim is made therefor. COUNT I SEAN C. LIMRIC V. ROBERT J. WOOD 11. Paragraphs 1 through 10 of Plaintiff's Complaint are incorporated herein by reference. 12. The foregoing accident and all of the Plaintiff's damages were the direct and proximate result of the negligence, carelessness and recklessness of Defendant, Robert J. Wood, in that he: a) turned left immediately in front of the Plaintiff's vehicle; b) failed to yield the right-of-way to the Plaintiff's vehicle; 2 . _ _~'""~". 0 ,~_ __".....' <_,,,_~,,,,_~~__=~_"" _ _, c) failed to keep alert and maintain a proper watch for the presence of other motor vehicles lawfully on the highway; d) failed to have his vehicle properly and adequately insured; e) was otherwise negligent. WHEREFORE, Plaintiff, Sean C. Limric, respectfully requests Your Honorable Court to enter judgment against Defendant, Robert J. Wood, in the amount of Five Thousand Seven Hundred Seventy and 48/100 ($5,778.48) Dollars, plus interest, costs of suit, attorneys' fees and such other relief as this Court deems just and appropriate. COUNT II SEAN C. LIMRIC V. ELAINE S. WOOD 13. Paragraphs 1 through 12 of Plaintiff's Complaint are incorporated herein by reference. 14. The foregoing accident and the Plaintiff's damages were caused by the negligence of Defendant, Elaine S. Wood, in that she: a) negligently entrusted her vehicle to Defendant, Robert J. Wood; b) failed to have her vehicle properly and adequately insured in violation of 75 Pa. C.S.A. S 1786(a); c) was otherwise negligent. 3 Co I " ,~ WHEREFORE, Plaintiff, Sean C. Limric, respectfully requests Your Honorable Court to enter judgment against Defendant, Elaine S. Wood, in the amount of Five Thousand Seven Hundred Seventy and 48/100 ($5,778.48) Dollars, plus interest, costs of suit, attorneys' fees and such other relief as this Court deems just and appropriate. Respectfully submitted, WIX, WENGER & WEIDNER Bc:K ~a~ Richard H. Wix, I.D. #07274 ~. Esquire 'f 4705 Duke Street Harrisburg, PA 17109 (717) 652-8455 4 VERIFICATION I, Sean C. Limric, have read the foregoing Complaint which has been drafted by my counsel. The factual statements andlor denials contained therein are true and correct to the best of my knowledge, information and belief. I am authorized to make this verification. This verification is made only as to the factual averments contained therein and not to legal conclusions and averments authorized by counsel in his capacity as attorney for the party or parties hereto. This verification is made subject to the penalties of 18 Pa. C.S. section 4904 relating to unsworn falsification to authorities which provides that, if I knowingly made false averments, I may be subject to criminal penalties. " -' .- ... ~. ..,-,,- ~ . '_'H~_=""~'o,;' ,'~-,. .' J -----'--1 .. SEAN C. LIMRIC, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 00-3185 CIVIL TERM ROBERT J. WOOD and ELAINE S. WOOD, Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE TO THE PROTHONOTARY: Please reinstate the Complaint in the above-captioned matter. Respectfully submitted, WIX, WENGER & WEIDNER BY~~~~ +-\. W'Vf-- Richard H. Wix, I.D. No. 07274 4705 Duke Street Harrisburg, PA 17109-3099 (717) 652-8455 Co } ~?, J b 0 I, j " SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2000-03185 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND LIMRIC SEAN C VS WOOD ROBERT J ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: WOOD ROBERT J but was unable to locate Him in his bailiwick. He therefore deputized the sheriff of DAUPHIN serve the within COMPLAINT & NOTICE County, Pennsylvania, to On July 27th , 2000 , this office was in receipt of the attached return from DAUPHIN Sheriff's Costs: Docketing Out of county Surcharge Dep. Dauphin Co 18.00 9.00 10.00 36.50 .00 73.50 07/27/2000 WIX, WENGER ~~ R. Thomas Kline Sheriff of Cumberland County & WEIDNER Sworn and subscribed to before me this aiM' day otC}..-'1 :l1nnJ A.D. Q'IIl.' , Q 7pufe-;..., #" Prothonotary ~ -~ I ~ ''''''''''''--', SHERIFF'S RETURN - OUT OF COUNTY ~ ( CASE NO: 2000-03185 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND LIMRIC SEAN C VS WOOD ROBERT J ET AL R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: WOOD ELAINE S but was unable to locate Her in his bailiwick. He therefore deputized the sheriff of DAUPHIN County, Pennsylvania, to serve the within COMPLAINT & NOTICE - REIN On July 27th , 2000 , this office was in receipt of the attached return from DAUPHIN Sheriff's Costs: Docketing Out of County Surcharge Milage 6.00 9.00 10.00 9.92 .00 34.92 07/27/2000 WIX, WENGER ~~ R. Thomas Kline Sheriff of Cumberland County & WEIDNER Sworn and subscribed to before me this .3/~ day of C).~ ~ A.D. n -~ 6:.~~ '- ~prothonotary ,~.~~.- I~"""",,",,"_, . @iiitt of tqc ~4~:riff William T. Tully Solicitor Ralph G, McAllister Chief Deputy Mary Jane Snyder Real Estate Deputy Michael W. Rinehart Assistant Chief Deputy Dauphin County Harrisburg, Pennsylvania 17l 0 I ph: (717) 255-2660 fax: (717) 255-2889 Jack Lotwick Sheriff Commonwealth of Pennsylvania LIMRIC SEAN C. vs Connty of Dan ph in WOOD ROBERT J & ELAINE WOOD Sheriff's Return No. 1560-T - -2000 OTHER COUNTY NO. 00-3185 AND NOW: July 17, 2000 at 9:49AM served the within REINSTATED COMPLAINT upon WOOD ROBERT J & ELAINE WOOD by personally handing to ELAINE WOOD, 2 COPIES 1 true attested copy(ies) of the original REINSTATED COMPLAINT and making known to him/her the contents thereof at ~6~4 JONESTOWN ROAD '\ T. :l- HARRISBURG, PA 17112-0000 , So Answers Sworn and subscrlbed to ' m. ilii. "" "'" 0' ~". '""" ? f~ ~. (::)~ 'h.<i" 0' '.ophin Coon',. Pa. before PROTHONOTARY By ~&" 0~ Deputy Sherif Sheriff's Costs: $36.50 PD 07/13/2000 RCPT NO 138944 TW/CW - In The Court of Common Pleas of Cumberland County, Pennsylvania Sean'C. Limric VS. Robert J. Wood No. 2000-3185 Civil , Now, July 12,.2000 ,20_, I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Dauphin County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. . . r~~~~~ Sheriff of Cumberland County, P A Affidavit of Service Now, ,20_, at o'clock M. served the within upon at by handing to a copy of the original and made known to the contents thereof. So answers, Sheriff of County, PA Sworn and subscribed before me this _ day of ,20_ COSTS SERVICE MILEAGE AFFIDAVIT $ $ In The Court of Common Pleas of Cumberland County, Pennsylvania Sean C. Limric VS. Elaine S. Wood No. 2000-3185 Civil Now, Julv 12. 2000 ,20_, I, SHERIFF OF CUMBERLAND COUNTY, P A, do hereby deputize the Sheriff of Dauphin County to execute this Writ, this deputation being made at the request and risk of the Plain~~~ Sheriff of Cumberland County, P A Affidavit of Service Now, , 20_, at o'clock M. served the within upon at by handing to a copy of the original and made known to the contents thereof. So answers, Sheriff of County, PA Sworn and subscribed before me this _ day of ,20_ COSTS SERVICE :MILEAGE AFFIDAVIT $ $ '"--~= "---~-~--.,,'-- -~-,-~. -"'''="^-,,- ,,-,--~"" ".-. -',',-'4_ -, 1__. "I " SEAN C. LIMRIC, plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. CJ()- J I.RS CIVIL ROBERT J. WOOD and ELAINE S. WOOD, Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE TO THE PROTHONOTARY: Please enter judgment against the Defendants, Robert J. Wood and Elaine S. Wood, in the amount of $5,778.48 plus interest and costs of suit. Respectfully submitted, WIX, WENGER & WEIDNER By 't?~i!. W~ Richard H. Wix, I.D. No. 07274 4705 Duke Street HarriSburg, PA 17109-3099 (717) 652-8455 " '.~~ -'.-~V,""-~,,.-.~,_ _~"~ ~ =~;_. I.,," ,,'__~ ,'I ".: .. SEAN C. LIMRIC, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 00-3185 CIVIL ROBERT J. WOOD and ELAINE S. WOOD, Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN Personally appeared before me, a Notary Public in and for said Commonwealth and County, Richard H. wix, Esquire, of the firm of wix, Wenger & Weidner, attorneys for the Plaintiff, who being duly sworn according to law, deposes and says that a Notice of Default Judgment, and Notice of Assessment of Damages were mailed to the above-captioned Defendants in accordance with Pennsylvania Rules of civil Procedure 237.1 and 1037. ~o 4 A )J Richard H. Wix, ./ r Esquire Sworn to and subscribed fit before me this Is day of h~ ,2000. ~~ 0., ~~ Notary Public My commission Expires: Notarial Seal Marcia A. Chismar, Notary Public Lower Paxton Twp., Dauphin County MY Commission Exolres Jan. S, 2001 '",,,,"'0- .c,_." '-, , ,- -~ ~ .,,' .. n <:::;) 0 c a -" s:: U') ..-{ ~g; f't1 ~.~"~F.~ "'1::l :2: c:- .~ :~j~~ '/')~~ -< ...-::~. r-:c v -TJ "';~I ~ 70:-: "Ti 2:0 :3.::: ~-O!() ~g - C"m .. -~ ~ l:"" 3J -< <.11 -< I I ~. II . ..'\\ I: "I ~ - ...... SEAN C. LIMRIC, Plaintiff : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : v. NO. 00-3185 CIVIL TERM ROBERT J. WOOD and ELAINE S. WOOD, - Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED To: Robert J. Wood 7624 Jonestown Road, Apt. 2 Harrisburg, PA 17112 Date of Notice: August 18, 2000 IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS NOTICE TO A LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU CAN GET LEGAL HELP: CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 (800) 990-9108 ?~/I. W~' Richard H. Wix, I.D. #07274 Attorney for Plaintiff wix, Wenger & Weidner 4705 Duke Street Harrisburg, PA 17109-3099 (717) 652-8455 h,'"" . I .. " CERTIFICATE OF SERVICE AND NOW, this 18th day of August, 2000, I, Richard H. Wix, Esquire, of the firm of Wix, Wenger & Weidner, hereby certify that I have served a copy of the foregoing Notice of Default on this date, by depositing a copy of the same in the united states mail, postage prepaid, Harrisburg, Pennsylvania addressed as follows: Robert J. Wood 7624 Jonestown Harrisburg, PA Road, Apt. 2 17112 WIX, WENGER & WEIDNER By: rr2 ~~ II C-<J;./.f Richard H. Wix, Esquire ID# 07274 4705 Duke street Harrisburg, PA 17109-3099 (717) 652-8455 ~ 1ti!ilfWa1lt.;1l;\IiIUii ~>."~ '_"1>I!i~,~il>lsJili"",,~;;l];1,",~l lliiiii . ~~...;...;...._ ~ I!tIliillilt"'"'"' " ~--'''' ~ -~.. """"""" - -" ~, j """"\.;j , ~ g <:> 0 "'O~ <:> j1 .1:1) fjjCS; r., j~Fi :!J 2D." " 2-'-' r-'~ <n!t: T1i"Tt ..,- -""y ;:S;L. " 0 ,--'-", ::::: . " .~.-=j{~) ~O I~r (- :J;;: a:d :iiic" ~..",,"(~ ;:)m .., ~ :.~ ;:- 3'i c.n -< ~ ;;"- ~ ", \. : - -- - - ,~" ' -_: SEAN C. LIMRIC, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 00-3185 CIVIL TERM ROBERT J. ELAINE S. WOOD and CIVIL ACTION - LAW WOOD, Defendants JURY TRIAL DEMANDED To: Elaine S. Wood 7624 Jonestown Road, Apt. 2 Harrisburg, PA 17112 Date of Notice: August 18, 2000 IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS NOTICE TO A LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU CAN GET LEGAL HELP: CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 (800) 990-9108 7?~ II. LJ10 Richard H. wix, 1.D. 07274 Attorney for Plaintiff Wix, Wenger & Weidner 4705 Duke Street Harrisburg, PA 17109-3099 (717) 652-8455 ,- _ ..~_.;""'-"-'_.~'~_ - ._~"_"...___.;, .-~.~._ . i ." - -~ -;. " CERTIFICATE OF SERVICE AND NOW, this 18th day of August, 2000, I, Richard H. wix, Esquire, of the firm of Wix, Wenger & Weidner, hereby certify that I have served a copy of the foregoing Notice of Default on this date, by depositing a copy of the same in the united states mail, postage prepaid, Harrisburg, Pennsylvania addressed as follows: Elaine S. Wood 7624 Jonestown Harrisburg, PA Road, Apt. 2 17112 WIX, WENGER & WEIDNER By: K~ II. W4 Richard H. wix, Esqulre ID# 07274 4705 Duke street Harrisburg, PA 17109-3099 (717) 652-8455 'j <.. ~~""j"'_""l!"'-_}ir,",,_&lW__i!,&i..rrr'\"""'~~_ -- w ", M ,~ """-"- ..... ~ ""-~:AlliIIi , ~~ . ."~.. ." "" "'1'1 "_.,, J' 0 0 0 c: 0 :;;;: '" "Un:; v.> .~.{ n1r...., r>1 ffi 2: 2_'1 -0 :!J Zr- ~~E tE C/)~ -<z -&::- 1:;::0 -0 29 ;x;:o ..L .. 2' ,-)" :eo ...... ?') >c 2> Om ~ ~ ~ Cl" --< -,,~ II : . ~ ,,,,',-" 'r--~ '~,,"- ,.~,o~.~" ". "_'.,___" '-"-,""'2;~. '_k:,-,""...~-_I;~ ol.. ,[ ",' " APPRAISER'S AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS COUNTY OF bj tU-IJ tlILL- ) AND NOW, this 1M day of ~ ' 2000, before me, the un~ersigned authority, personally appeared ~~ l~n(1 who acknowledged himself/herself to be an employee of State Farm Mutual Insurance company, and that the appraisal attached hereto accurately, reflects the damages which were sustained to a 1997 Volkswagen Jetta GT 4 DR Sedan owned by Sean Limric. I certify that these repairs were necessary, and that the prices for labor and material were fair and reasonable and those customarily charged. The undersigned also states that he has experience in the appraisal of automobiles for a period of years. Jf~ ~.~ Sworn to and subscribed to before me this lJ'day ~-fuYtb.A/ , 2000. otar y Co S l.re Yvonnil~det Notary Public Birminghan Twp.. Delaware County My commission expires Nov. 8, 2003 ---~--::---'--~'-f'::":--r------ - - - -_._- - - - -- - --- -- ------ -- - - -- ------------ 1 ":.:-' -:- ,,---.' " .....:--..1 t",:.!. .... I -" , ~:,...:' ,', r ~--. ' '- r' , ~ \. k~ , . :: - -. . - ~ . stATE FARM MUTUAL INSURANCE COMPANY, HARRISBURG CLAIM OFFICE 115 LIMEKILN ROAD - P.O~ BOX 257, NEW CUMBERLAND. ~A 17070-0257 (717),774-:9049, ~ , CD LOG NO 1191.', -0 08~07-99 ;,:38 AM ' ESTIMATE :LAIM INFORMATION CLAIM #' 38-J276-33201 COMpANY, ',,' "~:,,, I NSLIRED ' , ., SEAN, L! MF; (G C~,:~L._.MfN.,T.]'._':_~ '" " : NSPEc'rI ON'" ~''1;;c ,~;~~n'~'~c) TYPE L'RIVE, IN APPRAISER NAME RAY BOND LICENSE # 13186& WORK PHONE (717) 774-9021 AL'DRESS 115,LIMEKILN ROAl) CtTV STATE _~ NEW CUMBERLAND ZIP' 17070:'02137 ' POLICY #,.' , ", CLM REP/AGNT' TM, 7 1-888~713-4694 ..;' '".,... ......, . " -.. LOSS, r.'ATE."';:' 08~05~99',:,.> LOSS, 'TYPE: " ,.' 1::OiJ:'i:'S'iON':'::;,' . :,~" ',": ,:, ..'.': ,,:,;;,~:2:;;~1:io~i;;XTt6'tt~,,::~' ,- REfER TO THE AilAC:TE~ARrS'NOT.M~DE' " REGARDING REPLACEME "!;NT MANUfAcnlRER ll~ THE. ORIGINAl. EQUIP"" " ,: ' . ..'" " " ' FAX INSP DATE LOCATION CITY STATE (717) 774-2113 08-07-99 NC [i-I i \ PA , , ", \ ' ". . .. '.': JI'JNER ,.,,'....-...,--,_.. -,...': . -'~'~',,:: .:,';,"..' , SEAN LIMRIC .. :317 :3RD ST' SUMMERMLE , .. '.~,~" , . t , , WORf(# '" HO~lEtt( .-' .-~ ,-.,.. --. : ~.: :;:.J<i-.o:')' 7:;32~09'1)4 . , " , ' BOX :::i3{':, PA " 1 '7093- 03:::<1 -'. ',. ""';'.~~' . .>. .... "f~"~ " ." :;:EPAIR .. .,~_., ~. "~: SMITH' S I~UTO Bo[:'Y 1 5215 SIMPSON FERRY ROAD, MECHANICSBURG PA 17055- ... SHOP PHONIit; (717) 697-:::1:::6 , " 0, , CAR IN CAR OUT REPAIR, REG.' IL' FAX [lAYS 2:3 29130111 (717) 697-69:31';1 ....EHICLE 199'7 VOLKSWAGEN, JETTA GT 4DR SEDAN 4CYL GASOLINE 2.0 JPT IONS TWO-STAGE - EXTERIOR SURFACES MOONr"OOF TILT STEERING WHEEL REAR DISC BRAKES DRIVER SIDE AIR BAG ELEC REMOTE CONTROL MIRRORS BUMPER COVER MOUNTED FOG LAMPS REAR SPOILER AIR CONDITIONING CRUISE CONTROL PASSENGER SIDE AIR BAG BOf;Y COLOR CONDITJ.ON L I CEN'3E ,t LICENSE STATE BLACK I~ILEAGE VIN CO VI':: VEH I WOP # .s 1 :> f.:,::~O 3VWVA81HSV~102S306 6162 E'ITL".:340l:;1 PA ~':EMr-)Rf(S : "FOR SUPPLEMENT REI;{UEST, PLEASE FI)X SUFPLEI~ENT FiEOUEST FORI~ TO NP,NCY PITCHER , 1-888-317-4628.[F FAt IS NOT AVAILABLE,PLEASE CALL 1-814-333-3278. - Oi~' iNFO~~~~ION' ::,:" ------"1-- ,~ -~1;'::::-l--.,.--~.~\-~~.;;:~~-~--- .. !C. ~ ....' .......l ,;i-'-:'- s,..... , . 'V" ,., -:" " .--\",' --.....;;:;.,~. ~_. . .1' "- ''t' 't ~~ ", ",\~,~ " . 1997 VOLKSWAGEN JE;TTA CLAIM # 38-J276-33201 . .--~~ "ART -,"' 3TRIPES AND MOULDINGS t'lldg", Fende,.' Side Mldg,Fende,- Side Mldg,Rocke~ Panel Mldg.Rocke~ Panel 'RONT BUMPER Spoiler,Lower Fron~ Spoiler,Lowe~ Fron~ Fi ller, Ft"ont.BlHnp~i-; Fill 03'-, F,"ont Swopet'}' c:,=,v~~'l' Ft-or.,t:.. Burnf:;e'r:.';:~' CC1ver; F~:'Ot~t' 'BI.~inpei-;.";;' ------------------------------ "\ o <' . ~ ~-'! : GT46R SE['~N" ',' LOG 119~ L/R R/R LT RT, .....-- fiDE 0123 0124 0249 0250 ,.: Ri2flecb:lr,F,.t." EkuflPer :.....LT.: r':;efl ecto:..-,fr-t BlHnper-, RT Absorber,~f6nt...Bum~~r ". , 1 HI~:::07248A ~';" u 'RONT END PANEL AND LAMeS f'addamp Assembly L1'.' 0130 Par-klamp AssemblY:::.RT 0131 . . :~' ~ - ": -.. Lamp,Side Mar-ker.,::',;LT' ,.0132 Larnp,Slde' Ma,-ker :-~ RT,. 0133 Gdlle Asseinbiy' <;<Z 0028 .lH585365:3C'GRU Gd lIe Assembly Ernblern, Gr- I lIe !I> IHI~8!.i.:j600ATEl Headlamp Assy,Halo~.n LT Headlamp Assy,Halogen ,RT 1 HM941 OI e:B~,':", ' Reinf,Grllle Assem~l~:- IH585:36S5 Lamp Assembly,Fog IHM9416':l':lA Lamp Assembly,Fog H~~ad 1 amps Ai rn Fog Le,rrips ,Aim. ;ADIATOR SUPPORT Panel Asse~bly,Rad Sup 1 HM'305S9 1 H j-"anel Asse:nbly,Rad Sup 0064, 0065 0007 0028 0031 -0 ...:.' ';'.' ''", 08-07-:?9_: 9: :38 fW\ .' ' .. - OPERATION :,..; PRICE, ~T 0010 R&I Asi.mbl~ :_-,:"111: 0011 R& I Ass'''inl:o~ Y LT 0012 R&I Assembly ~'RT' OO~' R&I Assernbly , ,t':';'>-' '000 ** Qt,,,l I t,y ,-;"pl ~-,~~".'-.-~'. ~ ,,< ...... T',:;...... . ,...0../,.'..,' 0006-'Refir,ish. ",' - .' , '>T:".-\;~:<~~,;E!\" R&<I' Assembly' R&I Assembly RU Asse'nblY R&I AssemblY , ',,'... . '~.~, .' .'.' '. pat;\,:;:;~j~~1ltf~~) , SloAt- faCt:::! "":~".' Tw,:,-:,s.t..age TWCl-~t.ag~ St2t,I_~p R&I Assembly R~, I Asse'rob 1 y Replace OEM . ..,.~ ,~ "'.,:-- .' 52~ 95,.> ,. R&I A~s"'!nbl y. R~d Assemb 1"y . R8< I- A~se'r~bl-;'; F, R8d Asserri5f'v Repla'Ce OEI'V;~:. ;;.',: .' ,:':~"'-:~~~~~, :,:~,~' .,~"',...-. '. '-, . ;,".'1 .'.~ .",' '~., ';' . ".~..,. .:~; '. "10.,; 1,0: . -' ~Ii....,." .:","!:.-; : .. ,.:. .'.:,.'i.-,.. Refl,-,ish. . Sr~~r f~c~ '.. . Tl"4o.-stage Rep 1 a,::e OEi~,' ".~7~;:i~:~-' i , . ..... 20..40' 0041 R&I Assembly 0042 Replace OEM ,117.20 .,' ",,' "" 0043 Replace OEM LT 55.15 0056 Replace OEM ., 172; 25 RT 00-57 0':173 0986 R~,- I A,?'setnb 1 y Additiot1al operation Addifi,onal opet-at,it:)f) 0073 Replace OEM 2S8.35 0073 R,=finlsh S'-Jt~1':.c::...ce ::001... I NG (.NL) A I R Cc)ndensE'~I"., Ale r~/C Evacl Jat.e ~-: CONDITIONING OT31. 0977 Hecharg :f:* G!u~ol:lity Add i'1: ional t"epl pat~t. r")pera1:.i.ot"l 149.00 I':ONT BODY AND 1-IINC'SHIELD r=et-.der;Ft-ont LT 0103 Refinis~1 >>HEFINISH LABOR IS TO BLEND COL.OR AND CLEARCOAT ENTIRE PANEL LABOR RT \. '0. 2 Sl~ 0.2.' 8M 0.,3 8M 0. 3 ~8M 8M 8M pt1 ,.~.~:~Jfi~~: 2.1', ' " .. 0.4 0.6: \ SM 8M '.8M ~NC '.. >' ... '0;. , 8M SM.: '8M ":. SM..' 0..2 .," SM.... '1.7 1.4 ' , 0.3 RF, 0.2 8M INC Sl~ SM . . ,,'.' ,. .' " '. :.- "',' ".' .' "'.' .-' . . ' " . -- .... < ,. . '"",,,' "':"..' """"~"::>. ',: .'/, ":"""'~":'" .;,; "'>"'-'.'''' ~ :":':. __ ':.~", ,<,J', ;;.'.,,:.,:".-:::,'.::.. \,',..-':'."-:; :~., c.:<.>, ..',' '-:"':">'.".' ':..,..,':.::;,:.~:.,~,.>:.~f.,::/'::',".'~ :':;;~">':';'''<:--:i ." -' . '. ~. ::' . . NY P~R~N w~ KoowlNGly AND' wrr~' I~t(,:,r to' INJURE"OA DEFRAUD /..Nt INSilREA F;tE5'~'I.tAPP.JCAr;QN' OR CLAIM<-CONTAU:'!NG.'AN,/'FALSE.' INCOMPLETE OR -MISLEADING ~NFORMATION~. " . . . .. '>, ' ,..' "",'~ ~""'<~ ="'" "..".' .," ~_~'N.'''..~'''''.T",,,,,,''''''''''_''~~",",,,_i:_',,"~-s;,,,",, "-~ ~ -: ,_ c - - ---- -\--~--:x=-~--------,..- -- - -. -- --- - -- -- ---- -------- -- ---- '. .' ",;. ,...."' '.., j\" .. '...... "', . , ,---- ~, J'. >' \ .,. .......-. _ ...-- \ , '. .'~..f'':::: '. ~'. (""'. ~~-:::.:}< '0-'" '. . \'f' $~": >\.,.,.~: ' , ~ {'o'" ..'. 19'31 VOU(SWAGEiil -TETTA llT 4 CLAIM # 38-J276-33201 Fender ~ Frot~d:: Ferldet~;oFt-o~.lt.. . ))REFINISH LABOR IS Nozzle,W/S Washer Noz~le,W/SWash~r Wihdshield~Tinted NAGS FW21)06-GT > >W I NL'SH I ELL' F'R I CE CllIOTE Panel;oHood !;':J I TEt<1S >> - - -. ...~ . DR SEe'AN ':" LOI~ --', " --.: " -.'- --;,: t' "'..~ ~ .". '. . ..r: "7",':" nl 0~::07-99_" 9.= 38,1'11'1. ' 1196 ,-0 RT 0104 Repair- RT 0104,Refinish, TO BLEND COLO,R .ANp,q.EARCOAT LT 1069 R8<IAssembi};' RT 1070 R8<I Assembly, 0143 Replace'NAGS 1 :ENTIf'E,PAN!::t 289. 95:f: '. 1. O'~ 1. S*, 8M:' RF:. " 8M' '8M' INC*.SM . --. 18 INSTALLED FROM AI.1ERIC:ANAUTO GLAss. 232-6000. 008:3 Repla,=,,, OEM lS2..50 1;0 ,8M, ". >. .. '.. - ", ~,,-'-': " ", '. > ,:,~;'~'. YE~-~~i.:-- - . . ' ..' . ..;E;:~~!J~$'f:i:l:l}i~I~I~.' '_, ,>~.-'.-;,:,' .,', ..'. 'co, .';:.l',-"_' 8M .. 2-5 ~ '0 I) , lNG" SM' .,'-.'-', -. :"C. OE:63. R&I Assern~lY' 0889 Replace; OE;M .....' .,- ~-~ . .~ -:: -' . ,'4if:S5 . 1 HM823031 F. ',:: ,n:.,' P.ne>. HOOd. .....,"d~ ;~",.;:"~,D;~m(U~~4 IN/8t.t"ip, Hood Panel" 1,':" (11)87, Rt,I Ass"",ilbl y L,-,t.ch,Hood Pat1el ! 0088 Replace OEM IHM823509C, ,ASHBOARD AND COMPONENTS; Cy~,Glove Compt Lock J~odl,~le,Airbag' Cqn1:.rol 11 . 6N0909603D_:': ,..,' r,c,c,,", G1'qve Cc,rnp1:. ' .0893 Airbag, Instrurnent Pnl'~'~ - 0912 IH(18S0204 .,.' .'PPER STEERINI3 cOMPijNENTS Ai,-bag,St.eerir,g Wheel,; '.", OE:78 Replace OEM' 1 HOSeO 1990 1 C.' Clock Spring. IH09S96S3 EIHER CONSOLE AND SEAT TRACKS :3.221 t.be 1 t L T 1823 R""p I ace OEr~ ,1 1 HME:S.70S13B41 ~;ea tbe It", RT 1824 R.;;p l,-,ce OEN J1 IHMSS7706GB41 1(~I~UAL ENTRI ES PULL RADIATOR $UPF'ORT,' ))PULL TIME INCLUC'ES 8ETUP. CLEAN t. RETAF'E MOULDINGiS Pins!:,," ip,,,s-Tape REMOVE STRIPES&ADHESIVE Hazardous Waste Removal CAR CDVER EXTERIOR COl-rosi~n Protection CLEAN EXTERIOR At1ti-Freeze-Coolant F~:eft- iger-.r:1ni:. ." ., ......... ' , R&l AssernblY Repla.='e OEM ,: ' . '-'0,";0:-. -1:- . _,:",..;~4' -~ l' - .,:k. . , .. .6d:,~o' , .: ~<'~. : ~~..-:/:;\: .~{;~.,:: '.' ':' ~. .- ~; , . '>."C-'F<:' 'E:42~'-Oi:J" . --,....._, ''';:'';':.:-,.;:..:::-:.'..' '..-'..,;,;~.~-;!':..-. . ,-~, (lE:87 Replace 01"1'1 9?:;J$ . " , . .....0."'.:. 79:0-5 7':(. OS Addit.ic,nal.,?'pe,'ati':ln '-;.;' M07 Additional *,~ Clual i ty Addii:.ional ** IJuality ** Quality ** CI'-,al i 1:.y Addii:.ie'nal ** G!ualii:,y ** Oualit,y "epl part "epl pat't. ::3.00* . :3,s.00* ()pet-atiCln rep! pari:. oper-a'l.:.ion "epl pat't.. "epl pa,"t. "epl pa,.t op~2r ~it. i on 10.00* :3.00* 3.00* , :3. oo.~ If'iC ~'IESSI~GE 01 CALL DEALER FOR EXACT PART # I PRICE :INAL CALCULATIONS & ENTRIES ''','<,-;<'' '" ','f"~ -,,,,,,~_,,,"~~_-\,,---c.,-,<'"~""'_< >'.'."". -- . .. \, ' . , (.~i:}>::~2 . ; -:'.:~ ..::.-.......,:\ -<- ... , , ,0:.4 : S,M . ().:3:,- ME, . \ \: '>. ",,,;,.~. . -, ' '~~.:-'~:~~'~/~!;2.~/. ...1~~\i:; :.~'.(,,-' . " o. 7,"8:M .',. 0.7 8M , ';. ". * ,'... * ,',:3~ P.,' ~Mc'," 0, .-.* ..L . 0.3*' 0.1* RF* 8M R'F* 0.1* 0.2* 0.2* SI'1* SM* Slfj* :s.': ,.-;.;;;"'.-' -. . - -- -. - , , -.- "" '''. . .'- ,.",'; - . . - ",. _:> ~:,:" -:,;,:,~:_~;.~ ;~. :-~,;:~:a~~~.::;'~ {/ii" i;:,:~:,:~~i}:~~-~;;:::~~.;:-:~:~.~i~~, ~,;<::i~:::~<;~u~ .;~ .~ '~!sLbdiNG- J~~OA~n:l~ t'~~~ . -----,---;-- ~~-=..- -"l--~-~ ~~ ~/~ ~7,- ~ - -:-,- - - - - --- -- ---- --- - - - - - - -- - - -- .~ . ~ i ._ 'If t ~ :-', D"""'~-' '(~'r":A__ 0., '.F..,-;:~ -- ;.. -. ........ . ~ Iof' ~ r .: . . ~ 1';'31 VOLKSWMEN ,TE;TTA 51' 4 DR SEDAN CL.AIM # 38-J276-3:i201 LOG 1196-0 08~07-99 9:38 AM ~ARTS GROSS PARTS ' OTHER PARTS,. PAINT MATERIAL $ $ '$ 3,089.5S' €.SO. 9.5 222.70 , o,D..TUSnlENTS DISCOUNT ~1ARKUP PARTS TOTAL TAXON PARTS & MATERIAL~, ,6.000:-: $ 3,.'016.3.20 $:'237. n' LABOR, 1 :;SHEET METAL 2;-MECH/ELEC :)-FRAME,', " , ,t-REFrNr"SH- S-PAINT RATE $ 34.00 $ 34:(10 $ :3E.. ,Yo ",. . $34.00 $ 17.00 REPLACE HRS '12.8 2.8 REPAH=l HRS , '5;2 1 ;'4 12;8 . ':'...J i....," .00.3 ",-,,"c-i"," $ '612.00"", , : '142 ;-;<';;""!,':," . $, ,'; . C.I.:I;;:-..~-",.. :" $ ..', .:,;'~~~f.2k'i71~,' /'" J'.' t-: ... . _,_'-.i.' '--:':.', - '.ABOR TOTAL TAX ON LABOR @ TAX ON SUBLET (~ SUBLET,REPAIRS TOWING . STORAGE 6.000% 6.000% /.:. $ $, 1,200.20 :' 72.01 \... \ '''-'.-' ~ .. ^ / ." .... -; ~- .c'........, , , -:,.; :.;':'::~,~;~~.~,....:..:-~:-..; $" 5',.:473;:20 \,', $~:' : 25 (I '.00::.,., ,,' '. :-'" ",.,,' ',:<, ':'<ROSS. TOTAL' LESS': })Er'UCTIBLE '<',,'0;-; t' " ,.'-: " "':' :'IET ' TOTAL '. -' -'~.~'~- . $:' S".~~3;'}R';" : -'::--~'--:: :'.~_""J:-" . ,; -- "'~..: ; - ~ Y/02/02/00/00/00 CUM 02/02/00/00/00'Geocode: 17070 HARRISBURB< PEN PRO W0337 ES LO~ 11 % - 0 0:=1- O?-~9 10: os: 44 REL' 3';j7CD 07/99 COPYRIGHT, AUTOMATrC [:'ATA PROCESSING, INC. 1998 .. " 1. 8 HOURS WERE I~DDED, TO TH I S EST mATE BASED ON ADP' S TWO-STAGiE REF I N I SH FORMULA: 20:-: OF REFINISH HOURS, AFTER OVERLAP, P'LUS SETUP TIME FOR THE: FIRST l'lA,TOR PANEL, WHERE NO-r;ED. PXN :'<DP ".,-. .....,' ---------------------------------------------------------------------------- .........INFORMATION ABOUT YOUR ESTIMATE.......... ' 1. THIS IS NOT AN AUTHORIZATION TO REPAIR. ;::. FAIL.ING. TO PRESENT THIS ESTU1ATE TO THE REPAIRING FACILITY BEFORE A REPAIR MAY RESULT IN ADDITIONAL EXPENSE TO YOU. , ' '. . - '. . - . -', . ~,'. -,> ' ',d, '.," ;,:;':;,;, N -- ~", H -INtE'~T;'\ci: t 'R~ ~~ -D~~jjQ' A:N./ ;~s~@~; ~l~s :~~.':k~~i~~~ p~ C~!M ~o~r:~;~;~~ ,ArjJ'- ~A~.S,~_l~~~E OR ';!IS;~D,J!::,~ ~~~g~,,~ ~~:n -',:i ~~ " I . ~,,,,; . -------\-~:--~~-~---~~~\-~-~~-~-------~---------------------- .G.....~..;=~, ~~p~....A'.;:... 0 ' ....~!;" ~. , . "'. ~ "",...'~. -.# .\ . 19';)7 VOLl<:SWAGEN JETTA CLAIM # 38~J276-33201 . GT 4 DR SEroAN LOl, 1196 -0 08-CI7-9', .,: )8 AM J. ANY PERSON .JHO KNOWINGLY AND WITH INTENT T,j IN.JURE OR DEFRAUD A.NY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE,' , INCOMPLETE OR MISLEADING INFORMATION SHALL UPON CONVICTION BE SUBJECT '-0 IMPRISONMENT FOR Up. TO SEVEN YEARS AND PAYMENT OF A FINE OF UP TO ns,ooo. , , -------------------------------------------------.-----..------------------------ oM-SHEET METAL ME~MFCH(~LEC FR-FRAME RE~REFINISH SY-SYSTEM ::.->;:. . .~'O: . ~~. ..:'. 'i/-". _"10 .' .::-....--. .~..:.. -,.; '''.':~,..',':. "'. - ":' .'.~.l~~. ...'.'. - \ " , < \. '. .:.):'., , ,'. ,~.' ~ : .- '" . ..-_, .,' " " ~ " - ,.~, ' .: ,'.,." .... "'," --5-.,,-- ,.,." >' , ", .,', lNGINFCRMATiCN.. .V PI"R~"" wwf'i' KN(')WINl':.I"" .um WITW tt.lTI"IilT Tn IN IlIRi= I"IR nFFRAllO AllY t",...tIRI'R..E.l1 i=~ AN A.PPU(!ATIAJ.I AA ~1 A. U ("~NTAININc. ANY FALSE. INCOMPlETE OR MISLEAD, ,0 ,'"., -' u . . '>.,i -----------------------------------------------------------------. .. L .. / - iIJl'I'I.J-:~I~;rJT kl-:,;ONC 1.1.1.'\'1' ION .) ~~=~=~========r====~=~~ .', CO I.OG NO ;>'~IH -,1 ~-;Ul-'l'J.~;~IEN'I' :-;1 .; ,:I.AIN II J N~;UHI.;t) O\'JN!';H V~;JilCI.~; JIi--.J276-33201 SI':!\N J.lt,1HJC SI,;AN LIMklC 19~U V()I,K~:WAI;~;N ';1)1:; -,J',20 Pt,k'j' Cover. Pass Airbag HI';::;~;T ,".IH BAI; lCV~11 ;1)1:: PAriT 'IHtIJ Clock Spring ':AJ.CUI.ATION CHANGES (;H(J~;::; PAH'l'S I, I N~; I TI-:~l P.t)JlJ::;'I'~I~;N'I' TA,~ 01'1 I'AKTS !< W\'l'EIUAL ~;Uj;LI':T HE!'A 11,::; Tr\X ON SUIiJ,I';T ;"FP 1 N~;'J' TUTfl,lJ ;i .=t'lt~r'\H,{ .'Tl iJ I';st. ,'''[-'I'' 1 NI-;T TOTAL ~), :i.:~3. ~~() 2. ''3'} . ;J,f<. ... :. ." POLICY It HJ:;P DATe: Al-'I'HA.lS~;k 1)1,{ :oj ~;LlAN , .... OS-01-9~ HAY BONt) PtHCE AD.! LAHOI,{ RAT!:: '/0.% JNC ~IE ~'1.00. ~lark l~"'-c. PHICI:: ADJ LAtlOH HAT!:: 230.95* 0.2 ~1l'; 92.10 0.2 t.l~; .'1'0 3,298.'15 14.;>'~ 251.20 ~i '1.00 3.~2 DH'FI-:HENCI:: 209;20+ 14.25+ 13.41.. ~)/. 00'1- 3.42t I i I I J~;T'l'A liT 4 AUDEt) LINI::S ()l-'~;HAT LON Hep lilce OI::~l Sublet. S1 S1 ().OOO', . ;>'91.:;>'8~ A.JJPHAJ ~t<H f{A~ BOND HA t BOND ',--^;.~,~~,'ii~:!/f:;;~' :,'.,. ...,. ",. ;,~d.:~:',,~i\~: ~"; '-I ;~-._".i?"!;l,;i~~;~;'i,t1i.ii .~,~.',,'::..:,i,;J1'~..!_..;~ ~:"., '. ".. <;>-";"".'.'"' C' ';' ;'"';,e, ,;',~~c"A~~'}'d;.~ ,'':'' .),'.:!:i;i~;i.;.~,J,,,<--,,;: r~,~'- ,", ,,_-:,:;::;;,:~ .L'C....Ol~-.T.....-t.ii;i;:",; Cli.'\NGf:D LINES OI'EHA'1'lON Replace UEM, 51 FHU1-l 3,089.55 6. \)OO~"6 Mark 1>.000'. 23'1. 'iJ 6. t)0U~:' DAn; 08..01...'19 08-'l~-9'3 'l' It-1~; ~::;H AM 8:55 Al-l . t. i;.b,.- ~.~iIl__' ~ ....' .. ..."""".tio;llhr>~.,u",,,,,";;,>ii;l;~W;,;;_,;~l!llIliI ... ,I~" -~ ~~rllililiji:f""~ 0_" L . '~ "...~lIIIi.llr~ .~, . < 0 0 0 C 0 ;:e- -n ~ru (I) :;~3 m{", CT1 Z ~, " nl.....!.! Z-::C~ r- (j5t;;: +- ::gR -'< "0- (.5{T I-~ < ,~ )> "0 ~i$ 20 ::;;: ~o 90 .c am ~ ;:- ?,g m -< II -.... ~_.. - . J_ _.,,' SEAN C. LIMRIC, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : v. NO. 00-3185 CIVIL ROBERT J. WOOD and ELAINE S. WOOD, Defendants : CIVIL ACTION - LAW JURY TRIAL DEMANDED NOTICE OF ASSESSMENT OF DAMAGES You are hereby notified that in ten (10) days from the mailing of this Notice, damages will be assessed against you in the amount indicated in the attached Repair Bill in connection with the judgment which will be entered against you in the above- captioned action unless, prior to the date of assessment, you request a trial on the issue of damages by filing a written Praecipe with the Prothonotary. WIX, WENGER & WEIDNER By ?.AA.J.'d"~ /I W4 Attorney for Plaintiff 4705 Duke Street Harrisburg, PA 17109-3099 (717) 652-8455 Dated: August 31, 2000 .;.,<- L"'~",,,,l>IIlkr,, CERTIFICATE OF SERVICE AND NOW, this 31st day of August, 2000, I, Richard H. wix, Esquire, of the firm of Wix, Wenger & Weidner, hereby certify that 1 have served the Notice of Assessment of Damages on this date, by depositing a copy of the same in the United states mail, postage prepaid, in Harrisburg, Pennsylvania addressed as follows: Elaine S. Wood 7624 Jonestown Harrisburg, PA Road, Apt. 2 17112 WIX, WENGER & WEIDNER By: ?.A-< .J-d~ II (A/~ Richard H. Wix, Esquire ID# 07274 4705 Duke street Harrisburg, PA 17109-3099 (717) 652-8455 - .J....__4,folo.i"'''', SEAN C. LIMRIC, Plaintiff v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 00-3185 CIVIL ROBERT J. WOOD and ELAINE S. WOOD, Defendants CIVIL ACTION - LAW JURY TRIAL DEMANDED ~OTICE OF ASSESSMENT OF DAMAGES You are hereby notified that in ten (10) days from the mailing of this Notice, damages will be assessed against you in the amount indicated in the attached Repair Bill in connection with the judgment which will be entered against you in the above- captioned action unless, prior to the date of assessment, you request a trial on the issue of damages by filing a written Praecipe with the Prothonotary. WIX, WENGER & WEIDNER BY~.A~ N. W~ Attorney for Plaint1ff 4705 Duke Street Harrisburg, PA 17109-3099 (717) 652-8455 Dated: August 31, 2000 -. ~ I",....... CERTIFICATE OF SERVICE AND NOW, this 31st day of August, 2000, I, Richard H. Wix, Esquire, of the firm of Wix, Wenger & weidner, hereby certify that I have served the Notice of Assessment of Damages on this date, by depositing a copy of the same in the united states mail, postage prepaid, in Harrisburg, Pennsylvania addressed as fo'llows: Robert J. Wood 7624 Jonestown Road, Apt. 2 Harrisburg, PA 17112 WIX, WENGER & WEIDNER By: ?~,~ fl. WJ!i~ Rlchard H. Wix, Esquire ID# 07274 4705 Duke street Harrisburg, PA 17109-3099 (717) 652-8455 , ----}~---r-----_:_- ~ - - -.-- - - - - - - -....:- - - ----.- -- - --- -- ---.-----~ , --,.-.-', '.' ..".'1 ' . ,.., l.:-oJ, . - ,.' -.' " (-, :-.-~(.'~ ' r' . : ..... . .\"t>. _ <,..1:,. ....,J . . ", ,',- -. STATE FARM MUTUAL INSURANCE COI~PANY, HARRISBURG CLAIM OFFICE 115 LIMEKILN ROAD - P. O. BOX 257 ' NEW CUMBERLAND, PA 17070-0257 (717), 774~9049 , ~ , CD LOG NO 1196 -0. 08~07-99 9:38 AM' ESTIMATE ,~LAIM INFORMATION CLAIM # 38-J276-33201, COlrfPANY, I NSYRED'; . CLAIMANT:" <~:~;:>;.,-,;::,. -:,-~- LNEiPEC'doN"" ,. TYPE APPRAISER NAME LICENSE # ~~ORf( F'HONE ADDRESS CiTY STATE ZIP' ::. .- -:~i:.:.<r\~~.'~.: ,:_~ -.; ~~.~....: ~. ~:. ,-, -".-.' pOLI CY # ~t eLM REP/AGN.r .,.,TM.:..7 1:-888":'7:13-t-'V594 LOSS r'ATE.,"',:: 08-'-.05-99'" ',". , LOSS.TYPE ',..;:f:6(Cis.IQN..::r:. ,"," . ", >:~ ',: ',:': .:,'.. : ,.:...1~kcH:~~~11~o~k;t;6tt ~. :~: . REfER TO THE A. NT PARTS NOT,W_OE . REGAROING REPLACE~I~MI'NT MANUF"CTURER BY THE ORIGINAl. EO " " '.'., " ' SE~N, L.!MFlicS'" :' ~ ;,'_+4 ';.:,. :~. ',,-_,~ .". r'R'IVE. IN RAY BOND 1:31866 (717) 774-,9021, 115 LIMEKILN ROAD " NEW CUMBERLAND 1,7070-0257 ' FAX , INSP toATE LOCATION CITY STATE (717) 7'74-2113 08-07-':19 NC 6- ( ,,- \' \ PA , , ,,:". ...,. \.', Jl')NER .... .,".:....., , SEAN LIMRIC , ' 317 3RD ST' Bbx 331'~ SUMMERDALE PA" 17093-0331 ... . . -'~'~-'" '; r WORK# ., . HOME# ( ,.: ' ::,->,-~::~'---':. : .;.: ~T~)i.;-~'''',~~' ..... ." 7:;32-0'i04 ' ; :~" "".:.' , ..' ..... , .,..,.~:~, ,~;~'~~. ," ....,;--:,;;'...:.: ~:EPA I R ...,~--, - ..,;; SMITH'S AUTO BODY 1 5215 SIMPSON FERRY ROAD, MECHANICSBURG PA 17055- .. SHOP PHON" (717) 1::,97-',,'186 I " I CAR IN CAR OUT REPAIR, REG. ID FAX [lAYS' 2:3 2950111 (717) 697-6938 ciEHICLE' 1997 VOLKSWAGEN. JETTA 8T 4DR SEDAN 4CYL.' GASOLINE 2.0 )F'T IONS TWO-STAGE - EXTERIOR SURFACES i'100NHOOF TILT STEERING WHEEL REAR DISC BRAKES DRIVER SIDE AIR BAG ELEC REMOTE CONTROL MIRRORS E'Ur~F'ER COVER "10UNTE[.' FOG LAI~PS f'EAR SPO I LER AIR CONDITIONING CRUISE CONTROL F'ASSENGEF~ SWE I~IR B""G BODY COLOR CONDITION L ICEN'~;E # LICENSE Sf ATE r;LACK r~ I LEAGE VIN COVE VEH I N'3P # .S1 ~ E,BO 3VWVA81HSV~102S306 6162 EITL..:340::.:: PA ';:El~{~Rf(S : "FOR SUPPLEMENT RE(:!UEST, FLEA.BE FI)X SUPF'LE1~ENT f,EUUEST FORr~ TO NP')~CY PITCHER , [-888-397-4628.[F FAt IS NOT AVAILABLE,PLEASE CALL 1-814-833-3278. , , "" -" ' - .,': ' ' ,,' . -', " , - -~ ;jL.~.,~",~,~~~.i:.~;;;~:~~j- :~.i~-';J~Lii.~~;i:kL~~~~~.~;~~~~~~:;'i':.'~~~~~$;~,~~~;:.~-.~:.A',;,i~~J;~~:~-,~::_:J~:k~;;:&,;ii_~~:~~'j~~~~~,~:'~~-;~~:-~"~~EA~--~FO~~i~~"&:;: ,~ k.:"" -----;--;,--~--.1-'-:---.,.. ----- -",;:;--. --.----- --- . ,. ,:;,:.~ l ....,... .~/l ......'~21-~-' ....~..,., -==:, " --'. ',,',"'"" '.' ......,~.-:._.,.,.~K , y, ~:.~rr:A ," ,. , ..,;-, '. ,':, \,If,..i\ . , . '. I . LT 0010 R&I Asiembl~ .:'~~. RT 0011 R~d Asseinb~ y , ,LT 0012 R&I Assembly - _t ' _ ,_ - '., " .. Jff~J.'.~..'~ ~~.~~:f;.!,rh~~l r~Pl S'~H~fac.::! ':'-:~-'.' TWCi-...stage rWo-sta9~ S.3t.,-~p R&I Assembly R~,I Assernbly Replace CiEM" Ri:=f !eci;.ot-, Frt - Burnpet~' :-.'-,L T' ReflBctor,Frt Bumper 'RT Absorber,~font,.Burnper. '. . 1 HM8i:0724E:A ,;,-;:.':', 'RONT END PANEL AND~LAl>1eS Parklarnp f\ssemblY ';.~.LT" 0130 R&I A~."e.~nb,lX. Pat'klamp Assembly,., >:;J1T 0131 R1.d A~,se,,!,q.!Y ';" Lamp, Side Marker.:,'::LT,:. 0132 R&I' Asse'rnbfi f,,:,' Lamp,Side Mat'ker"':13T..0133 R&IAssem~ry:" Gdlle Assembly",:;;:' 0028 Repla'ce .DE.M'"," , 1 HS8S36S3I)GRU " " "',~: Grille Assembly 0028 Refi~ish.. ' SI~H-fal=e ' . . ... i!..' , Tl'-Jo.-~t:.age 0031 Replace OEi~, 19':17 VOLKSWAGEN J~nA CLAIM # 38-J276-33201 :'ART lTRIPES AND MOULDINGS l"lld:i, Fendeta Side Mldg,Fender 8ide Mldg,Rocker Panel Mldg,Rocker Panel "RONT BUMPER Spoiler,Lower Fron~ Spoiler,Lowe~ Fronb Filler;FrontBump~~ F i i 1 e,r, Fl'ont B'-~mp.t'; C(,'lvet~, Ft-oi.,~':, BurnF;e'r'./~.~, CCiver; F'::or';t: 'EkHnpe~",;~~;;,: LIR R/R LT RT Emblem,Grille . IHi18~~600ATEl Headlamp Assy,Halo~.n LT Headlamp Assy,Halogen , RT 1 HM941 018B;.':,., . Reinf,arilleAssem~I~: IH58S:365,5 I_amp Assembly~Fog 1 HM94169',A Larnp Assembly,Fog RT H~"2ad 1 ~irnps Ai rn Fog L.,\m'ps Aim lADIATOR SUPPO~T Panel Asse~bly~Rad Sup IHM'"'OSS91H Pan~l Assembly,Rad Sup ------------------------- , o -:.:!' .? ar4 t:',R ~Ei:'.AN.....' , LOC, 1199 -0' . . ~ '-, . ..-' '--J ......- ,08-07-,';19" 9::38 ~. :' '. ,.. 1'\11. CiDE L.ABOR RT OPERATION PRICE, 0123 0124 0249 02.50 R~t,' ,Rll<I R~<I R&I , ;: .:,'::..-'. \;:::--:~;:E-,4 Assembly' Assembly Assernbl y Assembly St1 SM 8i1 ,SM , 0.2 0.2 ,.0.3 0.3 "-' . .. "'..~ 'l;,-,;;;-">; d..~.;;.~....~t',,,;~;ll~~~;6.( 8M '8M f;~::i~-" .~j:f,URF.' .2. .1';'_, . .. 0.4 0.6' 0064, 0065 0007 \' . SM SM rNC' '.8M .s '2 ~ .~ 5~".:':, .~. .' ","1;. '" , '-"-~ . I;':;. :::~'~~~-~~::::. \:~-~, '.~_:', :~.' '.,~ " ,'-,....--".-. .. ,8M SM,; 'SM,~' '. 8M O. . 2 ,-;-' S~t:(, $','," -, ;~ ,'.-.' i9~; 1,0:. . ",~....-:" ~...".:.. ,:. .' ,'-. . J' ,;t-:':.{;~~:~';;' .-"-:- ::..~ .,', . ;~, ~.' - 20.40' 0041 R&I Aisernbly 0042 Replace OEM 11?20 0043 ~epl~~e OEM . ' 55.15 L'r "172.25 00,56 Replac. OEM 00,57 R~<I Ass'~mbl y 0973 Additiot1al operation 0986 Additi,onal operation 007:3 Replace OEM 2.58.35 0073 Refini.sh S'-H~ f-=ace CONDITIONING 07:31 (1',77 ::001... I N'3 ,;ND A I F~ ConcJenser, Ale ('i/e Evacqat..;: ~< F~echat-9 RONT BODY AND WINDSHIELD r=et1der;Front LT 0103 Refir1ish >>f~EFINISH LABOR IS TO BLEND COLOR AND ** Quality repl part Addi-!: ionz~l op~::t.a'I:.i.on 149.0(1 CLEARCOAT ENTIRE PANEL _ " :.. <" :::- ',- ,~,;~,__,,:,:~,-',>.: ::", _':::, ':',~;: :,.', ,-;,<,:;~:,;:.:,::.~;>:, ,-.:_ :,:: / ,:_~'.': ,-,:,:_,,;::> ,,<~::-,:,:,:.,:,2,,~i:;:~;;::~_~:~1;~i}~..:::::;'.~,;,::::-"~'" .':,:<~': ,,::,::.:,':::;;~'.-;,~~~,;;~i:~J~S.;:\;...\:;~,,2-:.;-.~,.",: ,.,", ,:'_' . - ,_ .'" - ::-' , "ly PEi:l~u wHo KNowINGlY At.lo' \yltJ.i' INtENT to_ ,;.uURE' OR OI;FRAUD AN'tINsU~~ FILES, AN ,APi;'lia", At. '01ol, "OR CLAIM co,Nf ~.I~ING At('( ~A. lSE.,'NCOMPLET.,., ,E,o., ~,.)v\,ISL~OI_~. G" INFqR~ T~"N' : - ~_ ~ .. ~ ~~~'''''<cA,~ . . _ "",,'" 0/.1.0' j,. ",,,,,,,,,,;1;: elt<.~_"::.l'~- ;~~-:' l,_ _ ,J _ -, -'--~--r--~--:C:~T--------"'~ - - ---- - - - -- - ------ - -- ----- -- --- '. ,". .,;;", "'" 'h,,...,", ::.....' ~.', . -,---- ... . . \.,. ..... .... . 1 , .'~..f' .::=,. ~,. 0~,'.€:r"':-- '<, '0-" ..' \ 'ff ~~""" -. . . ~;.-. ,,\_~~!'" . {',. ..\ cf. 1 '';/97 VOLKSWAGEN' JETT A L~T' 4 CLAIM # 38-J276-33201 Fer-,derl Ft-ont Fend~.:r:o Fro~.lt '.. ))REFINISH LABOR IS Nozzle.W/S Washer Noz~le.W/SWasher Wlhdshield,Tlnted NAGS FW2006-GT >)WINDSHIELD PRICE QUOTE PanellHood '. CLEAN EXTERIOR Anti-Freeze-Coolar1t f~:eft~ iger-i:1nt .';9 I lEt-IS . '. DR 'SEDA~", <, LCII;'j 1196: -0 ~., ~',,-::'~~-'l 08- 07-99., 9.: 3:3 AI~. ' ~'- ;-" ~. RT 0104 Repa it~ RT 0104 Refinish, TO BLEND COLO,RAN.t).'~~EARCOAT LT 1069 Rt<I Assembly RT 1070 Rtd AssEimblY, 0143 Replace NAGS . ~ . ENT I RE PANEl" 289.9S* " 1. O'~ '1.05* SM" .RF~ '. -- 8M', '. 'SM INC*SM . - -' IS INSTALLED FROM AI~ERICAN ,AUTO GiLASS.232-6000. 008:3 Replac,= OEM .',:: 1052..50 LO' SM , .' '_..... . ~.~.. . B_' ," >;;i~t,;~~~;~~tti.'.i;.!,','j,,11"~M(;,K ,,".' .-;.:, -.<:, - 25~ '01) . - "-', '.. 0863 R&I Asse~bl~" 0889 Replace; OE;M ~.." d-"'- .; . . " ,.-'. ' -I"": . '. ,421 ,805,' IHM823031 F.:,.:",,^.,~ Panel.Ho'od ." ,'-C' 0083 Refinish":""'~::,: ,," '" ,,;..";'::{::~~~:~:',;' ....\.;~~f:~[~:~~~(' 14/St..t"ip.HoQd Panel" /,' '0087,R~,I AssernblY , L",t..ch,H,:,,;od Panel i 0088 Replace OEM' IHM823509C, . A8HBOARD AND COMPONENTS,:, Cyl,Gilove Compt LQck Module,Alrbag Control ! 1 '6t~Ct9096Ct:<D." Doc,,". Grove Compt' , 0893 Airbag.Instru~ent Pnl'~'~' 0912 , , IHCI880294 ':',', -'F'PER STEER I N(. COMP,jNENTS . Ai,'bag,St.:eeririg Wheel,;.: ""OE178 Replace IH088019901C, Clock Sp,'lng 1 HO';1596S3 EIHER CONSOLE AND SEAT TRACKS :3>2at..belt LT 1823 Replace OEI~ '1 IHM854705GB41 Sea tbe I t to RT 1824 Rep I ace OEt~ 11 IHM8S7706GiB41 1(~I.UAL ENTR I ES PULL RAr,IATOR E;UF'F'ORT.~ ' ) >PULL TI ME I NCLUt'ES SETUP. CLEAN ~< RETAPE MOULDINGS Pins!:.,' i p,=s-Tape REMOVE STRIPES&ADHESIVE Hazardous Waste Removal CAR COVER EXTERIOR Corrosion Protection '. ';:.... ,,' R&I Assembly, Repla,~:eOEM - -. ;"':.,"'.,i '... .. .i:" .,:..:~..:,_~., - .":;. J:'. . <;::<~. "./, OE~( , '.:A_:61~::Jt;;.' .'-;--,i--;:. 842;00 - .,.:: - .... . ,;; .... - .}i::~~::;.{~~' ~ 9~;.:~g' ' '-';'-'1- . , .. :~. . CtE!87 Rep I ace 0.E:t-1 'r . . 79;05 79~O.s Addit.,lonal ,;o'pe,'ation ~1t)7 Ad,jitional ** I).l.,ality f~dd i i:. i Clna 1 ** Oualit.y * * ').l.,a II t.y ** ').I.,a1ity Acldii:.ional ** Glualii:.y ** C!ualit.y 13.00* - :3.5.00* OF'et.atior. "epl pad~ opet&ai;.ion '"epl pat-t.. repl pa,'t "epl pa,'t opet-!::,\i:.ir.:rt., t-epl part ,"epl pa,-t. 10.00* 3.00* 3.00* :3.00* lilC t"'IESSf':)F.iE 01 CALL DEALER FOR EXACT PART # I PRICE , I NAL C(~LCULA T I (iNS Z< ENTf< I ES INC 'SM , .. \" . ," .~ ;.,q. 1\ ',SM ,: 1 ~,O,"ME ,~;~~i~, : ~iJ~:~:'-~ri:;' .0 ?" ME", ~ :- .>.~-.~.- ~'\1.-::;_J:'::-. '-"'1:~,::. . , ';...'{; , 0.7", ~:.M ."- ~ 0.7 8M 3.0*:SMoi<., . - '" :,c -,'~. ::.-' . ri .....:tz , .k 0.3'" (I. 1 * RF* 8M FiP 0.1,* 0.2* 0.2* Sl~* 8M* Stfj* c _ . . . - -.;--...,' , , , v<-: :...",:,<::.""'~< ,;,~>.,,<",;'~';'\.~,>~--;,_,:_;;s...;L,,>..,- , ..' , . . ' -.', . -. ,,- "- . , ." . -' , .- . .--. ~~, ~~~:.::~:L~'~ .':~;~:;:-.;~:~,~~,:.~:: i ~,,::,~-.;'~1~~',:;;:::{[': - ~~ '~.'.; ~;.~<.l~L~;~:i:~~;j<-~~;'~,~:;:~j~:'_:;~~~~ ~E -'~R-~'ISLeA61~G' IN~~TlOri'~<,~- ~--~~\--~--~'~-~--~--~~~1~7-~-~~-------~---------------------- - '\. . ~ \ .-.-.. .,,", ~.- '-, . D"""''IO_ "~- '.~;i.\to-"-. 0 ......., ~~ d. .' ;. ,,-,,_".- _ '-,:. iI. 'V' ~.( . . . j 1997 VOLKSWAGEN JE:TTA GT 4 DR SEC~N CLAIM # 38-,7276-::33201 LOG 1196 _ J:: ~ -0 , 08-(17-99' 9::38 AM C'ARTS (;iROSS OTHER FAINT $ $ '$ 3,089. 5,s' ~ E.sO. 9-5 ' 222.70 , ':\D.JUSTNENTS DISCOUNT NARKUP PARTS TOTAL TAX 'ON PARTS 8< MATERIAL @ ,E.. 000% ",,: $ ::~~..963. 20 $'237. n' LABOR " 1 ~SHEET NETAL 2;-MECH/ELEC ' :3-FRAME.~ " 4-REFIi.:rr"sk' , .S-PAINT RATE. $ 34.00 $ 34:(10, $ :3E..00 $ 34.00 $ 17.00 REPLACE HRS , 12.8 2.8 REPAU~ HRS . "5.2 $ 1 ;'4 $ 12:8 }'& .<';;' ' ",. "...~..:'.'!. , 612.00'..... . - -,.~p",;~-;- .. - '142. 8 Oo'~',", ," , .:,;;~iJ~~.{i~t~:l'.';;.,':'. "'$': J;.' r-'" . '.'.. .,_,;.0." '. ";. .'.' ~ '.ABOR TOTAL " TAX ON LABOR @ TAX ON SUBLET I~ SUBl..ET:REPAIRS TOWING . STORi\GE: 6.000% 6.000% $ 1:$.. 1~:?OO.20 ',,72.01 \. \ i. ,~; -';<::.' " , '", ....;, ~. ~ ~;' ,_"~__~ _t:. i-':~, :,,"'." - ~_ >~:e:~~~.~,-.:...;>~. _ ~ .. $' 5', 473;'2(h $:' :'250'.00:::: , , .",. '"ROSS. TOT AL' LESS': r:'EDUCT I BLE '-. -. . -.:...;~ "lET- TOTAL . -.,~"~;:';''': ,..", $> S~.~~3\~;Q,,~;,::', <:::~~l . ' . .- .' ,;.. ~,~~...;. ~'- ',' Y/02/02/00/00/00 CUM 02/02/00/00/00'Geocode: 17070 HARRISBURG \ PENF'RO W0337 ES LOC~ 1196 - 0 08- (r:7.~~9 1 (l: OS: 44 REL' ~~'.37CD 07/99 COPYRIGHT, AUTOMATIC DATA PROCESSING, INC. 1998 ... " 1.8 HOURS WERE ADDED TO THIS ESTIMATE BASED ON AIW' S TWO-STAGE REFINISH FORMULA I 20;': OF REFINISH HOURS, AFTER OVERLAP, PLUS' SETUP TIME FOR THE: FIRST l'lAJOR PANEL, WHERE NO~ED. ",,-,,;: PXN :"lDP -- --- -- -_. ----*********INFORMATION-ABOLIT-YOUR-E:sT IMA TE**********-:-------'----- 1. THIS IS NOT AN AUTHORIZATION TO REPAIR. 2. FAILING TO PRESENT THIS ESTIi'lATE TO THE REPAIRING FACILITY BEFORE A REPAIR MAY RESULT IN ADDITIONAL EXPENSE TO YOU. :J, ALL SUPPLEt'lENTS F\EOUIRE PFUOR APPROVAL BY A STATE FARM CLAIi'1 i":EPFlESENTAT I VE. 1. COpy OF THE FOG:11 (8) l'IA:3 SfJ,rU'''IVEN 72THE l~:ON::;Ul'lER 01\1, _,_Q~_~~~~_l7 S, Et3T I1.!(.)TOR S I C1NA rUFE_,...... _.__ _.__ _. __ ,.€_j_~_.-.-----...-....-DATE-K,J.-~_CJ ; /C,. ~IOTICE: F,EPMRS TO THIS VEHICLE ,'lAY REOUIRE SPECIFIC WELDI1~G EC!lJIF't'lEI'H AS RECOMMENDED BY THE ~IANUFACTur,ER. . '- ',,'- .' '..' - "' ," - ',~' -. -',: . ' :';''',"'7'"4-' .': " :::, -::':"- . . -, ,-'- I '-RE OR DEfAAUD ANY INSJF.lEA FIL~S AN,'APPlJ9A:hp!.i OR Ct.)..!M.CON}_Aj~ING,,:":~. ~AlSE.,INC9MPtEif'"OA.-Ml~LEJ;DING__I;-:FO~lV...;,~IO~-j,. ,.,' ~-:-- -':--~, --,: --~~-~- --~\>~\...-~~-~-------~------- --------- --~---- . ,f'J..... . .c:P'~ ...' r' . 11"-'" "r"" ....,.., ~". . ..:,...a ........ 0 ~'P. ",'_ ',..,"if"~ ~.- . , ',' .' ,~ 4 . . 1997 VOLKSWAGEN ~.1ETTA CLAIM # 38~J276-33201 - LH A DR SE[:oAN LO(~ 1196 -0 08-(17-'3', 9: :38 AM '. -'" !. ANY PERSONI>JHO KNOWINGLY AND WITt-j INTENT TO IN.JURE OR I)EFRAUD ~NY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE,' , INCOMPLETE OR MISLEADINI;; INFORt'lATION SHALL (IPON CONVICTION BE SUBJECT 1'0 INPRISONMENT FOR Up. TO SEVEN YEARS At,1D PAYMENT. OF A FINE OF UP"TO nS,J)l)l). . . . . . . . ------------------~-------~---------------------------...------------------------ 311-SHEET ~lETAL ME.-M,ECH/E.LEC FR-FRAME' RE~REFINISH SY-SYSTEM .- " . ,~,~ - ~-. . .". 0- J. '." .",.,' '0' '. ~, . .... . '::'.: /'-;-.;:. "~'-. ...... -~:,-.. ':",~ -,._0'_""':'. !-,~:~-:y. .... "..-:.' . ." . , <' , ',.,', -',-", . . t' .~' . do " , , .'i PI'R~t.i'~....n it~;i..r:.I-'" ...",n .,i.,'ITl-l 'It.lTI'N;" T~'l~-"~"~;":'-'~ ;.;~~:i';.-I~"..;jy'-;~.~'I'IR;,,; ~~ ~;,..-"~~;'~p~~~'~:~' ~R m'~,u- (""~;";TAjNI~ AhlY ~AI ~E INCOMPlETE OR MISLEAOING INF<?J;~T!O_~ ,,, .,' , ,.~ ," 'ii. , . --.-,-,--.- -- ---- - - - - --- - - - -- -- - - - -- - - - - - ---- - - - - - - - - - -- - - - -- -- - --- - _.- - -. .., - iIJl'I'I.Hl~:rJ'l' kl-:,;UNC 1.1,11'.'1' lON -) ~=~~~~~=~~==:~~===~=:~~ ~ CO 1.0'; NO %-HH '-1 ~.;UPI'I.E~l~;N'I' S 1 ,,- .: ':I.AJN II J N:-iUHI':O O\'iNI:':H Vl::HICI.J-; 311...J271.>-33201 :-i~;!',N 1,H-1HJC SEAN L1MklC 199'/ V()I,K~;WAI;J-:N ... POLICY # HJ:;P DAn:: Af'I'HA.lSEK Dl{ :-; ~;[)AN , Ot!-0'/-9~ HAY DONI) ,I~:'I''!'A (iT 4 ,__ ADDED LINI::S OF~;H.I\'J' LON Heplace OI;;~1 Subl et, ';1)1:; LJ~,k'J' ',J~j2U CoverJ~)ass Airbag HESE'!' AlR BAG ICVMI S] ::>1 f'l{ln~ '/0.95 ~'1.0(h AD.! LAHOl{ HAT!:: HIC ~lE ~'ark 2~'o CHMJGED LiNES OI'J-:HA'l'lON Replace OEM,. :1)1:: PAH'!' '!HHf (;lock Spring 51 FRlel:: 230.95* 92,70 ADJ LAI:lOH 0.2 0.2 RAT!:: t'-1l-; '.If; ':ALCUI.A'1'lON CHANGI;:; (iHOS:; PAH'l'S I.lN~; J '!'1-:~1 A[)JlJ:;'J't~J-:m' 'I'A.~ em 1'.'\11'1':> !'. ~1A'l'EIUAL SlJJ~LI':'r KI';I',O.1 ~-:s '1'r"\X ON ::;UtH.I':'L' FHUr-1 3,089.55 DH'FEHE:NCJ-: 209,20+ 14.:1.5+ 1:3.41+ ~,I.UO+ 3.42-+ 6 . OOO-?~ 2 3 '/ . 'U '1'0 3,298,'/5 Mark 14.%~ 6.00U% 2S1.2U ~)'l. UU 1.>.000% 3.42 IS,OOU'; :"FP 1 NJ-:T TOTAL ,%91.,%8!- ~),:~Z3.~~O '2. 'j) . ,~l\ UAT~; 08..01..<;9 08-'/..~"~'3 'l'11'-11.; ~ : ~H:3 AM B:55 Atol A.lJPHAJ ~f'::H HI'. Y BONI) HAY BONO ;i n'I~Ij,.'\H '{ .or i 'J 1';;-1 t. ,"lr'p 1 N ";'1' TOTAL ... \ , t- ", ~.':,,: ,;;.".;;":~i/::, ;_'.n':"+"'~''''-'';''"'''."'i7",,i~~'' :, :R,;';;..:'i-{.-",^,~.'i;::~~~;':>.~~i,', ..t"".-i:-;,<>~:;,'~~,-;,~~ " .. ,'.,',- ,..L._"_.''''..,:'.<..< . ',"".,-:. of.,y<, C',-..',,'r" . -- ;,,_.~';"';f'l;:.;.;~~~~~_. - . ~,i./i':f.r.:-j~'~.:; <. ~"'7Y,': ~ ""'.. ..;.' '.'''^Cl''4T''''''';';~'';, ~ f _._M~~l1llllJIla~OlM",;,;'_iill..~~~lIIilIIIIIIiiiIr~-'~ " '~~~.Il-.ln:."- '"~ 'I 0 0 0 c <::> S': --q U> "'rv rYJ ::"j [t'fn " ..Li1 ~:o ,1"''-l''':''. ~~l .'uF;"~ ~~,,~ .;;- :nCJ r'('; ~~fS ~ .- ::E )$ -f--" -:;>-.0 -"" ~1~ ~'O 5>:c ~ <:- ~ G\ ::0 -< II ;ki SEAN C. LIMRIC, rl::dlltiCf HI TilE: COUll'!' Of' COH~'OH PLEM D^UrIIIN COUNTY. PENNSYLVTlNI^ vs. ROBERT J. WOOD and ELAINE S. WOOD, l)efellc1.'llt NO. 00-3185 CIVIL Robert J. Wood and To Elaine S. Wood , Defendant(s) YOll are hereby notified that on (1_, .11 . 2000. the fo110..in9 ~ll!:~ (Judgment) has beenentered against you i.l the above- captioneo cnse. CIVIL ^CTION - LAW Default judgment against Defendants in the amount of $5,778.48 plus interest and costs of suit. '^", 0 . I~. '~2> 1St rl.:k) 'i2 ~ ~ r'rothonotary- I I hereby certify that the nnme and address of the ('roper per,on(s) to receive this notice is: ^ Robert J. Wood Ib24 Jonestown Road, Apt. 2 Harrisburq, PA 17112 and Elaine S. Wood 7624 Jonestown Road Harrisburg, PA 17112 r "er~ntJirlO/;lI Defelldidos/as ror este medlo Se Ie estn Ilotlficando ~ue el de del 19 . el/1a siguienle (Orden). riiecreloT. (Fnl10')""'li(i sido nllotano en contr<< sllyn en el cnso mencionado en el epigrafe. FF.C'l^, I'rotonotario CertiHco '1un )", ~1.'3uiente direccion es la del oefendido/a segun ill<licaoa en el certlficildo de residencia: ^bOg3do ,l~ 1 Demalloallte DCBA-400-Rule 236(a)(2)-3/1/39 , ~ _,"~ _,.._--" ,",~._" ",.0,;0. , " ',- ->---;;,' c_ ",.' ~. ,_ C'" ,-.' ; ,- ,j/( ~ . SEAN C. LIMRIC, Plaintiff v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 00-3185 CIVIL ROBERT J. WOOD and ELAINE S. WOOD, Defendants CIVIL ACTION - LAW AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) ss. COUNTY OF DAUPHIN ) Personally appeared before me, a Notary Public in and for said Commonwealth and County, RICHARD H. WIX, ESQUIRE, of the firm of wi);:, Wenger & Weidner, attorneys for the Plaintiff, who being duly sworn according to law deposes and says that the judgment against the Defendants in the above-captioned matter was entered as a result of an automobile accident occurring on August 5, 1999. ~~~}Jc; Richard H. wix, Esquire Sworn to and subscribed before me this lsthday of ~O\lel<\\:'e..R.. , 2000. ~~ 0. . \' ~~,,,-, Notary Public . My commission Expires: Notarial Seal Marcia A_ Chis'Tl2t ..Notary Public t,ower Paxton r"p, Dauph,n County Mv Comm,ss,on Exnlres Jan, 8, 2001 ...-~~. [j/' ' -'-" ,<_""".".-.,r ,..,','- ~ , ,-.'^ . =,- ,---, ,,""_.,~ ~'.<'~" ' ~^ ,. .. " ~~ ---- o ~ ...... 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