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Home My WebLink About00-08749 d .",-, - ,-.,. """z . AMERlCAN MANUFACTURERS MUTUAL INS. CO.,a1sfo of JEFFREY E. McCULLOUGH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, : NO.: 00-8749 CIVIL TERM v. CASEY SWIGERT : JURY TRlAL DEMANDED Defendant PRAECIPE TO ENTER JUDGMENT BY DEFAULT To the Prothonotary: Please enter judgment by Default in favor of Plaintiffs in the amount of $8,676.20 in the above-captioned case. It is hereby certified that the Notice pursuant to Pa. R.C.P. 237.l(a), a copy of which has been attached to this Praecipe, was served upon the Defendant on February 20, 2001. Thank you. Respectfully Sub . Jo C. Swartz, Jr., sq e Hillside Corporate Cente 5001 Louise Drive, Second Floor MecharUcsburg,PA 17055-6912 (717) 691-2063 Attorney for Plaintiff JUDGMENT AND NOW, this fY/~ I~ 2061 , Judgment in the amount of $8676.20 is hereby entered in favor of the Plaintiffs, Ainerican Manufacture Mutual Insurance Co. and against the Defendant, Casey Swigert in accordance with the above Praecipe. BY (1...t;;) 'i2-~ ,--~. - I' < ,- ",,~'; -, C' .,. .";;--, _ _ ~ . ~ -, ,,~-; " " /' 4 AMERICAN MANUFACTURERS MUTUAL INS. CO.,a1s/o of , JEFFREY E. McCULLOUGH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, : NO.: 00-8749 CIVIL TERM v. CASEY SWIGERT : JURY TRIAL DEMANDED Defendant TO: CASEY SWIGERT 54 Fish Hatchery Road Newville, PA 17241 Date of Notice: February 20, 2001 IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITIEN 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: Court Administrator 4th Floor, Cumberland County Courthouse Carlisle, PA 17013 717-240-6200 -; LAW OFFICES OF WESLEY R. PAYNE john C. Swartz, Jr., Esq ire Hillside Corporate Center 5001 Louise Drive, Second Floor Mechanicsburg, PA 17055-6912 (717) 691-2063 Attorney for Plaintiff .' _I.l ~_l ~O" '-', .--.' c. -",' ~"'_ _~ ,'p, .. CERTIFICATE OF SERVICE I, John C. Swartz, Jr., Esquire, hereby certify that I have this ~ay of March 2001, caused to be served via first class United States Mail, postage prepaid, a true and correct copy of the foregoing pleading upon the following: CASEY SWIGERT 54 Fish Hatchery Road Newville, PA 17241 i~l.JMi\~L~'l~,'~~f,.~:p,,:fi"~J\lJi>jli1m14Ii:"'~_~~l-,i'T!Jj~~(,~Jil~l!li0':":'iili?&,,"-\"'4iot~~;l'i&~~~~~. "B'.__.'U " 'j~' " t ~ fi i.Q. 0 0 -() c , :s: ::J!: 8 -0 ClJ -;t.l'l' ~ men :;0 8' Z.o-, - ...... ~ Zt;.:: ,,0 C> ~z /J r::o ~ au '< -n ~ -,y (' ~Q _;;0. r- --u ':-: OJ' fg f >c ~ r:- ... 0 J ~ r-- - A , 0 ~ ~ ...0 ", ~ "'~,' ~~-'. " '~-""~-"" I","-'>-~~- ," ',~" <.- "'~. ,? , -'!" .,. ,~ ",I-' _ C' y '^ - . 11 .' ., ~ '. ~ : o -n ~:J ,'........, ':. ':";;:: ~~~ 'g:; -~~ ~~>, ~i~~ s" -". ?I ---. / oil ~- .j' ,." ,~ "" d. ,~.'_" SHERIFF'S RETURN - REGULAR CASE' NO: 2000-08749 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND AMERICAN MANUFACTURERS MUTUAL VS SWIGERT CASEY WILLIAM DIEHL , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon SWIGERT CASEY the DEFENDANT , at 0018:48 HOURS, on the 29th day of December, 2000 at 54 FISH HATCHERY ROAD NEWVILLE, PA 17241 by handing to ELLEN SWIGERT (MOTHER) a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 18.00 9.30 .00 10.00 .00 37.30 SO;~~~~~~e R. Thomas Kline Sworn and Subscribed to before me this J{ff' day of ~~"'r .:JA-b I A.D. C)'f' O. ~1/0,., nqQLT' rothonotary I 01/02/2001 KEMPER INSURANCE ~rj By: - ;;1 " ' H' 1, '~_J',' ~,; >-,~~,&:..~;~_ , AMERICAN MANUFACTURERS MUTUAL INS. CO.,a/s/o of JEFFREY E. McCULLOUGH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA Plaintiffs, : NO.: OC - t??'-I9 C c..'1 L '-r~"'I v. CASEY SWIGERT : JURY TRIAL DEMANDED Defendant 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 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 TillS 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. Court Administrator 4th Floor, Cumberland County Courthouse Carlisle, P A 17013 717-240-6200 :1: . " . , ,'. , , ,'. ",-;~- , AMERICAN MANUFACTURERS MUTUAL INS. CO.,als/o of JEFFREY E. McCULLOUGH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYL VANIA Plaintiffs, :NO.: 0-0- 'i?'19 C<.vJ/.u..- v. CASEY SWIGERT : JURY TRIAL DEMANDED Defendant COMPLAINT AND NOW COMES the Plaintiffs, American Manufacturing Mutual Insurance Co., and Jeffrey E. McCullough, by and through their attorneys, John C. Swartz, Jr., Esquire and the Law Offices of Wesley R. Payne, and files this Complaint by averring as follows: I. Plaintiff Jeffrey McCullough is an adult individual residing at 75 Carlisle Road, Newville, Cumberland County, Pennsylvania 17241. 2. Plaintiff American Manufacturing Mutual Insurance Co. (hereinafter "AMMIC") is an insurance company with a place of business at 547 Keystone Drive, Suite 100, Warrendale, Pennsylvania 15086. At all times relevant hereto, AMMlC had issued policies of insurance covering the losses incurred by Plaintiff McCullough as a result of the incident which is the subject of this lawsuit. AMMIC has made payments in the amount of $8,676.20; and, therefore, is contractually, legally, and equitably subrogated to any recovery. 3. Defendant, Casey Swigert, is an adult individual residing at 54 Fish Hatcher Road, Newville, Pennsylvania. 4. On March 14, 2000, Plaintiff Jeffrey McCullough, was the operator of a 1996 Dodge Ram 2500, bearing Pennsylvania registration plates, ZE S2740, hereinafter referred to as "Dodge Ram". 1 -, , . -. -,_~ ' ,''',_. 'oJ._ ..',;~; 5. On March 14, 2000, at approximately 1500 hours, Defendant Swigert was operating a 1987 Acura Integra, Pa license number XR4TI, hereinafter referred to as "Acura". 6. On March 14, 2000, Plaintiff McCullough at or about 1500 hours was lawfully operating the Dodge Ram westbound on SR 641. 7. At or about the same date and time, Chad Matthew Gayman was operating a vehicle eastbound on SR 641 described as a 1994 Saturn SG directly in front of the Defendant's Acura. 8 At or about the same date and time, Mr. Gayman reduced the speed of his vehicle and signaled with a left turn signal his intention to turn into Iritts Store located on SR 641. 9. Thereafter, Defendant caused his Acura to strike the rear of Mr. Gayman's vehicle and pushing the Gayman vehicle into the eastbound lane of 641 and the lane of travel of Plaintiff McCullough. 10. As a direct and proximate result of Defendant's actions, the Gayman vehicle struck the Dodge Ram causing damages to the Dodge Ram in the amount of $8005.26. A true and correct copy of the damage report is marked as Exhibit "A" and attached hereto and incorporated herein. 11. In addition, as a direct and proximate result of Defendant's actions, Plaintiffs were required to expend $670.94 for rental vehicle expenses. A true and correct copy of the rental vehicle expense invoice is marked as Exhibit "B" and attached hereto and incorporated herein. 2 ;'~ l ~' .-- ~ ~ -. ,~ ~ "I,. ililS:* PLAINTIFFS V. DEFENDANT CASEY SWIGERT- COUNT I NEGLIGENCE 12. Plaintiffs incorporate herein by reference thereto paragraphs 1 through 11 as if more fully set forth herein. 13. The aforementioned collision was a direct and proximate result of the negligence of Defendant Swigert, which consisted of the following: a. failing to stop his vehicle within the assured cleared distance ahead before striking the Gayman vehicle; b. operating his vehicle in such a manner as to allow his attention to be diverted from the road ahead of him, thereby causing the subject collisions; c. failing to have regard for the actual and potential hazards then and there existing at the time; d. failing to have his vehicle under proper and adequate control under the circumstances existing at the time; e. failing to have his vehicle under proper control in order that it could be readily stopped, turned aside, or the speed thereof slackened upon the appearance of danger; f.. failing to observe vehicles lawfully traveling on the roadway, such as the Gayman vehicle and the Dodge Ram in sufficient time to avoid striking or colliding or causing a collision with them; g. failing to maintain a proper lookout for other vehicles lawfully using the roadway and allowing his attention from the roadway ahead to be distracted and thereby failing to observe vehicles, such as the Gayman vehicle and the Dodge Ram being operated on the roadway; 3 ,<~ - J - ,--~ ' "--,; __i ,- ".--~i\ h. failing to apply his brakes in sufficient time to avoid the collision thereby preventing the collision of the Gayman vehicle and Plaintiffs vehicle; i. failing to use due care and caution under the circumstances; j. operating his Acura in violation of the P A Motor Vehicle Code. 14. As a direct and proximate result of the Defendant's negligence, Plaintiffs incurred damages in the amount of $8676.20 total, $8,005.26 for vehicle damage and $ 670.94 for rental vehicle. WHEREFORE, Plaintiffs demand judgment in their favor and against Defendant Casey Swigert in the amount of $8,676.20, together with costs and other such relief that this Court deems just and appropriate. Respectfully submitted, LAW OFFICES OF WESLEY R. PAYNE j Jo C. Swartz, Jr., Esquire LD. No.: 62012 5001 Louise Drive, Second Floor Mechanicsburg,PA 17055-6912 (717) 691-2063 Attorney for Plaintiffs 4 " ~A&,..SIf\~vltt: ~.. ,Auto . HeavyEqwpmf:int . Home . , , ',' ',',' POST OFFICE BOX 7462 ' .., STEELTON, PA 17113-0462 'HONE 717-939-9891' ' , . p" , FAX 717~939-1992 . .~ - "" ;'L ~ " '..il ~. 'Date:,' 4/28/0002:57 PM Estimate io: Ac-0222~52 .. Estimate Version: 1 Supplement: 1 (F) 4/28/0002:57:03 PM Profile 10: CUSTOMIZED Damage Assessed By: Gerald Walton Supplemented By: Gerald Walton Appraised For: KEMPER,PTIDUNLEVY Condition Code: Date of Loss: Deductible: File Number: Claim Number: Fair 3/14/00 UNKNOWN AC-0222-S2 253AE137622 Type of Loss: Collision Insured: JEFFREY & KIMBERLY McCULLOUGH Address: 75 CARLISLE RD NEWVILLE, PA 17241 Telephone: Home Phone(717) 776-0196 Mitchell Service: 914527 SUPPLEMENTAL Description: Body Style: VIN: Mileage: OEM/ALT: Color: Options: 1996 Dodge Pickup R2500 20 Pkup 8' Bed 135' WB Drive Train: 5.9L Turbo Inj 6 Cyl osl4Wo 1 B7KF26C1TS558372 Wcense: ZE.52740 PA 55,884 o Search Code: B17113 GREEN & GRAY 4 WHEEL DRIVE, ALLOY WHEELS, AIR CONDITIONING, POWER STEERING:1>OWER BRAKES POWER WINDOWS, POWER DOOR LOCKS, TILT STEERiNG, CRUISE CONTROL' AM-FM STEREO CASSETTE, SUolNG REAR WINDOW, AUTOMATIC TRANSMISSION, STEP BUMPER V8 DIESEL ENGINE, MANUAL REMOTE MIRROR, 2-DOOR PICKUP Line Entry Labor Line Item Dollar Labor Item Number Type Operation Description Fart Type Amount Units -,- AUTO BOY OVERHAUL FRT BUMPER ASSY 1.4 2 436266 BOY REMOVElREPLACE FRT BUMPER FACE BAR New 310.00 * INC 3 401060 BOY REMOVElREPLACE ' FRT UPR BUMPER FILLER COVER New 64.00 INC 4 401070 BOY REMOVElREPLACE FRT LWR BUMPER FILLER COVER New 83.00 INC 5 401090 BOY REMOVElREPLACE FRT BUMPER AIR DAM New 49.75 INC 6 400491 BOY REMOVE/REPLACE R FRT BUMPER SHIELD New 24.76 INC /I 7 400492 BOY REMOVElREPLACE L FRT BUMPER SHIELD New 25.00 INC /I 8 401160 BOY REMOVElREPLACE L FRT OTR BUMPER MOUNTING BRACKET New 21.25 INC 9 401180 BOY REMOVElREPLACE L FRT INR BUMPER MOUNTING BRACKET New 27.50 INC 10 401032 BOY REMOVElREPLACE GRILLE New 255.00 0.3 /I 11 401650 BOY REMOVElREPLACE L HILAMP ASSEMBLY New 183.00 0.3 /I 12 AUTO BOY CHECK/ADJUST HEAOLAMPS 0.4 51 13 404550 MCH REMOVElREPLACE TURBOCHARGER INTERCOOLER -M New 795.00 2.0* 51 14 900500 MCH* REMOVElREPLACE FITnNG New 23.75 * 0.0* 51 15 900500 MCH* REMOVElREPLACE DAMPER New 64.50* 1.0* 5116 900500 MCH* REMOVElREPLACE FLUIDS New 23.50 * 0.0* 51 17 900500 MCH* REMOVElREPLACE STRAP & BOLTS New 11.41 * 0.6* Sl 18 900500 MCH* REMOVElREPLACE SPACER New 5.35* 0.0* 51 19 900500 MCH* REMOVElREPLACE SEAL,DRIVE New 15.00. 1.0* 20 401136 MCH REMOVElREPLACE TRANS OIL COOLER -M New 250.00 '* 1.3 21 600500 FRM* REPAIR FRAME Existing 5.0* 22 900500 BDY* ADD'L LABOR OP BALANCE LEFT WHEEL 5ublet 7.00. 0.0* 23 405940 MCH REMOVElREPLACE EVACUATE & RECHARGE AlC .M 1.4 24 405950 MCH REMOVElREPLACE AlC REFRIGERANT RECOVERY -M 0.3 This estimate has been re.calculated with a modified profile. ESTIMATE RECALL NUMBER: 3124/00 13:02:34 AC-0222-62 UltraMate is a Trademark of Mitchell International Mitchell Data Version: APR_OO_A Copyright (C) 1994 - 1999 Mitchell International Pege 1 of 5 All Rights Reserved '" ~.... ' " "" SA~iSTARSINIGAPPP '.ISALSERVICE ill(<<iLiii~~~lr:"~3~19~' 25 406030 MCH REMOveJlNSTALL 26 407140 REF REFINISH 27 407310 BOY REPAlR 28 413330 MCH REMOVE/REPLACE 29 413360 MCH AUGN 30 414130 MCH REMOVEIREPLACE 31 414140 MCH REMOVE/REPLACE 32 414180 MCH REMOVE/REPLACE 33 414190 MCH REMOVE/REPLACE 34 414960 MCH REMOVE/REPLACE 35 400653 MCH REMOVE/REPLACE 36 415850 MCH REMOVE/REPLACE S137 900500 MCH* REMOVE/REPLACE S138 900500 MCH* REMOVEIREPLACE S139 900500 MCH* REMOVE/REPLACE S140 900500 MCH* REMOVE/REPLACE S141 900500 MCH* REMOVE/REPLACE S142 900500 MCH* REMOVE/REPLACE S143 900500 MCH. REMOVE/REPLACE S144 900500 MCH. REMOVE/REPLACE 45 936001 ADD'L COST 46 AUTO REF ADD'L OPR 47 933004 BOY ADD'L OPR 48 AUTO ADD'L COST 49 AUTO ADD'L COST .. .>;<':;:' ',; - '-, -.., ,;'<. "."'.;~:'.:'~'>_' ...h. "_', _,.,- . ..' -', . -.~~, '::-, "",. ." .'. ,", '-, '\:.~: :~:,;~:_ p....~e':. -~;,-:'4I2S/OO 02:57 PM_ :".- '::, , '.,: Estimate 10: .. Ac:.D222~52' >. ,. , ' Estimate Varsion: 1 Supplement: 1 (F) 4128/00 02:57:03 PM Profile 10: CUSTOMIZED Existing "'\';.' AlR COND CONDENSER L FENDER OUTSIDE L FENDER PANEL BLEED ASS SYSTEM -M FRONT SUSPENSION -M R UPR FRT SUSP CONTROL ARM ASSY -M L UPR FRT SUSP CONTROL ARM ASSY -M R LWR FRT SUSP CONTROL ARM ASSY -M L LWR FRT SUSP CONTROL ARM ASSY -M L FRT SUSP STEERING KNUCKLE -M FRT SUSP AXLE HOUSING .M LSTEERING TIE ROO -M GASKET,OIL TUBE,OIL TUBE,OIL FlrnNG,OIL CONNECTOR TRANS FL_UID F1lTER,,~;r~',= SEll-LER ' TOWING ,:CiEARCOAT UNDERC9'.iTING . PAlNT/MATERIALS' '. HAZARDOUS WASTE DISPOSAL .M Existing New New New New New New New New New New New New *"Qual Repl Part New New 63.00 63.00 66.00 66.00 400.00 2,925.00 67.00 4.50. 22.25 * 28.50 * 23.75 * 6.00* 6.20* 7.50. 4.95* 88.75. .~,':' '--f- 7.00. 42.50 . 2.50* "t:'::, ~_I eO ,-,'",.,,' . ~. : ,. ;,-;,'- ..-.'.... 0.8* C 1.7 1.5*# 0.7 2.0* INC # INC # INC # INC # 1.6 # 3.9 # 0.3 # 2.0. 1.0* 1.0* 0.0* 0.0- 0.0* 0.0* 0.0* 0.8 * . Judgement Item.;: # . Labor Note Applies C - Included in Clear.Coat Calc." S'" . , .. (JpPI:/ElilTh " ~ f.!lilVTA.L Remarks GREAT POSSIBIUTY OF HIDDEN DAMAGE .,..-. LKQ AVAIL,BUT,PRICE IS HIGHER lliAN NEW Prior Damage LEFT DOOR-LEFT CAB CORNER AND RIGHT BED PANEL This estimate has been r&-calculated with a modified profile. ESTIMATE RECALL NUMBER: 3124/0013:02:34 Ac..o222.52 UltraMate Is a Trademark of Mitchell International Mitchell Data Version: APR_OO_A Copyright (C) 1994.1999 Mitchel/International All Rights Reserved Page 2 of 5 ~~~ "Ii -'->C I, c~- ,,^ .sA~'9JA~SIN.lqAP~t \ISALSERVICE ~: . Aufoo.HetJvyEqL/,pme.nt. Home '<;"(..: . iF': ,"'...'.' "'ypostPFFICEBOX 7462' " " '_:'-~,__"'''.~';':\:~:':,,', _.' SrEELTON~ pA 17_113..0462 . : ,':, '.'. ,; , ?HONE '"717-93~~9891 :.:.. " FAX717~939-1992 , . Date:. 4i28ioo 02:57 PM " Estimata 10: AC-<i222-52".... Estimate Version: 1 Supplement: 1 (F) 4/2B/DO 02:57:03 PM Profila 10: CUSTOMIZED Labor Types: **KEY** BDY- Body BDS- Body Structure REF- Ref~n~sh GLS- Glass FRM- Frame MCH- Mechan~cal Addit~onal Operat~ons/Items: ADD'L- Addit~onal O~R- Operat~on QTR- Quarter FNDR- Fender FRT- Front RR- Rear L- Left R- Right U~R- Upper LWR- Lower OTR- Outer INR- Inner ASSY- Assembly SUSP- Suspens~on EXT- Extens~on BRKT- Bracket INST- Instrument RECON- Recondition ATG- Assembly Time gu~de QUAL- Qual~ ty REPL- Raplacement QTR- Quarter O~- Or~g~nal Equ~pment Manufacturer AM- Aftermarket O/H- Overhaul A/C- Air Condit~oner INCL-Included R&I- Remove and Install R&R- Remove and Replace RPR- Repa~r --'..<'. 't. SUPPLEMENTAL I. Labor Subtotals Body Refinish Frame Mechanical Units 3.9 2.5 5.0 20.9 Add') Labor Rate : Amount 35.00 . 7.00."' 35.00 . 0.00 . 35.00" 0.00 50.00 0.00 Sublet Amount, 7.00 0.00, 0.00, 0.00 Totals 150.50 ' T 87.50 ,T 175.00 T 1,045.00 T II. Part Replacemant Summary Taxable "arts., . Sales1\,,:, @ Total Replacement Parts Amount 6.000% Amount 5,965.41 357.92 6,323.33 Taxable Labor 1,458.00 Lobar Tax @ ,. 6.000% 67.48 Labor Summary 32.3 1,545.48 III. Additional Costs Amount IV. Adjustments Taxable Costs 45.00 Customer Responsibility Sales Tax @ 6.000% 2.70 Non-Taxable Costs 88.75 Total Additiona' Costs 136.45 Amount 0.00 I. II. III. Total Labor: Total Replacement Parts: Total Additional Costs: GraBS Total: 1,545.48 6,323.33 136.45 8,005.26 IV. Total Adjustments: Net Total: Less Original Not Total: . Net Supplement Amount: 0.00 8,005.26 6,249.21 1,756.05 Sl: Gerald Walton 1,756.05 This estimata has baen ra-calculated with a modifiad profile. ESTIMATE RECALL NUMBER: 3/24/00 13:02:34 A~222-52 UltraMate is a Trademark of MitcheU International Mitchell Data Version: APR_OO_A Copyright (C) 1994 -1999 Mllchalllnternational All Rights Reserved Paga 3 of 5 _, ~ ~ _ ~ . " l ,I,j ~A& STAR~INIGAP~P\ISAL SERVICE ~~l~"I,!_;'J.\~ " ~~_~~.. ~ _',./1ea~y E9ulpr~._nt '~'., ~~me., .~:, .,> ' <. .. ,,( ,," , !\',:"i" '0 PClSTOFFICE BOX 7462,',' , " ," .,"0 STEElTON PA 17113-0462 :0', ,,', ,",' '-'. "..' - ,,' "..,... -" -','--"', '-'- ' . "-" -' .. " ..', PHONE 7177939-9891..;": ' . , FAX 717-939-1992' """.,:-. _ '-'" - - d ,~-,L ' ..'::Oat,;i',O,4,28ioO 02:57 PM Est;mai. io, "Ac-il222-52 '. estimate Version: 1 Supplement: 1 (F) 4/28/00 02:57:03 PM Profile iD: CUSTOMiZED PENNSYLVANIA DISCLOSURE: AUTHORIZATION TO REPAIR: This is not an authorization to repair Vehicle owner is responsible for authorizing shop to begin repairs. If vehicle owner is a third party or claimant, the insurance company should be contacted to confirm liability coverage before authorizing repairs. CUSTOMER CHOICE OF SHOPS: Selection of the repair shop is the responsibility of the vehicle owne:o. Vehicle owner is under no obligation to use any specific repair shop. Starsinic Appr. will provide, upon request, information regarding repair facilities that will be able to repair the vehicle for the appraised amount. .,"".. . APPRAISER: _ ~~ PA LIC.#h7..z7'Z COpy TO: INS. CO.";-<,~ OWNE~ REPA.IRER~fj!~I5ATE DATE~ 1../ l'd/loo , , . SUPPLEMENTAL This estimate has been re-calculated with a modified profile. ESTIMATE RECALL NUMBER: 3/24/0013:02:34 Ac.ll222-52 UltraMata is a Trademark of Mitchell International MHchell Dala-Versian: APR_DD_A Capyri!lht (C) 1994 -1999 Mitchell internatianai All Rights Reserved Paga 5 of 5 ;_.~ - I, -~- VERIFICATION !, Jeffrey McCullough, verify that the statements made in the foregoing pleadings are true and correct to the best of my personal knowledge, infonnation or belief. ! understand that these statements are made subject to the penalties of 18 Pa.C.S. g4904, relating to unsworn falsification to authorities. <?~ ~7PCC~ 'Je ey ~llough ..- 1 , ,~--:~ !: , .,-- ~I: . - ~ - - ~~ .,.C_' VERIFICATION I, Linda Rodgers, Representative for American Manufactures Mutual Ins. Co., verifY that the statements made in the foregoing pleadings are true and correct to the best of my personal knowledge, information or belief. I understand that these statements are made subject to the penalties of 18 Pa.C.S. S4904, relating to unsworn falsification to authorities. inda Rodgers, resentative for American Manufactures Mutual Ins. Co. , .'u,' --"-;'~jITrf" Iilm~PfI;j~..'-1 -__. _ _ ':,".,:. .',. "",.. '<' _ .', ~~I' 'b;,'~'" -'":".;~~ " ' ':- ,~, ,,", -~'''' ~i!m.ffi(j&'i'!Il'i>r.d0fdl'i'.R3,Jj,,@~~_ '. ~ ,~ "~~tM..: ~ Fi l' -tQ. (") <::) ~ c 0 .~ ". C"J ~ vEt r', ITlr;- ,C') a Z:::c p ~ ~ zc;; N 0:: ~e~ ~'''t) VJ (} ~7~i - ~-'h ~ ~ )>l:~~ N 1 CJ 6' ~ Z ". p:: -~ 0 1- -< r'-' 10 6 $ " "" " ~ ~ _~'" ","~. .,_ c ' '~'O~""''''''_.' ""."", !"!. ',"", ,', "~""., ,_ - ~_ .,. ~"'''' .,.-"'" ""., "r. ,,~ , ",0/" ',,- ~ rC ., J_~"" - =.-':,.' - -,',~ . "" o -'T-j ~ !' "'1_":'::: ~'.-. ;""1 -:-'.0;:) ~Jl,,-:) :c~2 ~c~ (:S;"fl ::;;j ::0 -< _~~. .~" . ,~.>, 0/ ~~~' i i.: i.! i:l ~- ! tj II \i :1 11 .. " l: H ii Ii !i Ii I: Ii , Ii Ii " :.1 0) .'.'~H