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HomeMy WebLinkAbout99-04612L S LL N *d 1 S LZ i O` A LYDIA R. FEHR, as parent IN THE COURT OF COMMON PLEAS and natural guardian of CUMBERLAND COUNTY, PENNSYLVANIA CAROL L. FEHR, a minor, Plaintiffs AMICABLE ACTION V. NO. 99 ESTATE OF BRUCE FEHR, Defendant ORDER AND NOW, this day of L 1999, upon consideration of the within Petition, a hearing is scheduled on the day of C 1999, at 'f GO Q.m. at the Cumberland County Courthouse in Courtroom Number ?. BY THE COURT: ?? u ?? LYDIA R. FEHR, as parent and natural guardian of CAROL L. FEHR, a minor, Plaintiffs V. ESTATE OF BRUCE FEHR, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION NO. 9 9, yL is ac;;<,( 1 t. ORDER AND NOW, this-23-rpay of , . s 1 , 1999, upon presentation and due consideration of the foregoing Petition for Approval of Minor Plaintiff's Compromise Settlement and Distribution of Proceeds, it is hereby Ordered and Decreed in accordance with the provision of Pa.R.C.P. 2206 that the Petition is GRANTED. Payment of fees and expenses as listed in the Petition is approved and payment of Twenty Nine Thousand Four Hundred Twenty-Five and 00/100 Dollars ($29,425.00) to Minor Plaintiff Carol L. Fehr is directed to be made and deposited in a Bank, a depository which is insured by the Federal Government, and no withdrawal will be made from such account until the Minor Plaintiff attains majority, except as authorized by Order of Court. BY THE COURT: yr - ? i.?1i?11Y 59 AUC 231 F I i I: 2? P-EK., LYDIA R. FEHR, as parent and natural guardian of CAROL L. FEHR, a minor, Plaintiffs V. ESTATE OF BRUCE FEHR, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA AMICABLE ACTION NO. 99. y(.12 &.. T, PETITION FOR APPROVAL OF MINOR PLAINTIFF'S COMPROMISE SETTLEMENT AND DISTRIBUTION OF PROCEEDS The Petition of Carol L. Fehr, by her parent and natural guardian, Lydia R. Fehr, respectfully represents: Carol L. Fehr, the minor Plaintiff, is the daughter of Lydia R. Fehr, Petitioner, herein. Carol L. Fehr is 15 years old having been born on March 24, 1984. 2. On April 2, 1999, Carol L. Fehr, sustained a right femur fracture, right anterior tibia and fibula fracture and a right mid-shaft ulnar fracture with radial subluxation after a motor vehicle accident. 3. Minor Plaintiff was a restrained passenger in a vehicle being driven by her father, Bruce Fehr. 4. A copy of the Police Accident Report is attached hereto as Exhibit A. 5. Minor Plaintiff was flown to the Lehigh Valley Hospital where she underwent surgery for her injuries. 153105/MLB 6. Defendant Fehr was covered by an insurance policy with Nationwide Insurance. 7. The Defendant driver and his insurer have agreed to pay and to compromise all claims arising from the injuries to Carol L. Fehr for the sum of One Hundred Thousand Dollars ($100,000.00), subject to the approval of your Honorable Court. 8. Said sum represents the policy limit on the above-referenced liability policy. A copy of the declaration page is attached hereto as Exhibit B. 9. In view of the tender of the full coverage of the Defendant driver, Petitioner considers this to be a fair, just, and equitable settlement and to be in the best interests of the Carol L. Fehr. 10. Petitioner wishes to accept the settlement with a structured payment plan consisting of $40,000 payable at the time of settlement and guaranteed payments of $18,315.00 a year for four years beginning on March 24, 2002 and ending on March 24, 2005. 11. Should the Court deem it necessary to schedule a hearing to approve the settlement, and if a hearing is scheduled, Minor Plaintiff, her mother, and Petitioner's counsel will be present at the hearing. 12. Your Petitioner has retained the law firm of Angino & Rovner, P.C. to prosecute this action and has entered into a contingency fee agreement with said attorney whereby said attorney is to receive, for professional services, 301%4 of any amount recovered after filing suit, plus reimbursement of expenses. However, Plaintiffs' counsel has agreed to reduce his fee to 10% or Ten Thousand Dollars ($10,000.00). , 13. To date, Plaintiffs' counsel has incurred expenses totaling Five Hundred Eighty- Eight and 12/100 Dollars ($588.12) in pursuit of Plaintiffs' claim. 14. Petitioner understands the remainder of the settlement up front money, $29,425.00, is to be held in trust for Carol L. Fehr in an account which is insured by the Federal Government and that no withdrawal be made therefrom until Carol attains majority or authorized by Court Order. WHEREFORE, Petitioner respectfully requests your Honorable Court to approve the Minor's compromise settlement and authorize the payment of attorney's fees from the fund due the minor and direct payment due to the minor to be deposited in a bank in trust for Carol L. Fehr. ANGINO & ROVNER, P.C. L o. 47281 45 3 North nt Street H g, PA 17110 (717) 238-6791 Counsel for Petitioner Date: July 2%, 1999 EXHIBIT A r. MAY-24-99 MON 11:30 AM JOW" D BOGAR FAX NO. 717 7'-7 2086 RPR 21 1999 10:42 FR AIJIDE WYONISSING610 373 6391 TO .37834 " ^ -r- COMMONWEALTH OF PENNSYLVANIA !-1 POLICEACC/OENTREPORT n)M REFERTOOVTJILAYSHEETS REPORTABLE IM NON•REPORTABLEM P. 02 P.02i10 12.E PENNOOTIACONLY mom= 1. ]0. COUNTY DOGE wUw&t 488 Barka Co. 06 _NAME Y Penna State Police z,. MUNICIPAL 'c'k Tilden Tv 238 a.sTA row ? A L nauwaT Hamburg 4340 zONE 09 PRINCIPAL ROADWAY INFORMATION 5. INVIEFWATOR BADGE II.ROWNO.OR _ NtnABETt 9 ffl?e STAEETNAME SRO 78 265 6. RO Y 8ADOE Za. O 1A. TWE 23 ACCESS ' W /TF - NUMBER 6 UMIT 65 mph HIGHWAY 2 rfCONTAOL 2 7, 6 KL !, ARRIVAL INTERSECTING ROAD. DATE TIME 2106 04/02/99 . ROIRE N0.0 STREET NAME 9.ACC fO. DAY OF WEEK 27. SPEED 28. TYPE . 4LCE65 DATE 04/02/99 Fri LIMM MIGHWAY COMROL +I. I XDP ,zN t" IF NOT AT INTERSECTION. DAY 2100 Of UNR6 2 .. . M tKI LED 4.8 INJURED 13. PRrV. P . 00 Y ? N A CCOENT ^EO 16.0104EHICLE HAVE TO 00 17. VEHICLE DAMAGE l1, DIRECTION `n a2.013TANCE FT E N S 5 6q FROMSRE• 15 REMOVED FM7MTHES 0 0 UNrri r , MI. 0 R I UN?2 'UN 1•u 77.O?? WAS 1:1 99 2-MODERATE MEASURED ESTIMATED ? Y [] N ® ® UNR1 a OT NTR L PRINCIPAL t EG[ING ONETRUCTION W I - -'I 16. D0 19. pEHN00T ? I J MATERIALS YO NO PROPERTY Y ? N Mae= . L EGALL N 37. G. ' H. STATE SS. LEGALLY Y N l7. REG. A PARKM PLATE HFD 7 57 Pa PARKE07p PuTE -,_, 38. PA TL X% ? a0. S A flTe*w 46541789 •, ouror TEVw 1>.pyn7,vn AD.OWNIER 40. OWNER Bruce b Lydia R. FEHR - - - - ronunT11`"p^ 4775 y w m NEER ADORERS 7366 Wertzville Rd_ 47. OWNER AcIamss203 Hal Muldrov Dr. 32. CITY, STA E AZ CITY, STATE A ZIPCOOE 1 Pa. 17013 azIPCDDE Norman Ok 73069 1I4), N- MAID; Q. YEAR 44. MW L?993 _oc. 1997 Frei htliner QLMOOEL•(NUi b. INS. BODYTYpe F00001 ine Y7?8 Nr •. UN"- 4'. MODEL - (NOT I0.IN9p LODYTYPEI N/A YiR NO UNK? V17 BODY ?TVPE 42 PECAL USAGE 0 49. VEHICLE OWNF%I+O' 1 87. BODY TYPE 4 d8. PECAL USAGE 6 AO. VEHICLE OWNERSHR' 10 (0 INOLLL IMPACT 51. VEHICLE . TRAVEL So. INRIAL IMPACT 51. VEHICLE s2 TRAVEL _ I`DINT 11 STAIUG D T SPEPJI 99 OO1 STATUS 2 `..PEED OD Irs7. A;LE St. ORNR " ORMER 55 +). ICLE SA.ORIVER ,N DRIVER I`JORAOIENT 3 SEWC POE Ell CONCfr4N 9 GRADIENT PRESENCE CONORION 156. QRNER 57,3TATE 55.ORNER 57. STATE WMBER 17839437 Pa NUMBER 31947 NC i?U.OQ N. R NAME Bruce W. FEHR = p CRO?iER _ _ f l u . aRNER AocAESS 7366 Wertzville Rd. N. DRIVER AOoREBB 503 sandpiper Dr. _ I CO CITY. STATE 60, CRY. STATE AZIp000E Carlisle Pa. 17013 a 21P000E ,8rli _ 16i, SE% 62. DATE OF 81. PHONE 07, SEX 62. DACE O8 P dlIO-N77-8161 16/44 =0= GIRTH 07/0 7 57 717-697-3626 / M BIRO1 ,A,COMN.VEN. S. R 06. COMM. VEH.ai. DRIVER v ? N CLAsS N ? CLAU 6) CARRIER 1 67.CARRIER Ytra Tnr. ,/o Xtra Lea e8. CA IER 98. CARRIEA ADORE59 ADORE93 .01 Park 270 Dr 400 I1 STATE 59. CrfY• STATE Louis MO 63146 St &ZI CODE . L21P000E 170. USDOT D ICC A PUC P 70. USDOT 7 ICC A 108207 P.UC 6 , n. 1. n Go 7,GVWR n. 7a GARCO 7+.[p;VyM OOO CONFlG. DYTYPE -0NFIG.6 OOYTYPE 2 V . 75. NO.OF )5. HAZ MUCUS T7. RELEASE OF W T 7s. NO.OF 78 71A2 AROOU9 CO 775E O HAZMAT KO ? J E I AXLES MATERALS Y O N O UNXEI AXLES 5 MATERALS UN Y N R D LL1S f11A51 PAGE: 1 2834774 ;NE IGAIINU AUhH ' MAY-24-99 MON 11;31 AM Pml;" ^ 80GAR FAX NO, 717 7'' 2086 P. 03 APR 21 1999 10:43 FR AWIDE WYOM15SING610 373 6391 TO 17834 P.03i10 n, 4"PONONG EAIS AGENCY INCIDENT #:' TO. MEDICAL PACam ACCIDENT DATE; RVFORAWTIC 0 C 0 E F G NAME ADDRESS H I 1 K L M J_ n..r A 1-?.- 1 4 F 3 3 1 0 Carol FEHR Same an Opril L? q nor 12,,... tl. ILLUMINATION ®Q WEATHER 00. DIAGRAM ? i 0 O ROAD SURFACE ED ? 1 I •M'. PENN15MANUI GCHOOL OIITRICT ' I I I IF APPLicAna) ss.0 :€GP`aD?aW ?I3EE ATTACED DTAGRA* R ' OWN614 i f AT, P PI U TO F OFIS. SEQUENCE OF EVENT8, WDNEW STATEAIERTB. AND PROVOTC ADDITIONAL OETAMLLKE WAURANCa INFORMATION AN D LOCATION OF TOWED VEHICLEe, IFKNOWN. d unit 1 a roached the ear of Unit121 and in an attempt to to p# applied brakes while overvin in a north vest direction. Unitile right front tine left front o Unitil ruck the right rear of Unit023 towed unit. U on impact with unite? .j left front collapsed inward a ro: 10ft and mg to rest pgrtially eath the u 2 towed unit facia in a west e t vast di eti n. U pan impact with Unit 11 V 2 did not move and .suAtained V t roar tire axle damage to its tows unit. Unitf2 came to rest MORE INSUKANLL4 N ==CT" COMPANY ?lan Etenefit Cor O N IN F IJA,TIQN Wntionuide?naLTr.ALnce_c UNIT PO ICY i ? POLICY 75 N Self Insured • N None w. noun WRN[3803 NAM AOOnESS PHONE • 'U U (. G 41. VIOLA11ONZiNDICATED uNrtt Unsafe nosed None Q 0 U74172 None Of, t: n. TYPC m. RESIA,TS OTTST 91R O 02. TYPE 93. RESULTS ONOTESf BL.INUfbT1GATI0N USE TAT REFUGE COMPLETE U:U: iC3T ? REFUST 1FS?ND .. O ?.??ryr? LINK lMK UNR2 viirti D °?o 0 ? _- O D INVECrIC.ATTNC AGENCY AA•A! 1111901 YA": 7RIA77A MAY-24-99 MON 11:31 AM JPPF ^ BOGAR PAX NO, 717 7?' 2086 RPR 21 1999 10:43 FR AWIDE WYOMISSING610 373 6391 TO ' .7834 COMMONWEALTH OF PENNSYLVANIA ?=-AT PAA CONTINUAVONSHEET InOI REFER TO OVERLAYSHEETS FPFORfABLE RINON•REPORTABLE rl P. 04 P.Od 10 PENNiOTUMO"LY (DENT f 4- AWOF.NT n COUNTY MUNICIPAL 621488 04 7 /09 .... QF; CODE 914A OEPSON INFORMATION. USECIVERV.Y• ZSHEET FOR CODES a c 0 E F t NAW ADDRESS N I d K L M B7.NARRA?71yyfE :.:. •?.:: :•.+>`•++tn . it5 stopped Position facing I:&criirecl at theiscene at 21.OR r o 04102/99 Fii and both IMP-; ?pr? i? thou iTial:rest positions. ObE: v d was the folloviOg-, opr;g? ;an-q: m"-. :-: in iouisi:dei of: his vehicle. The ail li tite:adtivaEedi The male juvenile o a'a"ti• ?mc ioal personnel. O r 1 6 femme Juvenile werA sn}ran,Re$ vehicle. Rescue ereon ha r. o ' in the: _ of dniElla liiesi the a eared to be in good co pPp_• t' . E We to 'datiTagc, Unit}ls Augedomete7?was not observe' nor: c r i 7erte$ as gvi6eTice: 1n observation of the rg?dway vas mad- and no Apt*rjm?llt-Al .substaic;6 were observed. At the scene were membP ey Ambdlaoce 1672. Upon extrication T, iuvenile f1oKn 4ia? Mod Vad to Lehi-qh-Vqlley llotq?ital Cedar Crest, aerks Co.: coroner Richard 0. SE:' s 2145hrb 0:4/02199 Fri and oronounced Onril deceased at 2750 Numerous Pelaugements were taken in reference CO this AccldLlnt? 1-4 Ag; linear:coior'8inat6 method and are tabulated below: 8efierence.aoint is O'Ew drainage culvert and mdrked,'. Ri'•hit tear tandem tire of Unit J2 55' west. 818p JRi'ht rear foriwatd tandem Lice of Uniti2 5815" went b •'6" BbCI6 of RR 'Leif t:rearitandem fire of Unit12 54' west by 17!3" :aotithiotiRP Lefc?rear?forw'rcT tandem tire of Unit42 5817" west b I7'3" 4outh of RP RfghE Bear Lire of Unit11 40' vest b 2110" :ootith:Of :RP i ( MORE ) • BG. DEscnu* LAT m. SECTION NUMBEfl (ONLY I HA ) Tc NTC UNIT1 0 0 I UNITS 0 0 91. ROaASLr (OZ )TYPE 91. "RESULTS p YI. flOaAaLE F2. ESULTS gI.IWMGAneN F TEST ew. USE TEST USE 0 View. L] REFUSE COMPLETE? RNIT O._ 9'° lMN UNIT : %Cj LINK YES NO. new" AA45C(TM) PAGE ? .... ___ ..__ MAY-24-99 MON 11:32 AM JANF'' ') BOGAR FAH NO. 717 7?' ?086 APR 21 1999 10:44 FR ..-,,WIDE WYOMISSING610 377 6391 TO 37834 -?^ COMMONWEALTH OF PENNSYLVANIA I 1 ® PAR CONTINUAT70N SHEET 7t?oL REfFAmovEPUVSNEETS gmuAa* ffk%m cp=ABLE I, P. 05 P.05/10 PENNIDOTU36ONLY OENr 70oem? Nu Y 4 QA 1 02 /2 raUNTY NWNICIP L 2 Coo F 06 coop 2 18 ea ?¢'pNYA?fON•L6EOVERAYS2 EET WLI ODOES e C O F O NAME AOOn 69 N I J K L M v Ri W& ht :front; ti re: of Unit#1 51' 1' vest b 4`5" :s uth :of :RP Def t near tiire d Unit 1 3813" vest by 9 130 :sou -Gefi front -*ti' e of Unit#1 49194 Wes h 11`5" 34612&b of RP 9t :xr 2Uriit}1 iimpendino_skid mark 191 3" east by 7186 :sour :south scegmen,t of Unit#1 9' east by 71•7" Fintith ;of:R Skid Inari segment of Unit#1 RP to 7'8" south Skill mark -e Mont of Unit#1 7' west by 712" south: P: grid mark segment of Unit#i 17' - west by _ 6'4" sou of RF! Skia atari se ment of Unit#1 26' 6" Weat b 519":so•t Skid Gari s?e menL of Unit#1 _ 37' vest b 4194 u End:of U6it4l:sk'id m-nrk 47' vest h 414" sour-ti 'fotal ioeAsuted lengi-h of Unit#1 skid 68' Additional ineasucemants taken: center: m6di31:of:178 vest bound 9'2" Lift lane of 278: West bound 12' 5-5 iit lane of :176 West bound 12' North Berm bf!178 vest bound 10' 04/99 Fri: ar 918 ro, thig kreene r i nt•arrzipu pd opr42 + Oor#2: seated :thar. he was travelling west b ound on 175 and :noti"d Ghat traffic:vas Lxcicing up due to a crash that he over heard on theradio. C r 2:con timed: to relate that ha atone A r all. .Mr-VIOL I NS G1 SECnCN NUMBERS (CNLY IFC ) T N C UNrt t o 0 UNr2 FABLE jn7yPE 91 LT.. QN7TffiT M- UNRr USE TEST .0.--% cl nar UNR2 UBE e2 Pe TEST 0 0 97. '9075 ?.TEST 61.INVESTIGATION PEFl ? CCMPI E ? lym ® C. MAY-24-99 MON 1132 AM Pmvp ') BOGAR FAH NO. 717 7P 2086 P. 06 PPR 21 1999 10:44 FR ?nJIOE LJYOM ISS ING610 373 6391 TO 37834 P.06/10 COMMONWEALTH OF PENNSYLVANIA N + ® PAR CONTINUATION SHEET 1700 REFER TQOVFALAYSKFETioeaenwe.flunu.nen...,...,. n I GENT ACCIDENT DATE Q4 /07 /Q E ()A COME 2 R SON INFORMATION. ISEOVEPIAY R2 SKEET FOR ODDEs 0 C 0 E F G NAME ADDRESS M I J K •L M 97.NARPATNE: li rite; wnd waited for affiq. ' tie felt hie- truck move sli h what Too e 1 k ' lass on the hi•hva truck!toiinvesti ate and saw tb4 assintanea?on:ttie C.B. radio because a crash had oc curred, Alehn;me s• eisLnt in accordance vi F Mon= interstate ;closure message sent 04/02/99 Pri a t! reo• eT lne niessa •e sent 04/03/99 S' t at 0033hra. Berke :Coi Coroner Richard G. LUSEY had determined mulEi •leitrauli7a and internal in'uri s. ca +N of de rdL_wrin photo ra ha of the scene Vero taken b Photoa to be fotmardcd to P.S.P_ Hamburg for file, ;and riegati.vem shall be retained-,at qQp tj}ie adingl?? I of Mlference Invest- ator'a Su lementar Truck-Tracto r tie ort attached to Otation cb Trailer rc -ietration information: TN Registration Z 54026, own4dr- :Raf.pr :t- n t#kock#.' 67, Oird 69. Fruehauf. . 4'*Sjsted:at tt a Ucone followio ; C 1: Scott BRENN1lN, P.S.P. Hamburg IIniQn Fire Ca: o€ Hambur StTartlesville:Fire Co. N;otifiicaEion of death made b this trooper and Cpl. Scott BREN\Ati to: deesdoiT • brother hard Rji RWTHP. ar ?i3 MORE, • W. OESCPISE VIOLATIONS G0. C PUBEAS (ONLY IF CNAN0913 TIC NTC 7 00 UNIT2 01. RMAELE 09 Rl. ESUL fh, POIUELE n2 E UsC T6ST OuTA USE TEST PL NIT I O.._ A% C3 SUNK UNIT- 0 0 tb. ESULT9 7 NOTUSE LN, INVE5T161?i? [ ID I O.__?e c3 REFUSE •YE9 OE&M El I '? ?'?••'? PAGE: 5 INVESTIGATING AGENCY ll MAY-24-99 MON 11:33 AM JAmt:" ^ BOGAR FAX NO. 717 7?7 ?086 APR 21 1999 10:45 FR .AJIDE UYOMISSM610 373 6391 TO 57834 ' COMMONWEALTH OF PENNSYLVn, °rA PAR CONTINUATION SHEET I R7 AEFER MOVEIiUYSIEETS ..FVWTABLE n6NeN.HFa0ar.aL6 rl P. 07 P.07/10 PFtRmrt awv I DE NB 7cc10 N OCUNTY ZOE MUNIG AL l2 ERSO WFONNATIDN.LL5EOVEHUYF28HEETMRCODEe e C 5 E F C NAME ADDRESS H I J K L 4 87.N RA E: :Onf til was not recovered for structural failure . a in Unit L was itowe(3 to Kramere v:r •. thati w ock r. SP7-0615 iissu d to opr42 at the scene and mailed to the deceden ' r. B0. pESCHIB VI LA N 90. SEOPON NUMDEM (ONLY NAMED) TC NTC UNIT, -- 0 a UNIT2 It. UHAULE BL PE USE TEST .KfTt rol ESULTS C3NOTEST d REFUSE _^ °?L Q UNK Qt. RO'"B BLE B2. PE W. ESULT& NO TEST USE TEST REFUSE UNIT2 UNK Q 0 G/,INVE571WnON .. COMPLETE T YES Eg ND E3 ww• jwMj y . .. PADE:_ INVESOGATIND AGENG? MAY-24-99 MON 11:33 AM JPMF` ') BOGAR FAX NO, 717 7a7 2086 APR 21 1999 10:45 FR AWIDE WYOMISSIMG610 373 6391 TO ,9834 `..-k COMMONWEALTH OFPENNSYLVANIA n RBe1:RTenvepuvawcTe \ POLICE ACCIDENT SUPPLEMENTAL P. 08 P.00/10 uC :4T ?'""PbLICEINF ORMAT ION_'` ' `^ v`i 1YVFMGYVNII1tllE "' '`" `'°'4'' ,tinwVI VCYOYL? . . .. , , ; ACCIDE TTIM B:LOC ATION' , _ wMGER .DATE 4 Imilf (3 gq 10. OAY?VftkK 2. AGENCY NAME PA State NAVE Police - 11. TIME OF 12.NUMG R DAY 2100 3, row A. PATROL PREeSxir adilYa/4310 BONE DFVNRS 2 13. E KILLED 1 1, E IwuKEO S. PRiVCi 2 I 1 - s. WV ICATOR BADG m COUNtt 'ss?•^._ NUMDER 6762 . CODE S.APP GY VAUGE 21, MUNICIPAL C O NUMBFR Tilden Twp. UNIT /: COMPLETE ONLY THE INFORMATION THAT HAS CHANGEO SINCE ORIGINAL REPORT X LEGALLY Y N 37.R G. STATE YOfIhER . PARKED ? PLATE NAME 39.PA1 FOR 60.DA R CUT-OFSTATEWN ADDRESS Q.OWNER BO. CfTY, STATE 6 ZIPCODE AI.OWaE- - ADOPIC55 ".5EX 02. DATE OF 53. PHONE GIRTH A2 CII E . A 21POODECODE M.UWM VEH S.0RIVER BS. DRIVER A3. YEAR M. MIKE - Y ? N CLA55 5. S. I 61. CARRIER AS. MCDEL(NOT AS. WSURANCE 60.CARRIER BODY TYPE Y N 71 VNK ADDRESS A7. BOGY AB, PECAL Av. EHICLE CO. CITY, V ATE TYPE USAGE OWNERSHIP A 21P000E 50. ROLL IMPACT 61 EHX:LE 52 7RAVEL 70. USDOTa ICCB PUC POW STATUS SPEED ?. NICLE GMOIENT RIVER PRESENCE NV R CONOITICN EHICLE• ARG CCNFG, OYTVPE 74, GVWp LI.OpNER S7,STATE 7s, NO.OF B. AROCUS . RELEASE OF NAZ MAT BT. NARRATIVE • IDENTIFY PRECIPITATING EVENTS, CAUSATION FACTORS, SEQUENCE OF EVENTS, WRNESS STAYCMEMIb, ANO PROYIDE AOCRIONAL DETAILS Refer to Police Accident 2222M manual- 1ewental Section D-3 a. Requestc4: 04/02/99, 2120 11mrs b. investigator: Tpr. Derek Beck - le. Arrived: 04/02/99, 2225 Hours ?d. This officer photo ra ed the scene of this traffic accident. The photographs depict the f I final rgyt msiticn of bath vahicloa. i i. ' i - u+waANCE caA NFCRANTIdV R,. INVCSf%iATYJN COMPLETE? UNIT POLICY NO NO YES & No Q. "' "•'"-' PAGE: 7 INVCDTI0ArN0 AGENCY ' L 1 0 0 i a D% v A Li c d rt? 4 7 'O V N a m a a a E H Z 'W "E fy -UO CO H aw C Y f+ "ao A U3 Ln O p Q. V • •wa vzmaew Doh a I FO W o, Om •N + H 4 O O 4•• $\O +UZNvm H O Z ON -1 v!H W ! 41 K a W W Z$O M 4 w 01i60'd 60 'd I G Q G o ? r-- N O 0 Q O n n n n L.i n H I Q I n d I q C7 Q Q v284S? Ol 1629 £6 £ 019'JNISSIWO.U1 3a 9802 L£L LIL 'ON Xd8 Mc N rn w w b d V d w v 0 u V fi N 9 •A ? 6 a .C t0 0 rl 0 w 0 w 'M+ Md Sb:01 6661 IZ Ndu 8 v S?wOf WV b£:II NOW 66-bZ-AUW MAY-24-99 MON 11:34 AM JAMFP 'I BOGAR FAX NO. 717 737 2086 P. 10 APR 21 1999 1045 FR UIDE WYOMISSING610 373 6391 TO .7834 P.10i10 a z W S ! to Z. to in 1i 1•., ' Y ° 0 1 z w Uy ?IE?;, w w „ ; dta i3yNi: b U), y F' Q ZQ ' ?? ;q:a! W 'Ql. .. Y z t77rlf??7;'?J M ..1.. '` H 3 j a Q LL C `W 0.W N> '• Q P C ^ J N :i r N K = N L7 EL o W J N ` v2 ?? x 0 LL ?m rc '[Y 1U Vizc.`_ 'r N I-- O A F pry. U ;,:m 1t;' V -?Y:rr:: ?, Q Q m: S:: •.. O r•'' O. W W 1fl•W tj 'r 01, I.-W 'S. i ~ O 0 • .••, P; CIO :3 0 MAY-24-99 MON 11:3b AM JPMF? 1) BOGAR FAX NO. 717 737 2066 APR 21 1999 1221 FN AJ(Uk MII'IISS(NLib IN JeJ b3y1 IU 5rUJN N' R COMMONWEALTH OF PENNSYLVAn A POLICE ACCIDENT REPORT /r?vl oceee •n nuxel AV 6uPRTx REPORTABLE Sa NON-REPORTABLIM P. 11 r, eara PENNOOTOAB ONLY .. .. • q3.R , '.... _. .. I.NW NUMBER a 20. ERAS ' 0 LAk` NP(? S-CA'Y? ?t,L 21. MUIC Al UOPc4 6tZN 'L'wP _ CODE 241 _ J. w CPA oL PRINCIPAL ROADWAYINFORMATION PRECINCT M Q a !{ ZONE O T A OR DADGE 4"r ??r• f' K NUMBER S4S I ~ .ROUTE NO. OR STREET NAME S Q O Q 7 2 1 _ OVE E c O 23 . D (.4.)TYPE ( ACC60 M /I e A/ W w A7/t NUM o5woN• HIC14WAY LIMR CONTROL A. A 7 T µ INTERSECTING ROAD: 20O5 $ o% 9q TIME DATEOA _'-'. .. u .. •.4T •..? 1'?P_ R uT HO.OR STREET NAME ' S.A IOENT' Id. DAY OF WEEK D 26. E 27.9 A?. ACCt DATE54102 I LIMIT HgHWAY CONTROL 11. TIME 12'o us I IF NOT AT INTERSECTION: 2000 ms .1776 4.0 IHJV 11 PRIM. PROP 30 CROSRSTRE OR ZS I Q ACCIDENT Y N 9EOMENTMARKERSFG1•AC..l WXAVKF. 16.010 VEHICLE HAVE TO BE 17. VEHICLE DAMAGE NIT I 21.01 E TIO 3201STANCE 3 FT. d MI. FROM SITE N S E W F•ROMAITIE REMOVED fROM THE SGENF,7 NIT 2 0-NONE U 3 1 LIGHT 13TANCE WAS 15 UNIT 1 U - MODERATE 2 MEASURED CD ESTIMATED 5 11ppI1 -Y 0 N (J?.1 Y ? ME] - J - SEVERE - UNIT 2 a JL•CONSTRUCTICN OTRAFFIC PRINCIPAL INTERSECTING ZONE ? CONTROL ?(? to. NIAZAROOUS MAIERIALS Y? N 0 16. PENNOOT PROPERTY Y Q N 0 DEVICE a ? .. • ..i.r}'1}?7 . MIr•1 . , 1?.? ?n :: ? :r'?(.,r.? .o .4? i4i.@' L.e ... . -• AL6'tW41" V? . .. W. LEGALLY Y N 07. RE0. 06.9TATt 26. "GALL, V N 37. REC. 36.6TATE PAWO1 [? PLATE q0 J? N'f PAR*07 ? RATE 36, ]B. PA TRLe OR , OVT-0P-STATE VIN L , SL L••L 2 1 OVT-0FSTA7E VIN • 46. OWNER A6. OWNER - Not r.L1 r?L K• ?+C'ti- ._ AI. OWNS 41. OWNEN 7jy ASE -7 P ADDRESS 2070 2 ADCRE66 _ . 42. CITY. STATE 42. CITY.&TATE 1 6ZIPCODE c` eE '-TOQIL NY 1002 62JP000E m. YEAR ".MAKE AO. YEAR ". MAKE AS.M -(HUI 40.019. ? CI m. MOOEL-(NOT RODYTYP6 Y ? NO UNK? LRJK BODYTYPa GR0.L.f7 Y M 7 Ai. BODY ,AS PEC A6. VEHICLE A7. BODY PECIAL TYPE USAGE PAC 92 T ' IMPACT St VEHICLE POOT STATUS 7TJ. PEED Re m r om POW 9PT: SJvFJ1K:LE 61,0 66 DRNEJL u. HICLE SI.ORM1'ER V SS URJVFR GimiFNT 4 PRESENCE I CONDITION 1 GRAOIENT PRESENCE CONORION Be. DRIVER 01. wA. F NUMBER 9 21 1? 9 491 1 N-1 06. DRIVER NUMBER 67, A W. ORRIER 96. DRIVER NAME NAZH?wll:?l- K • 1c11,+G NAME 70. OH 09 . O RNf R -T I ADDRESS 20 7 ei `1 T rl AFL AD 60. CITY. STATE 10027 ` ` k 60. C(TY. 9 ATE AZ6YOCE ( lORK N SZIe'COor Lt? " 61. 02.OA OF 62. P ONE ' - 61.6EY er DATE OF 09. P NE R 76 G1.0 O GIRYH 64. CCMM. VEN. 65. DRIVER a. COMM. VEH. 55. UHNER Y O N DE C1A96 Y O N O CLASS 67. A I e.CAARIER b. CARRIER 66. CARRIER ADDRESS ADDRESS 60. CITY. 67ATE 6P.CITY STATE - It Z67CCDE A ZIPCODE 70. VUSDOT 6 ICC 6 '- PUC 70. USDOT 6 Icc F PLIC F 73 CARGO 710NYi! R 72. H. 71 D-SRGO H.CCAS'R . CONFIG. YTYPE ASN H CONFIO. ODYTYPE NK ANDDU4 OF 76 ND 79 E OF /MDAAT 77.RQF m.N0.0 7i1 MDOVS n. IF V O H ? LINK . . . AYIES MATERIAI.9 ff %ii AXLES MATFALLLS IM MTIOAT6I5 AGENCY May-lt ln>sl rAYA: J,`._ 2261306 MAY-24-99 MON 11:35 AM JPNT 'I BOGAR FAX NO. 717 717 7086 APR 21 19Jy 12:21 IH IWIUt WYUMIbnINUb119 J(j 03'% IU IrWV C,vi,va' 12 7a REanoiloaia?ew6' "!?46 INGOENTWLA -6214i3G FA> Lrrc . ,?, , E S. MEDICAL ACCIDENT DATE' v?m 'NV oTlgll . B C 0 E F n NAME ADORES! N 1 J K L M I ( ItA 2 2, op 4wI o O 8 O a I M 22 12? I ASLG v, ti?'i• 1471.13 • NFw to4<%Y 100 N7 O Q 13 0 4 [ ?t ALUMSIATK)rl ®(9 WGTHIR ®ROAD SURFACE EB. OIAOWLM? I I SCOn T ?+42Yful E?`lKbw•+?KEMT? ^ ?(?• 914 n11?? I t` ? I I IN. PENNSYLVANIA SCHOOL DISTRICT (IF APPLICABLE) rlo?-• E OERry ? I •1'? , i q I E. OESCR VON OF OAX"ED ROPERIY _ i - ^ Oy-WEA I t I ; 7 i 4! J ye Ra row i i rrtt01 PHONE Od SUAJ3TL.ELVILYC1. 4 KL,1 S7.KARf1ATIVE•1 EMIFYPRECIPRATINOEVEKL0.CAUSATKAPACTORS,SE12ULNCEOFEVENTb,WRNEU=AT ENTB,ANO PROVIDE Agarrpom? OETAM UKE INSURANCE INFORMATION ANOLOCATION-OFTOWED VEHICLES LF1010M. TLAI Aft.O EI,.T CL.,?3$ f.>r-,•t ?•I -AS TOAV CIL-M 7 w, ,1 .N Twit LE'FY 0 N l1ri•T I T A.v?Lt 4 >T IN A N04 TKw SST O.OC T.o,.. UP AN FM wqv-L-r T G (?.. - q nC U,aIS `, !YOU t f m7 NK N?..T UFO- IM?AGT Sv,l b l TRAu ELkD pY A'? LN q 5l.?lJT'1V?Gr O• •' t n•+ q.,0 MA•CE SECo•r04Q 1"pkcT Y n•r Q•ZI PON w,TI.1 O Z Ifi U.. t?l TQAVFLICl7 PP¢OIC 207'7 Ir., NO' we r .4 GTIC? A.•L C kA-F- TO ILE.ST Tw% CFr S TW V- F6-r, 4y TNI TQOGP6Q AO.Q.v r_, A$' TN LA.fe or- 7 ,rv _ $C Q T- ?•1 <(b n, F21 LEI-l,T?) wAS 1N V['flv'. 1L1 S , A[ I wl•r •C4E% 0.T L-4.6 4 L.+('o ^• ?C= e4vgT. ,.I OF -rw ROA?WA 5c41E' - - Amt MANS vl •t FRO uN..T ?I. OCCiA9A•+t of I-AI..LT`I REFUSE C1- 0QLE INSURANCE I N COMPANY \ Ir^+"x?124NCt CN5• INSURANCE INFORMATION COMPANY UNIT POLICYIt)a NO J UNIT 7 POLICY NO u. AOUK ro6a.S4 SIETNEL PA.1 Y17.9 RS ?,•.oKe+Z9K^_ N77NEBBEA NAM - ACORESS PHON INDICATED 90. SF.CT;CN NU L L 0 0 0 0 O"BLE S2 TYPE OBASLE Pt. TYPE SJ. REGULTU ?NOTESTBt.VNVEyT10ATION USE TEST UTEST e a REFUSE Campt9 Y 7 O UNIT ] O•_ _ c3 UNK YEO R'1 NO zIwyl AA.LS (11AU)' PACE: ?- INVEST1OwTRN6 wUFM:T 2261306 MAY-24-99 MON 11:36 AM JPNl;I' 'I BOGAR FAH NO. 717 737 2086 P. 13 APR 21 1999 12:22 FR JWIDE WYOMISSING618 373 6391 TO 37834 P. 24/08 = ; • +"`" COMMONWEALTHCFPENNSYLVAN/A /^? •?;?N I, A PAR CONTINUATION SHEtT ,?yg9i•7170E7V66Ar91ffT5 ® Rf30RTAME'MNOMEPORTAMS ? PENNDOTUSEONLY LA:: 21 ... A 0 q CAUNTY? MUNIUE LZM1 I I CM -NO rY 23W:.6T WR COOFS R C O' E F G NAM ADDRESS N I J K L N P.II Nr4TNE FATtytc'iLY: CR r,WL f'4- Ica<. PEg9C,.Lw, E.L. OwL. OAIw.'r z A.raSF W.AS `?ISt• ?.: w?Tw1 41 1 u. ...Gp e• T T bMR 04 O• RI ? ivp} •' 'c - .'h 'T 'v.l F E T G uNlT al, wlTr.i 'NYIr-IU1C0? 'T ?'• it?l ?.`? ? lri T1.1 1 LAN W vY 'Tti> T • F 0.TC.1iY `• 'H 'r,i: K T I+LKM6?T W?-rN F•INA1..1,. T [? ?' •? T W ?Y w1 t t) ?[ - lu l Ail Q • RT vJ 1 Y Fr r r W 4? o 7b : COI O: A : At' Itv T" e P-OAOWA%,Y, P 4h FIN L_L-X R.FI_•'rC :H r= TA 7 IK .O r+l QCI T 7..GT A56 Srr_ ( CJxL• SCOTT • ErNAW 'r.>_fY?? ': •NAI T 1<ZA" Jr T WteV V/ •T I v+ -Q - 1: rat CL-T= 'U ( Ql E-MOU :CJ'C.%ATT • 26NM ATI n pa :i SLS• OP6t N A551 ZI w?ro+ PFI Co. TGO V4 EaE i' ffvi E oT. 0,tm.wi F..I OL Q9 . pF tyk"& SRCn• fA OE5rAg TUPIS 69. SK710H NEERS(ONLYI CHAMED I C NIC LMTI 0 0 UIR2 QI. BAME 492.IrYPE ro ULTS [',)10TBT T 1 lSF TF? _9 '4 Q Rf UNK 0 0 Pt. ,UM LE 92 E in. U ?NO TEST 61.INVEbTWTUN? UNIT2 USE TEST 0. J-% PEFUNK YES ND 1J.99p (1IP-0 FADE;_ Gt?tn run niWAwr vim. MAY-24-99 MON 11:36 AM JPNCO ^ BOGAR FAX NO, 117 7?T ?066 RPR 21 1999 12:22 FR WIDE WYOM I SS I NGG IO 373 6391 TO ;7834 COMMONWEALTH OF PENNSYL VANLA NIA POLICEACCIOENTREPORT m01. %=,I Ym m.YFMYIANI.ErI P. 14 11Y.HSiLtl PENADOruSE? - CODE .. 20. COlMTY ' NUMEER LA-62 48y '' . 2AC Ly ' PO GE 21.MUNICIPALMY CO P EQN ?wP Q NAME PA STAI 3.siAIDw A.PATA L PRINCIPAL ROADWAY INFORMATION PRFSE,cT gt. d 0.d zoNE - y. WVEA7IGA OR NUMBER 4S UK 22. ROU1 It NO. STREET NAME 5 Don Z5 -78 T 5 _ ??E / 2ACCEA . SP CONTROL E J NUMBER ID NT AY LIMRCnSt•iO W I T N A• INTERSECTING ROAD. DATE 71ME 200.,5 -- ky + 20. AOVTa NO. on •C,.,;_`; STREET NAME •.._ J. t0.0A OF WE15K T• SPEEO 7d. E .ACC 39 DATE C2Vd. F 9L 1 LIMtr HIGHWAY CONTROL ,1. R +2•NUMW IF NOT AT INTERSECTION: ? 20 S - IT .17. / A./ I UN D 15. PRN. PROP ACCIDENT Y N ® b. CROS'3'9,REEFdt SEGMENT MARKER ZS tS. DIOVEHICLE HAVE TO BE 17.VEHICLE DAMAGE +. DIRECTI N 3I.OUTANCE 3 FROMOrE N S E W FROM SITE FT. q MI, REMOVED FROM THE 3CENE7 0-NONE UNTT1 © 33. ISTANCE WA5 (p'7 ? UNIT, UNIT2 1-LIGHT ESTIMATED LJ MEASURED (?1 •Y © N ? Y i^ I N El 2•MOOERAT6 r5 3•SMFIE UNR2 Y,CONSTRUCT'ON CTING (50. TRAFFIC PRINCIPAL INTERS • IONC a E CONTROL a I i5' HAZARDOUS k? 19. P +EgOPERT' Y N LSI f V U N . . . r ' ' " . ;•: :'.?VL?i FiA_1i??'r?t"r!?Ii?:: :%. 'S"...'`%Zr. >N? ',i?' ;w?:i?:::'il ., Y •F: ; ... h . :.?:i!I>t1 '.: ? 1r A ?'i : , • 75, SPATE ]G. LEWLLY Y N 37.REG. PA ' 30.1 O uy Y N 37. REG. 7a•6TATE PARKFp7Q PLATE Xg03J I I PARKED? PLATE 1 ert ]0. A ik ? 85 X r 5G 2 K r -.LOA 52 l 1 O 2 a , 1 n H OUT•OFSTA7EVIN L G3 -a - w. ovmEfi' .D. owN ( ' NAr.a AI.L1EL K. KLN j MAi1f LT Ma,220. _ - ,? yT rf OWNER ApORES5 1 .2 MOd2'AI ?C> R Y LUV . Al. OWNER ADOREss 9-C) 7Q '7 T rA A? l'' `I F A2. ffY. STATE Q. CITY. STATE AZIPCOOE IV A 21P000E wLXy??f{ PA.??!z_4 M. MANE A]. SL. !m RO r'A. M O - ( OT aA. INS. Y M N? UNK? A5. M00EL • (N UWC? BODYTYPEI %gck s BODY TYPE) F ,SODY B. PECIAL U y A BODY PECIAL 4 USAGE TYPE 5 O USAGE TYPE do. INTr AL IT SI VEHIG O 501NMEAL IMFj?PT 51 VEHICLE POINT 6TAN3 I POINT STATUS H 0/. OWR 53 HICLE .ORNER 1 NDITION Z . jvGRAD1EJ7T 2 PRESENCE L CONDITION . CO OMOIENT PRESENCE STA7E S7 55. DPNER 57. STATE 1 P . 3B.ORIVER NUMBE0.' m rr e' NUMBER W.OPAA"sR r55, oi? I NAVE 912AA Y. M0,2 NAME .13RNER 52 so. DRAIFR . ADDRESS 1'1'74- ?F- . opQ'T QO • ADDRESS 60. CT Op.C STATE PCODE 2 aZIPCCOC N rME1K 17545 A I PRONE p m.PHON 1 ? . TE OF 01.3EK B2- A mrli 07 OZ AL BIRTH DRIVER M VEH 65 63 M. COMM. VEH. Ol. DRIVER . . . Y 0 N CLA63 C. Y O N O C1A66 1 A. CARRI 67. IER -- ?65.C I DREW B/.cARRIER - ADDRESS AD CRY BB. CRY. SPATE , . . • ZIPCOOE PVC / A ZIPCOOE 70. UB00T P ICE / PUC / 70. V T F ICC I ,R ? T3 GAHCA 7d, GVWR T2 H. GONPIC. 7] OOY TYPE 7A. UVWK CONfq. I ?i!• GY TYPE s C "I iT. REL ?NO UNK? 7&. NEq WLTERWSUS V. Y O EN F UNKQ AXLES ERLLLS LUT INVESTK+AT01G AGENCY AA45 111/001 2261307 MAY-24-99 MON 11:37 AM JPNGO "I BOGAR FAH NO. 717 737 2086 APR 21 1999 12:213 FR WIDE WYCN f SS f NG610 373 6391 TO ;7834 COMMONWEALTH OF PENNSYLVANIA rV l POLICE ACCIDENT REPORT P. 15 P.06/08 R 0SHES ? REPON7ABlE NON • REPOH7MILEu low lri PENN it s+,a lac CODE NUMBER ?'?02149? +'^ RtY 21. MUNICI PALITY CODE NAME ,. STATION/ A. PATROL PRINCIPAL ROADWAY INFORMATION PRECINCT ZONE S. R BADGE ;M ROOM Pig. OR NUMBER STREET WARE 6. APPROVED OV -`^ BAOCE 77. SPEED TYP 21. 15 AACCESS NUMBER HwMYAY LIMB CONTROL rAL IaA wN P. INTERSECTING ROAD Tw DATE fWE . -'IN : ApoolkT .:•:v 6A O : WFOUTENO OR STREETN me r. : i 9.ACCI ENT 70. DAY OF WEEK 27. SPEED 20. TY AC DATE LIMIT HIGHWAY CONTROL. 11.714 - 12. NUMBER IF NOTAT INTERSECTION * DAY OF UNITS . .13.1 KILL O 6.8INJURED 13. PRIV. OP. R ? ? 30. CROSS STREET OR NT Y N ACCwE SEOMENTMARKER 18. 010 VEHICLE HAVE TO BE I7.VEHICLEGAM40E NONE UNIT a 31. DIRECTION 32.OISTANCB FROMSRE N S E W FROMSITE FT. MI, REMOVED FROMTHESCENE7 , LIGHT ® 1 - 33. DISTANCE WAS El UNITS UNIT2 - MODERATE 2 ESTIMATED ? MEASURED 1 ?? : , •Y ? N R Y U N ? 3SEVERE UNIT 2 CONSTRUCTION OTRAFFIC PRINCIPAL MERSECTING 209E D I 18. ? ? R y 10. PENNOOT ? 0 DEVICE MATER Y N IALS PROPERTY Y N w ^ 7.97A7E 36. LEOAU.Y V N 37. REO. Y. LECAtIr Y N J7. REG. 38. STATE PARNEG 7 ?Q PUTE PARI@D 7 Q? PUTE 39. PA LE C11 AST RLEOR OUT-OFSTATE VIN OUT-CF-STATE VEN 10, OWNER r-^ 40, OWNER ADDRESS ADDRESS _ 42. CITY, STATE 1 STATE A Z07f.ODF 121P000E Al YEAR Y. MAID: 13. Y K. MAKE 16.MODEL•(NOT AO. '13 O CI fS. AK,OEL•(NOT • .INB. Y ? N? UNKQ UNK BODYTYPE) Y N TVPE) BOOY A7.BODY S. PECWI. 10. ICLE 1. OY' B. PEOIAL 40.VEHICIE TYPE t3 GE OWNE7L4FiIP TYPE USAGE OWNERSHIP 50:1' IAL IMPACT St VEHICLE 62 TRAVEL SO.INRULIMPAC St VEHI LE 52 TRAVEL -POINT STATUS SPEED POINT STATUS SPEED KXE a. R 55 DRIVER 63. w RIVER a • JO I PRF.SPIICE CONDITION GRADIENT PRESENCE CONOITgN DRIVER 57. STATE NDR 37. STATE MOWER PEOF STA I N GA NUMBER SA. RIVER 60,ORR/ER NAME9VV&w rv MAL.CJ7?'L WpOOMOUS? NAME 39, DRIVW 60, ORr R III ADDRESS' wc.4T FLG?LLA-0 Sr, AbOREW 60.CITY• TATE 00. CITY. STATE BZIPCOOE 5or.AMIT HLC_ A• 18256 aZIPCOOE BiP NE OI. 62. ATEOF 01.9 6ZC M0F 83. HONE , M 2 ?G LJ Fo EI.COMM.VFJf. SS.ORNER L CAMM. VEH. 11S.ORNER V C3 N 0 CIASS Y Co N? CUSS 61 7. RIER 1 IER - - rAR 1 760 5u 9 8 Y. ADDgESS ADDRESS AODPE9B •_ 89. CITY, STATE 60. CITY. STATE ' A ZIPCOOE A ZIPCODE - M. 00TIF ICC 0 VC 11 I 70. U T9 wC 0 kin rL 7J CMGO U. GVWR CARGO R. 77 7/. GV R3 CONFIG. OOYTYPE CONFIa. OT TYPE r IS NO. f 70 HA2AR0006 T, RFAEARC.OF:uSWf 73.90. Df 71 ARDOU . Elm 77ca wwwl lMK N ? Y ? AXLES MATERIALS Y Q N ? UN N AXLES MATERIALS N • ? - AA45 (1195) PACE: J•>- 2261308 MAY-24-99 MON 11:38 AM JPNGP n BOGAR FAR N0. 717 737 2086 p 16 APR 21 1999 1223 FR WIDE WYOMISSING610 373 6391 TO 37834 P.07iP,R .if7.liE?oiAINti:E'N1'ACP++F6'b-1 r.. L!Q lti 1A ? F.IE,6i " ''6 INCIDENT*:':Li?:;62;,.. .. 7R.61®1?IIl.! m w vacc EY• •c esr CCIDENT DATE: ' '? -• w .'i' C a., . 0 'E F 0 NAME t; AOCFWM N I J'v 1..X C• •Y ?' 1 O 4 Opp, " 1 C O O.t O O q ?L...R11.1GC? ?. ae _? ..,,, n. ?L1MIy. 3 2' O' 1 ILLUMINATION ®®WEATNfR OIAORAM M. CMB KpE?•.r 1 I ®ROAO SURFALC SyE6w1,1..T ttt b 1 l /G6Ji ?•L I i 64. PFNNSYLVANUI SCHOOL OISMICT BERM ' (IF APPLtCABLE) I i i ' Qu Z ( ? 116.0E RIPTIONOFOM OA PROPERTY _ I , ggg??1 i QWNER I 1% I MEL711L • PROM R PTD?ge.TlAu 1 OO?? oR SN?R7 'btu lu.G M 47. NARRATIYE- IDENTIFY PRECIPTATIN3 MITI, GUeAT10N FAUTQFtX' ENCR OF 4YENT6, WR 4TATEYENT6,AN0 PROVIDEADOMKAL OETAL&L11M INSURA CE • N INFORMATION AND LOCATION OF TOWED VEIMUG, IF KNOWN. •. AOCYp7„ruT CV4&*Q 0 AS UKrTb(' WAS :4AV ElLtN[i 7 wp w.7ylly THE L.E,FT L/W llK,T X12 ..A-s ORS Ef :ab" RC.vldu: A.OC.C.Le •"FCZ,BF. L.•1-62 ) BLOLIr' ? ?..r T I ti7 Lkti-: A\+J GrrO ?.rjYCLI N WAS, Vr 1>L O. T.tE QI T otOE OI: u..L.t C,'Z Lrir.7 "i S F4r?-+Y T UG T L.E;:T Q .A F Uw'T~2 DOM tnP GT la.,a.c?,t CO^•T•••U v-. T wt•??.+ Try LE,-,r L4•.. PP4c SOFT ;k+O C'N-F TQ ST ?b YMIN YwtE t.<_Ft I.AnIE FA,p wFST. LJIPOw 1MD k3",T1' SPUN ,/J COLA R4T It W IS Q 6,f.T?a N S-RUCY, Pl!OESTQ lal-A Oti TQ V -L ?ISPfer2 CT t q w?ST E41T O.ACCTOwR, UwTd CA TO QCST wTNIH TN L&T > 0&, i OF '7F ..R \N So T•H wE5'r O,Zr_a'?,C 1. UPO.•L to P'AC,T WITH uuttA`Z P000ZST41A*4 TQA,v,tLA V•.I $OU7.twcEiT' 0,4cCT10.+ PPeoX•ZOF r CMOae? 1N9URANCE C{1MPANV INSUNANCE COMPANY ' NPCAMn710N U IT RI - k. S ..R E EXCnA. t!rg CT P WFORAATION l t'•tS. ?• ' OW C?4 Z UNIT FOLICYI ,z3 31 M. NAME 11 IUNt ?vpuF 1LN0\.. ..1 w"MmEa NAM ADORU:99 -` NF• l, G ow. vivLAw C I UNfTI uNS4F E SPE:0 ?I-7I t•.? F-C 0 0 F7 UNTx 6Lbc,c. ^1G I20AOWAY 1VO?.a IT 00 91. URORASLE 92. ni 97. RESULTS ®NC TEST 91. OBASLE TYPE g3. RFAULTS ?NC7E9T 04.1 ZTOATION r r REFUTE liOE TEST ,. f O O.-_%D O SUNK YESC Ittl MO % ? -- o nw? 1119?1 PACE: _? _ UNESMATUt ACE1?CY 2261307 MAY-24-99 MON 1138 AM JPMCO 'I BOGAR FAX NO. 717 737 2086 P. 17 APR 21 1999 12:23 FR VIDE WYOMISSING610 373 6391 70 ;7834 P.08/wd COMMONWEA1..THOFPWYLVAN/A reimruLEaar •`-??t it ,:,,Y veW PAW6V ?INUrp?uewana E3 _? n•:.. ?YN? C'AME So :REST IOWNG T?l? 5ouTr.1 NEO/AL. wNCI+:T":MS'TO.OOP, AQ2?•a ra 0.T trLE SCE n+E AT 20o$1.1R5 b4 CJ Z.Ir/?/ F'•,?1 :A?'?_• '?>w'yiY.g C..+ .Z \H NE?2' F,NA? 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NCj Z'O TNr_'ML 4bWr OF u,v,Y NZ AI-0: Sg 7 . i Lk <fOA.L,?LLiT?WAQA H,r"<• ?E04S'rR,A? ..OC'OHCtYF- F??L,I,L•LY .Q6:LgfiEO }{" ,TC11E+O T? MCn+E 3V1' IT w/AG TGO LAvw.. 7Q0.F1-,C WA=: Ca?TgOI.L3C} ?3t r?_a' `kSe O:F 0?;M + F4E Cr=-?= t'1Art6uQG• u"" T TI $•t.3^•t'z n•?M1Au Tp A??4S' ?I •*n ,2 wCECCER . v ERC•AL wARN,r•LG IS5uE0 TC) 06R1 &.Mz P./.J v: eOD5.1c?7S?.: S •C..,015 ISSU L`O OPRe% C?wK?,2 Or L)n,t? A!?IJ :M'ICILEO TC i", 000 t?bc? `: w.aESCneEVnunrnLS oa Lee 1LNL I c I nn N U16T6 . pgOEbT'41A1ts Ll. L%"-T ACCESS NW•Ij rvcsw c' Ll O UNT2 ... 015 OARt 01. W. LTS ?} NO iCSf fl. BAfSIE . O1 W. LTO EMNOTEur QmweSfI aw USE IESf REFUSE USE .. TEST -3 nVU T'. UNn: O•_ S'. !] LINK UNR] O•_ Ye d UNK YES [] tiL:1k7(1Aq. 'PALE: INYESTCGATINO AGENCY i NATIONWIDE CENI 3Y 11 AUTO POLICY INSURANCE DECLAAATIONS Nslbnwks Is on your side Page 1 of 4 These Declarations are a part of the policy named above and Identified by policy number below. They supersede any Declarations Issued earner. Your policy provides the coverages and limps shown In the schedule of coverages. They apply to each Insured vehicle as Indicated. Your policy compiles with the motorists' financial responsibility laws of your state only for vehicles for which Property Damage and Bodily Injury Liability coverages are provided. Policy Number: Policyholder: 58 37 B 876755 (Na dl 0 6 m' Issued: OCT 22, 1998 me nsured) LYDIA R 8 BRUCE FEHR 7366 WERTZVILLE RD CARLISLE, PA 17013.9032 Policy Period From: NOV 15, 1998 to MAY 15, 1999 but only If the required premium for this period has been paid, and for six month renewal periods if renewal premiums are paid as required. Each period begins and ends at 12:01 A.M. standard time at the address of the policyholder. INSURED VEHICLE(S) & SCHEDULE OF COVERAGES 1. 1993 FORD MTR HOME ID #1FDEE14NOPHA75131 Coverages Limits Of Liability COMPREHENSIVE ACTUAL CASH VALUE COLLISION ACTUAL CASH VALUE LESS $ 5 PROPERTDMAGLIALIABILITY $ 50,000 EACH OCCURRENCE 0(1 e,? people- $ 100:000 EACH PERSON UNINSURED MOTORISTS-BODILY INJURY $ 300,000 EACH OCCURRENCE UNDERINSURED MOTORISTS-BODILY INJURY TOWING AND LABOR FIRST PARTY BENEFITS OPTION 1-MEDICAL BENEFIT to US OPTION 2-INCOME LOSS BENEFIT FOPTION 4-FUNERAL BENEFIT To r TORT $ 100,000 EACH $ 300,000 EACH $ 100,000 EACH $ 300,0100 00 EACH $ 10,000 SS 6,000 TOTAL S 1;000 MONTHLY 100 VEHICLE ENDORSEMENTS 2237 Six Month Premium $ 30.70 $ 24.80 $ 33.40 2357 $ 5.20 2358 $ 18.80 $ 1.80 $ 18.40 $ 4 .20 TOTAL S 163.20 Auto-7100 VERIFICATION 1, LYDIA R. FEHR, as parent and natural guardian of Carol L. Fehr, a minor, have read the foregoing PETITION FOR APPROVAL OF MINOR PLAINTIFF'S COMPROMISE SETTLEMENT AND DISTRIBUTION OF PROCEEDS and do swear or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa.C.S.A., Section 4404, relating to unsworn falsification to authorities. Witness ??? zel? Lydia R. Fehr Date: `;/,ql9 y 153387/MLB I . A . CERTIFICATE OF SERVICE I, Marcy L. Brymesser, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that 1 am this day serving a true and correct copy of PETITION FOR APPROVAL OF MINOR PLAINTIFF'S COMPROMISE SETTLEMENT AND DISTRIBUTION OF PROCEEDS on the following via postage prepaid, first class United States mail, requested addressed as follows: Ms. Annette Long Nationwide Insurance Company 1137-A Kennebec Drive Chambersburg, PA 17201 Claim Number: 5837B87675504029901 Ult? i Marcy L. ymess Date: July 29, 1999 e mss. rIV) ii- LYDIA R. FEHR, as parent IN THE COURT OF COMMON PLEAS and natural guardian of CUMBERLAND COUNTY, PENNSYLVANIA CAROL L. FEHR, a minor, Plaintiffs AMICABLE ACTION V. NO. 99-4612 Civil Term ESTATE OF BRUCE FEHR, Defendant PROOF OF DEPOSIT In accordance with Pennsylvania Rule of Civil Procedure 2039, attached is a photocopy of the deposit slip issued on September 29, 1999 from Legg Mason Wood Walker, Inc. to Lydia R. Fehr c/o Carol L. Fehr, as proof of deposit of the settlement proceeds. No withdrawal can be made from any such account until the Minor attains majority, except as authorized by a prior Order of Court. Date: October 11, 1999 200526.1\RAS\MLB 4503 North Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff TIMOTHY N. ENGLE LEGG MASON MOOD WALKER INC 214 SENATE AVENUE PO BOX 8853 CAMP HILL PA 17001-BB53 717-737-6500 800-433-8186 Client Confirmation Legg Mason Wood Walker, Inc. I'll HIMHIuu E I HII I L I I ??u FIIE UE?I?? nnl LYDIA R FEHR CwF CAROL L FEHR 7366 WERTZVILLE RD CARLISLE PA 17013-9032 NSACTION YOU BOUGHT 29,000 PATRIOT BANK POTTSTOWN PA C/O FEDL INSD TO SOOM-ACT/365 DUE 03/29/2000 05.7502 PAYABLE MONTHLY ON 29 09/29/99 DATED DATE SOLICITED AS OF 09/27/99 YIELD 5.750 % TO MATURITY NOT RATED BY MOODY'S/SAP/FITCH B-03 09/28/99 LCmE -__ .... le99 Mason Wood Walker Incorporated T P0. Box 1476, Baltimore MO 71107 1476 -' • 410.539.0000 BRC 1242377 CREDIT K _ •. MpOn M1M Yyh X! ,LLnl+pe. trc All.nhb FFC ?I , '• RECEIVED OF q -`- -2- 9 p1 ACCT. NO. CD'7 -2-(57:, I - 1 non. S?q. y15.oo CI?__ N PAYMENT OF TRANSFER TO N/O X JIu? , LEGGjv1ASON N100D WALKE ,INC. ' rEN \oTRCSPp•.VI$ I. E 11 A LuR<F I I, Ell LTl\p FRr {\?DELIh,II LFF LTI\,. TN{\\iCNa ON E\f11Mla.a NET AMOUNT 29,004.57 .; CERTIFICATE OF SERVICE. 1, Marcy L. Brymesser, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day serving a true and correct copy of the foregoing PROOF OF DEPOSIT upon all counsel of record via postage prepaid, first-class United States mail, addressed as follows: Ms. Annette Long Nationwide Insurance Company 1137-A Kennebec Drive Chambersburg, PA 17201 M cy L. Brym er Date: October 11, 1999 200526.1\RASMLB v t? ? V