HomeMy WebLinkAbout00-06536
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COMMONWEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
NOTICE OF APPEAL
FROM
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JUDICIAL DISTRICT
DISTRICT JUSTICE JUDGMENT
COM_NPLEASN... :J.OOO- (PDt., c..;,,;/
NOTICE OF APPEAL ~t. ,;2(" 'JOOO
QTY
I MAG ~st NO ~~3~~~
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vs.
PEllANT
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This block will be ~gned ONLY when this notofion is required under Po. R.CP JP. No.
l00llr..
This Notice of Appeal, when received by the District Justice, will operate as a
SUPERSEDEAS to the judgment for possession in this case.
Signatute 01 Prothonotary or Deputy
If appellant was CLAIMANT (see Pa. R.CP.JP. No.
1001 (6) in action before District Justice, he MUST
FILE A COMPLAINT within twenty (20) days after
filing his NOTICE of APPEAL.
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This section of fOllT! to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.J.P. No. 1001 (7 I in action before District Justice.
IF NOT USED, detach lrom copy of notice 01 appeal to be served upon appellee).
PRAECIPE: To Prothonotory
Enter rule upon ~ (.n//"tJrtrt1. ~e/f.1 ,appellee(s),to file 0 comploint in this oppeal
NBme of IkJe(s)
(Common PIeos No. /LOOO- (ffS3& c.. ;\1"( or suffer entry of judgment of non pro~
RULE: To
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{" yl/,'~('trlt €.tc ()e/ h
Name of appel/fie(s) 1
Signatllre of appeIJant or his attorney or agent
, oppellee(s).
(1) You ore nofified that a rule is hereby enlered upon you to file a complaint in this oppeal within twenty (20) days after the dote of
service of this rule upon you by personal service or by certified or registered moiL
(2) If you do not file 0 comploint within this time, a JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOu.
(3) The date ?fservice of this rule if service was by moil is the dote of moiling. ~
Date,~~ ~.)OOO~_. ~~kA 1(1/- ~iSu.._Ya~
AOP<;:.312-a4
COURT FILE TO BE FILED WITH PROTHONOTARY
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FilE COMPLAINT
(This proof of s.!rvice MUST BE FILED WITHIN TEN (10) DA YS AFTER filing the notice of appeal. Check applicable boxes)
COMMONWEALTH OF PENNSVLVANtA
COUNTY OF
; :S$
AFFIDAVIT: I hereby swear or affirm that I served
o a copy of the Notice of Appeal, Common Pleas..No. , upon the District Justice designated therein on
(date 01 servioe) 0 by persoMI service 0 by (certified) (registered) mail, sender's
receipt allached hereto, and upon the appellee. (name) , on
, 19_ 0 by personal service 0 by (certifiedi (registered) mail, sender's receipt attached hereto.
and turther that I served the Rule to File a Complaint accompanying the above Notice ot Appeal upon the appellee(s) to whom
the Rule was addressed on . , 19~ 0 by personal service 0 by (certilied) (registered)
mail, senders receipt attached hereto.
SWORN (AFFIRMED) AND SUBSCRiBED BEFORE ME
THiS
DAY OF
.19___
Signature of affiant
Signature of official before whom 8ftidavit Wi;lS m$dfi
Title of official
My commission expires on ~w
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',~"COMMONWEALTH OF PENNSYLVANIA
,~"qjCOUNTY OF: CUMBERLAND
09-3-04
NOTICE OF.JUDGMENTITRANSCRIPT
CIVIL CASE
PLAINTIFF: NAME and ADDRESS
'AUTO COLLISION EXPERTS I
6365 BASEHORE RD.
MECHANICSBURG, PA 17055
L ~
Mag. Dis!. No.:
OJ Name: Hon.
THOMAS A. PLACEY
. Add""" 104 S. SPORTING HILL RD.
MECHANICSBURG, PA
T'~pho",(717) 761-8230 17050
DEFENDANT: NAME and ADDRESS
tRABER, WILLIAM R
44 ,VILLAGE CT.
MECHANICSBURG, PA 1705?
L
Docket No.: CV-0000158-00
Date Filed: 5/11/00
VS.
I
WILLIAM R. RABER
44 VILLAGE CT.
MECHANICSBORG, PA 17055
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THISI~rqJlOTIFY YO,lJrHAT:
. Judgment: .
[!] Judgment was entered for:
.FOR-P-LA:'tr.tTTFF .
(Name)
IIT1'1'n ~nT.T.nlTnl\T RY1>RRTR
[!] Judgment was entered against: (Name) RII~RR WTT.r.TIIM R
in the amount of $ . J, '124' 61 on:
o Defendants are jO)...,ffi'tIYi8:r1d\siSeraIlY I~e. c;:
,0 () {, c:rf H
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O Damages will be 'assesSed 01J::~ c;-
1:1' 1-'
o This case dismissed without pJfudicef ru
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(Date of Judgment)
R/'Io/oo
. .
(Date & Time)
/
Amount of Judgment $ 1.250.11
Judgment Costs $ 74.50
Interest on Judgment $ .00
Attorney Fees $ .00
Total $ 1.324.61
Post Judgment Credits $
Post Judgment Costs $
------------
------------
Certified Judgment Total $
O Amount of Judgment Subject to
Attachment! Act5.oH 996$
o Levy is stayed for
days or 0 generally stayed.
o Objection to levy has been fiied and hearing will be held:
-
Date: "-,,. "" ... ..,'" .. p'" .,. " "''''''''''''~~_.'''"'''''r'''''i,'!'''''. , ".,
Place:
Time:
,
ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENl":IlY-,\7tLING A NOTICE
~~~~NE;~u~~:d~~~~~r;H~:OTARY/CLERK OF THE ~~~~:~:I~~:~~:~~~~~I~!~:~~t~:;;;:;~AL."
: v~J,. .~
'?S - .?-n-CX) Date" j , District J~ti~e
.ning the judgment.;.
, DiStrict Justice
I certify that this is a true and correct copy of the recor
&...~o-(J() Date
My commission expires first Monday of January,
AOPC 315-99
SEAL
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DISTRI.CT' JU$TI~EJUDGMEI\IT
CoMMONPL~AS~!f'iJOOO- ~S3/P (.;,,;/
NOrl(:~()FAPPEAL~p~:i~(,. ~ 006
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Notice is aiven that the oppellonthos filed in'th~ obci-ie<:ourtofCommonPleoson appeal from thejudgmi>nt rendered by the District Justice on the
dale~dint d menti . .1"", " ',' ' " '.' . ,.. ;'
JUDICIAL DllYRICf
CITY
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STAn;
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ZIP CODE
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This block will be ~aned ONLY'whe~ this notation isrequiredunqer~a: ~.t.PJ.P. No.
10088. .. ".. .
This Notice .of Appeal. when' received by the District Justice. wiIJ..'opeiole as a
, .'. .".' . ',. . .... "
SUPERSEDEAS to the judgment for possession' in this coso.. .
'lfappellantwaS.GLAIMANT (see Pa. R.GP.JP. No.
1001 (6J,iQ.,"lCtipn before OistrictJustice, he MUST
FfLE A COMPLAINT within twenty (20) days after
filing his NOTICE of APPEAL.
Signaturedl Prothonotary or DeptJty
~-~~P~~b~ijtl,.:fULETpFIU'COM~I,AI~I,A.....D 'Rli!L"YOFILE
(This section of foon to be' USed ONLY whim appellant was DEFi'{NDANT (see fa. R-C.P.J.P. No. 1 ()(j 1 (7) in action before Qistrict Justice.
IF NOT USED, de(aCh from copy:?,~;notice 01 appeal to be seNed.'lPon.appellee). '" . ."
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PRAIl:CIPE: To Prothonotary . '.,.
Enler rule upon ArAD (n/It' 6l{h1~e/l,>
J 'Name'of IJee(S)
(Common Pleas No. 6200~; (oS3(P <.; ,,;1
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(3) The date of service .of this rule ilservice was by mail is the dale of moiling. . . . ' f)., I
Date:~~ J(".)Qoo~_. ~flJC/kc.lfII ~~~all<JxAY I
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,appellee(s), '" 'file 0 ~plaint (n this; oppeal
RULE: To
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. NjIir}e of appljJ/fIe(sJ . I
or suifer'entry of.jiJ~~ "foon pro~
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Signature- Of'BppenanfOr~ his attorney or agent
,oppellee(sj.
(1) You ore notifie9 tho.t.,0 rule.is herebyenlered upon you to file 0 complaint in this oppeol within twenty (20) days offer the dale of
service of this ruleupony.;~,bype,-sonal service or by certified or registered moil
(2) If you do not file. a ~plaint within this time, 0 JUDGMENT ()f NON PROS WILL BE ENTERED AGAINST YOU.
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. COURT FILE
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NJPC 312-84
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PROOF OF SERVICE ~FNCTrqt1 ~P~:~.~iRU~~ T1 FILE COMPLAINT
(This proof of ."rvice MUST BE FILED WiTHiN'T~~ (1o)~AY$IAtf~~ hung t~e noiic~ of,lappeal. Check applicable boxes)
COMMONWEALTH OF l'ENNSYllfANIA I,'"" f! 'iil 'I
COUNTY OF .!;w."Vl6v,i:~ '1,'::.1
AFFIDAVIT: I hereby swear or affirm that Iser\! if' '.: ",
.t8:1.Ja copy of Ihe Notice OfAP~eaj,COI11'11~Jj~l~as'~p.~~
(date at service) ~ i,I:, .);
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receipt:alt3ched hereto,' and~ponllJe appt\iI~,(ria'~), .il .. . on
L:''&,l. <r . ,.Mli,!i;i,r:""D Oy ~19~~~rial' '~IO ': " , " efllfl~dl (regist~te~l mall, sender's receipt attached hereto.
o and further that I served th'e-'A\lle toFiI~'a .. rmPlair' acc'b'lJl~a~ri~g t~e4bove N~~ide'IOf Appeal upon the appellee(s) to whom
.the Rule was addr~ssed qn, . ... . '. ." ...., .!'. . . ',;;i .. :11~9~ 0 by pers()ral service 0 by (certltied) (registered)
mail, sender's receipt attached hereto. '; :! ::: . ' ii,!' III' ~" ;1
SWORN (:FFlRMED) AND SUBSeRt.B.. E ,.D....,.,.....BE. F.OR,E...~~...,E~I; ..,i.:".'""., . ...... . ' ., ',i,i,,:,. I,' ,i. ."" (.' ~.. .. '.'i..".,.'.... J!.9.:
THIS tP . DAY OF /Yd' , Mji~';> Uv~I/,A4
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signaturf!.of-pf~!f,ial before wh
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My CommlS~IOr ,EXp:Jr~~D.cil",~,r,17,aDOl
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Postage $ '3~) --
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Certified Fee I LJ 0 ;'--::J
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CJ Restricted Delivery Fee cJ:)'" 0
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:; TotaJPostage&Fees $ ~(\6 V-'SCOL~ "<10,
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by (certilied) (registered) mail, sender's
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AUTO COLLISION EXPERTS,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY
vs.
NO. 2000 - 6536
WILLIAM R. RABER,
Defendant
CNIL ACTION
NOTICE
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 obiections 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 iudgment 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 CAN GET LEGAL HELP.
CUMBERLAND COUNTY BAR ASSOCIATION
2 Liberty Avenue
Carlisle, P A 17013
(717) 800-990-9108
C-~
4ar~nDeibler' e-
General Manager
Auto Collision Experts
6365 Basehore Road
Mechanicsburg, P A 17055
(717) 766-4733
Dated: \o\~~\co
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AUTO COLLISION EXPERTS,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY
vs.
NO. 2000 - 6536
WILLIAM R. RABER,
Defendant
CIVIL ACTION
COMPLAINT
AND NOW, the Plaintiff, Auto Collisions Experts, pro se, in response to the Rule entered
in the above-captioned matter files this Complaint and states the following in support thereof:
1. Plaintiff, Auto Collections Experts ("ACE"), is a Pennsylvania corporation with
its address at 6365 Basehore Road, Mechanicsburg, Pennsylvania 17055.
2. Defendant, William R. Raber ("Raber"), is an adult individual with a last known
address of 44 Village Court, Mechanicsburg, Pennsylvania 17055.
3. On or about December 6,1999, Raber brought his 1992 Ford Mustang, VIN
IF ACP42E5NF117673 (the "Mustang") to ACE with an insurance estimate from CNA Insurance
and requested that ACE perform repairs on the Mustang.
4. The total repair estimates from CNA Insurance totaled Four Thousand Seven
Hundred Six Dollars and Sixty-One Cents ($4,706.61). A true and correct copy ofthe original
estimate and supplements to the original estimates are attached as Exhibit "A".
5. Raber authorized ACE to complete a portion of the Mustang's repairs and agreed
to pay ACE for the completion ofthose repairs.
6. The cost to Raber of the repairs completed by ACE totaled Three Thousand Two
Hundred Thirty Dollars and Eighty Five Cents ($3,230.85). A true and correct copy of the work
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invoice is attached as Exhibit "B".
7. To date, ACE has received payment for the repairs only in the amount of One
Thousand Six Hundred Forty Dollars and Ninety-Four Cents ($1,640.94).
8. The balance due and owing ACE is One Thousand Five Hundred Eighty-Nine
Dollars and Ninety-One Cents ($1,589.91).
9. Raber has failed and refused to pay Ace the balance owed for the repair of the
Mustang.
WHEREFORE, Plaintiff, Auto Collision Experts, requests that a judgment in the amount
of$I,589.91 be entered against Defendant, William R. Raber.
Respectfully Submitted,
aren Deibler
General Manage
Auto Collision Experts
6365 Basehore Road
Mechanicsburg, PA 17055
(717) 766-4733
Dated: \o\~..1>\c>o
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10/18/2000 14:32
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7568750
KH FORD INC
PAGE 02
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11/24/1999 at 02:18 fH
09084
RllB2731
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IW./)DlQ P.lt~ INllVAANcl:
FOR ALL TilE cmtl1MN'rS 100 loll\IQ:
. 401 PENN S'l'.
P.O. BOX 16203
nADING, PA 19612-6203
(800)936-4203 Fax: (610)775-1849
ltl'l'2MAn: or ItlCORD
W.itten bYl JAMBS ACKER '144466 11/24/1999 02:17 p~
IIdjuat&r: JoIlNICA LEIIIS-AP .
IlIsul.'ed, lIILt.Il\M R1lBE1I
Ovner: VILtrJl)l IlABER
Addnl..: 44 VILLAGS CT
Ml:CIl1INICSBURG, PA 17055
~.~nes.; (717)564-1643
Even1ng: 1717)728-0448
~l.m '111182731
Polldy 'US2111S1390
Date &of Loa.: 11/18/1999
Type of LoIS: Coli iBion
PoJ.nt of lII:pact: 1. Right Front
tnspect
Location:
Susinsss: (717)564-1643
WOllK
hpall' l1IIXNoWN
facUlty:
Days to llepa.i..
L108n.. ,
92 FORD IlUSTANG GT 8-5.01.0-110 3D SILVlIR rnt:
VINt U'ACP42E5NF1l7673 Liftl aLX.4245 PA P.-tXl 0.",
Inte~ttent Wipers tinted. Glass
Dual rounors Clear Coat Paint
Power a.akes Ddvtlr Airbaq
Cloth Seats Bucket Seata
5 SpeeQ Transmi..ion Aluminum Wheel.
OdClllltter: ~3296
Body S~c;Ie MOldings
Power Steedng
Po81tractioll
Recline/Lounge Seats
~---._-~----~-------~----._-~___~~M_...___.___._______~.~___~___.__________~~__
NO. OP. DESCRIPTION on EXT. PRICE XJ\BOR PAINT
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2 Rspl Cover 1 29"9.26 2.7 3.0
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10/18/2000 14:32
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7668750
KH FORD INC
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11/24/1999 at 02,18 ~
09084
1l.11827Jl
IllflHt.TI OF IlECOIUl
92 rom Ml18T1\NG Gr 8-5. OL-KO 3D SILVER IRt:
-~-------~-~-----~-~--~---~----._---_.-._---_~w.____~___~__~~~________________~
NO. Of. D!'SClUfi'tION Q'l'r EX'!'. PIIICE tABOR PAINT
----_._._~------~~----------~-_._._-~-----~---_._-~----~--~-----~~~~-----------
3 Add for Clear Coat 1.2
4 l\epl l\T race bar b.t:acket fog lamp 1 56.42-
5 lIepl Sa! conne<:tinq 1 76.00-
6 fRONT LllME'S
7 R4lpl IlT roq lill11p assy "'/0 GT 1 124.80 - 0.3
8 EXHAUST SYSTeM
9 Repl liT MUffler IIlanual t.nna wIllE "" 1 154.84 m 0.9
10 Repl LT Muffler manual trans w/rrr fI/O 1 191.57 1n 0.9
11 fEIIDSR
12 Repl RT Side lII01dinq lOwer front wI 1 128.58 .- 0.5 0.5
13 fRONT SIJSPENSION
14* Subl Aliqn front "'hellIe 1 llill tl.
N 15' Repl L/II 'lite (FIRESTONE) lI70' ~ 1 138.99
If 161 Repl RIll t1re (FIRESTONE) 870~ /vo 1 138.99
174 Repl ~o~nt and balance wheels 1 20.00 T
18 QtJAaTER. PlINBL
19* Rpr RT outu panel .LQ 2.5
20 Add for Clear COat 1.0
21 Retn fUel dooz: 0.3
22 Add for Clear Coat 0.1
23 TIl.M LlO
N 24" Rpt Lid .Q.,1 Q.J!
25 REAlI LlIMl'S
26 Repl RT Teil lllllll aSliY Gr bhcll -ot 1 "11'" 1"'1 0.5
27 REAR llllMPEI\
28 Repl Cover 1 200.00 1.5 2.3
29 1ldd for Clear Coat 0.9
30. HlIC,Opct4t!OIl1l 1
311 Refn r.tnt color for match 0.5
32 OTJI8Il CHJl1\GES
33' E.P,C, 1 3.00
~._._-----~--------~_._-------------------~--------------~----~--~~~---~-------
Subtotals ..) 1815.71 11.8 12.3
2
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10/18/2000 14:32
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7668750
KH FORD INC
PAGE. 04
11/24/1999 at 02'18 EM
09094
R1182711
1,,,,ng,D OF RlOllIlI)
92 FOan MUSTANG ~ S-S.0L-80 3D SIL1IEIl int.:
Litle 15 , BETTERIlENT 1'AK8N FOR 3/32llds or TP.l:AD LEn.
Lin~ 16' : BETTERMENT TAKEN FOR 3132nds or tREAD LBI!'T.
LIne 24 : Tnt!: IS TO .lILIGN AIIIl ADJUST DECK LID.
~--~~~-~._------~------------------~._-~-----~----~-~--.-------.---~---__~A____
Estimate Notes:
1lO LKQ FOUND, CIU.LElJ CIlUCKS,CllRS or 1ID,5 P.I\IlADISE,
"DRIVES/lA1!'T JlND UNDlll\ CARlUlIGlS w,y /lAVE HIDDEN IlIIMI\GE.
ifILL EVALUATE AFtER VERICLl IS IN SHOP TO IlEGIN IlEPJURS.
.'TIRE PRICE FROM NnrIONAL TIRE AND BATTERY.
I?a~ts
Body tabor
Paint Labor
Pal\'lt Supplies
sublet!Kiso.
Other Charges
11.8 hra ! $ 34.00/br
12.3 nrs @ $ 34,OO/hr
12.3 hra @ $ 16.00fbt
1852.77
401. 20
418.20
196 . eo
20.00
3.00
---.___._M_._.____~_~___~_______~.__~.~_____________
SUBTOTAL
Sales Tax
Total LollS
$ 2891. 97
'$ 2891.97 @ 6.0000\ 173.52
$ 3.00 @ 6.0000\ 0.18
TOTAL COST OF REPAIl\.!l
---.-.~---------------.---------------------------~-
$ 3065,67 V
AllJUSTHl:NTS:
DeducHble
L/a Tilf (rIRBSTONE) 870\
a/a Tire (FIlISTONE) D70t
500.00
103.13
103.13
-.-~---~.--.-~----~-----~_~_______~_n______~_.______
TOTAL AIlJUSTMENTS
NET COST or REPAIRS
$ 706.2.
$ 2359.41 N
\eo:.::> ~ NO
l.........,""- ')
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10/18/2000 14:32
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7558750
KH FORD INC
PAGE 05
11/24/1999 at 02:18 PM
09084
1111B2731
En_R 01' llIleoJm
92 rMn HllS'tANG GT 8-6,OL-110 3D SU.VEP. Int;
THIS IS NOT AN AUTHOllI&ATIOll 'l'O REPAIR. THIS MPlWSAL IS BASED ON TIlE Ol\Ml\GES
INSPECTED B1 TlIE APPRAISER.. NO SOPl':r.tMBNT rol\ ADDITIONllL IlP.MllGES, PAl\TS, LlIlloR
OR RATE CHANGES WILL BE CONSIDERED WITHOUT P1\IOIl NOTICE TO THIS APl'MlS.l:II.
Am !'EliSON WIIO 1IN0WINliI.Y AND WITH INTEII'l' TO OtrRAtlD Am IIISURANCB COMPANY OR
O'l'1IEIl PEllSON FILES AN APPLICATION FOR INSURANCE OR STAT&M&IIT OF CWM
CON'.l'AINING ANY Ml>.TERIALL:l rALSI: INroRMATION OR COlICE1\LS FOR T!III: PUReOSE or
MISLEADING, INfoewttIOlI CONCf:ll!lUIG AllY fACT MATEl\tlIL THEM'!'O COlt1ITS A
FIUIlJDl1LliNT INSURANCE N.T, WHICH IS A CRIME lUll) SUBJECTS '1'1IB PERSON TO
CRIMINAL .lUlD CIVIL PENALTIES. THE FOl.LOWING IS A LIST or ABB1U:VIATXONS OR
S'lMBOLS. 'tAA-T MAY BE USED 'l'O DESCRIBE WORK TO BE DONi: OR PAll'l'S TO BE REPAtrotD
or REPLAcED: ~OR5: ABIllllVIATIONS/SlMBOLS. D - DISCONTlllUED fART,' A ~
APt'ROXlMATE PlllCE LI\SOR TUES: B.. OODY LllIlOR D - DIAGNOSTIC E..
tLECrRtCAt r a rlUlME G" GJJISS M ~ MEClIANtCAL P - PAINT WOR S"
STR\JCTOW '1' = T.l\XED I'IISCELLlIIIZOUS X ~ NON TWD MISCELLANEOUS PATlIIIAYS:
ADJ .. ADJACENT ALGN.. ALIGN AIM.. AI1TERMARKET IlLND.. llLtIlD CAPA ~ CERl'Un:O
AUTO PARTS ASSOCIA'l'IOli D&R.. DISCONNECT l\NJ) RECONNECT EST ~ ESTlHATli: EXT .
PRICE .. tlllIT l'1lICE MULTIPX.UP Ilr TIlE QI.ll\NTITY INCI. ~ INCLllDED MIse..
MISCEld.!\NEO\JS NON-lIDJ.. NON ~N't O/It.. OV!;1\HAI,I1, ot'. - OPE1\l\TION NO. a
LINE IlIlM8ER .. O'1'Y ~ QtlAA'rITr QUAL REey a QUllLITr RECYCLED l'MT QU1lL REPL a
OUIl.LI'fY .UPLACElll!N'l' PMT UCOND.. RECONDITION REm.. REFINISH RUI." P.EPLl!CE
Ilu .. REH:lVE AND INSTALL R6R" UMOVIiI AND RllPLACE RPR - REPAIR RT.. RIGHT
SECT ~ SECTION SUBL.. SUBLET 1.'1'.. LEFT W/o.. WITHOUT W/_" WITH/_
SYMBOLS: ... MllNUl\L LIII! ENTRY '" OTIlER [IE. .MOTORS Ol\TJWASE INFORMATION lWl
CilllNGlilll, .. ~ DA'l'ABlISE LINE' wtte mSl\Ml\RlOlr H.. NOTES ATTACHED TO LINE.
\' ' '
Estimate "baSed on lIOtOll cAASli lSTXlf.tING GUIre, Non-astedsWI itoms ON derived !rOll\ tile Guide
DR2JC85. tlatabase Date lOfU99. Double utorhkl"I items indicate pam Slll'Plied b1 a supplier
other than '.the original" eqIlipuent manofal:turer. '..Pound sign m items indicate llliIl\ual entdes.
WA itellS have lloln ::ertifieO tOr fit and finish by the c.rtiiild Auto Potts IIssodation. "I.GS
Part Numbers, Prices and Labor Times are providGd from National Auto Glass Specifications, Inc.
'. ',";.,
Path..ys - A ptoduct 'of CCC Info_tion Services Ine.
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10/18/2000 14:32
-,
7668750
KH FORD INC
PAGE 06
\
02/29/2000 at 01:59 PM
09084
1.,4. ~...
R1l82731
CNA INSURAN~ CtlCPANII!S
READING PER.SqNAL INstllWlCt
FOR ALL THE COMMITMENTS YOU Ml\I<E
401 PENN ST,
P.O, BOX 16203
READING. PA 19612-6203
(800) 936-4203 Fax: (610) 775-1849
SUPPLEMEN'l' OF RECORD 1 stMofAAY
Written by: JAMES ACKER #144466 02/29/2000 01:59 PM
Adjuater: MONICA LEWIS-AP #
Insured: . WILLIAM RABER
OWne~: WILLIAM RABER
Address: 44.VILLAGE CT
MECHANICSBURG, PA 17055
~inass: (717)564-1643
8vening: (717)728-0448
Claim 'R1l82731
Policy 'US211151390
Date of LOs.: 11/18/1999
Type of Loss: Collision
Point of IlIIpact: 1. . Right Front
. .
Inspect
LOCation:
Business: (717)564-1643
WORK
f\epair UNt<NOWN
Facility:
Days to Repair
License .
1992 FORD MUSTANG GT a-5.0L-HO 3D SILVER Int:
VIN: IFACP42E5NF1l7673 Lic: BLX-4245 PA Prod Date:
InteImittent Wipers Tinted Glass
Dual Mirrora Clear Coat Paint
power Brakes Driver Airbag
Cloth Seats Bucket Seats
5 Speed Transmission Aluminum Wheels
OdoIIlete~: 53296
Body Side Moldings
Power Steering
Positraotion
ReCline/Lounge Seats
NO.
OP.
DESCRIPTION
QTY EXT. PRICE LlISOR PAINT
2
------- CHANGED ITEMS -------
Repl Cover 1 -299.26
-3.0
-2.7
1
_~~iHIilio!i'r"
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10/18/2000
'j
KH FORD INC
14:32
7668750
\.
02/29/2000 at 01:59 PM
09084
SUPPLEMl:N'l.' OF RECORD 1 SUI+fARY
1992 FORD MU5TANG GT 8-5.0L-HO 3D SILVER Int:
PAGE 07
R1182731
--------------~-----------------------------~--------------~-------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------~----------------~
3 SOl Repl Cover 1 299.26 Inc1. 3.0
4 Rep1 RT Face bar bracket fog lamp 1 -56.42
5 SOl Repl RT Face bar bracket fog lamp 1 56.42 Inc1.
5 Repl Bar connecting 1 -76.00
6 501 Rep! Bar connecting 1 76.00 Inc1.
....------ ADDED ITEMS -------
2 SOl O/H front bumper 5.5
7 SOl Repl Face bar 1 128.33 Incl,
8 501 Repl RT Cover retainer 1 33.78 Incl.
11 501 AIR CONDITIONER & HEATER
12**501 Repl AIM Condenser all 1 171. 00 m 1.4
13 501 Evacuate & recharge m 1.4
14. 501 Refrigerant recovery m 0.4
15* SOl Rep! FREON ! 54.96
40# SOl Refn 2 Tone set-up and refinish 3.0
- ..
4.1 SOl Repl Face bar 1 247.53 0.5
42 501 Rep! RT Extension 1 164.44
N 43# 501 Rep! Dd ve shaft 1 327.12 0.5 M
SUbtotals ->
7.0
-------------------------------------------------------------------------------
3.0
1127.16
Line 43 : SHOP ATTEMPTED TO BALANCE DRIVESHAFT BUT FOUND IT WAS BENT,
-~------------------------------------------------------------~----------------
Estimate Notes:
NO LKQ FOUND,CALLED CHUCKS,CARS OF MD,& PARADISE.
uDRIVESIlAFT AND UNDER CARRIAGE MAY IIAVE HIDDEIII DAMAGE,
WILL EVALUATE AFTER VEHICLE IS IN SHOP TO BEGIN REPAIRS.
**TlRE PRICE FROM ~TIONAL TIRE AND BATTERY.
2
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O"M:
10/18/2000 14:32
~I
7668750
KH FORD INC
PAGE 08
.',
0212~/2000 at 01:5~ PM
09084
R1182731
SUPPLEMENT or RECORD 1 stMaRr
1992 FORD MUSTANG GT 8-5.0L-HO 3D SILVER Int:
Parts
Body Labor
Body Labor
Paint Labor
Mechanical Labor
Paint Supplies
(Estl
(SOl)
-2.7 hra @ $ 34.00/hr
9.2 hrs @ $ 36.00/hr
3.0 hrs @ $ 36.00/hr
0.5 hrs @ $ 51.00/hr
3,0 hrs @ $ 16.00/hr
1127.16
-91. 80
331.20
10a.OO
25.50
48.00
----------------------------------------------------
SUBTOTAL
Sales Tall
$ 1548.06
$ 1548,06 @ 6.0000% 92.88
---------------------------~----~-------------------
TOTAL SUPPLEMENT l\M:lUNT
$ 1640.94
6
NET COST OF SUPPLEMENT
Estimate
Supplement S1
3065.67 JAMES ACKER
1640.94 JAMES ACKER
Workfile Total $ 4706.61
TOTAL ADJUSTMENTS $ 106.26
. NET COST OF REPAIRS $ 4000,35
THIS IS NOT AN AUTHORIZATION TO REPAIR. THIS APPRAISAL IS BASED ON THE DAMAGES
INSPECTED BY THE APPRAISER, NO SUPPLEMENT FOR ADDITIONAL DAMAGES, PARTS, LABOR
OR RATE CHANGES WILL BE CONSIDERED WITHam PRIOR NOTICE TO THIS APPRAISER.
3
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16/18/2666 14:32
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7668750
KH FORD INC
PAGE 6'3
02/29/2000 at 01:59 PM
09084
R1l8273l
llUl'PLDIINT OF RlCOR!) 1 lllH!1\RY
1992 FORD MUSTANG GT 8-5.0L-HO 3D SILVER Int:
ANY PERSON WllO tINOWINGLY AND WITH INTENT TO DEFRAUD Alff INSURANCE COMPANY OR
OTHER PERSON FILES 1\N APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM
CONTAINING ANY MATERI.l\LLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF
MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A
fRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON. TO
CRIMINAL AND CIVIL PENALTIES.THE FOLLOWING IS A LIST OF ABBREVIATIONS OR
SYMBOLS TIlAT MAY BE USE]) TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED
OF REPLACED: D 5 DISCONTINUED PART, A - APPROXIMATE PRICE B5BODY LABOR
lFDIAGNOSTIC E~ELECTRICAL F5FRAME G=-GLl'ISS M=MECHANlCAL P-PAINT LABOll.
S-STRUCTURAL T=TAXED MISCELLANEOUS X-NON TAXED MISCELLANEOUS ADJ-ADJACENT
ALGNo.ALIGN A/M=AFTERMlUlKET BLND5BLEND CAPA-CERtIFIED AUTO PARTS ASSOCIATION
DiR-DISCONNECT AND RECONNECT EST=ESTlMATE EXT. PRICE-uNIT PRICE lro"LTIPLIED BY
THE QUANTITY INCL-INCLUDED MISC-mSeELLANEOUS NON-ADJ-NON ADJACENT
O/H-OVEIUlAUL OP...OPERATION NO.=LINE NUMBER QTYooQUANTITY QUAL RECY5QUALITY
RECYCLED .PART QUAL REPL-QUAtITY REPLACEMENT FlIRT RECONIPRECONOITION
REFN=RE.FINISH REPL-REPLACE RU-REMOVE AND INSTALL R&R=REMOVE AND REPLACE
RPR=REPAIR RT5RIGHT SECT-SECTION StJBL=SUBLET LT-LEF'l' W/o-WITIIOUT WI _ ='/lITH/ _ /I
= MANtI1\L LINE ENTRY * = OTHER [IE. .MOTORS DATABA:?E INFORMATION WAS CII1\NGED].
** = DATAIlASE LINE WITH AFTERMl\R!<ET N .. NOTES ATTACIlED TO LINE. TIlE ATTACHED
ESTIMATE REPRESENTS AN APPRAISAL OF THE COST OF REPAIR FOR THE VISIBLE DAMA.GE
TO TIlE VEHICLE NOTED AT TIfE TIME OF INSPECTION NECESSARY TO RETURN THE VEHICLE
TO ITS PREDAMAGED CONDITION. COSTS ABOVE THE APPRAISED AMOUNT MAY BE THE
RESPONSIBILITY OF TllE VEHICLE OWNER, THERE IS NO REQUIREmNT THAT THE VEHICLE
OWNER USE ANY SPECIFIED REPAIR SHOP. INFORMaTION REGARDING REPAIR FACILITIES
WHICH WILL BE ABLE TO REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT MAY BE
AVAILABLE FROM THE INSURANCE COMPANY. IF USED PARTS ARE SPECIFIED, THEY ARE
REQUIRED TO BE OF LIKE KIND AND QUALITY TO THOSE BEING REPLACED. INCIDENTAL
CHARGES sueH AS TOWING, PROTECTIVE CARE, CUSTODY, STORAGE, DEPRECIATION,
BATTERY AND TIRE REPLACEMENT ARE NOTED WHEN APPLICABLE.
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VERIFICATION
I, Karen Deibler, General Manager of Auto Collision Experts, a corporation, Plaintiff in
the within action, verify that the statements made in the foregoing document are true and correct
to the best of my knowledge, information and belief. I understand that false statements herein are
made subject to the penalties of 18 Pa.C.S. 94904, relating to unsworn falsification to authorities.
-/
~arenDeibler
~
~
Dated: \o\~~\oo
5-
,
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CERTIFICATE OF SERVICE
AND NOW, on this J.~ay of October, 2000, I hereby certify that I have served a
true and correct copy of the within document, via certified mail - return receipt requested as
follows:
William R. Raber
44 Village Court
Mechanicsburg, Pennsylvania 17055
Dated: \",\~1>\oo
- 5 -
~Do;bl~ sf-~
General Manager
Auto Collision Experts
6365 Basehore Road
Mechanicsburg, P A 17055
(717) 766-4733
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