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Home My WebLink About08-4994F:\FILHSThents\Donegal 3050\Catrent\53 A3050.537.coml.wpd/nlm Created 9/20/04 0:06PM Revised: 8/19/08 11:31 AM 3050.530 Seth T. Mosebey, Esquire I.D. 203046 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, IN THE COURT OF COMMON PLEAS OF Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 0 ,4J QQy el0 L' L CIVIL ACTION - LAW WILLIAM M. SHENK, Defendant JURY TRIAL DEMANDED 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 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 maybe 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, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 South Bedford Street Carlisle, Pennsylvania 17013 (717) 249-3166 Seth T. Mosebey, Esquire I.D. 203046 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, IN THE COURT OF COMMON PLEAS OF Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. NO. CIVIL ACTION - LAW WILLIAM M. SHENK, Defendant JURY TRIAL DEMANDED COMPLAINT 1. Plaintiffs Kevin Bender and Nancy Bender are adult individuals residing at 137 Shippensburg Road, Shippensburg, Cumberland County, Pennsylvania. 2. Defendant William M. Shenk ("Defendant") is an adult individual residing at 109 Turnpike Road, Newburg, Cumberland County, Pennsylvania 17240. 3. On or about March 28, 2008, Plaintiff Nancy Bender was traveling south on Newburg Road in Hopewell Township, Cumberland County. 4. On or about March 28, 2008, PlaintiffNancy Bender was operating a 2002 PT Cruiser owned by Plaintiffs. 5. On or about March 28, 2008, Defendant was operating his 1995 Honda Civic north on Newburg Road in Hopewell Township, Cumberland County. 6. As Defendant was negotiating a left curve in the roadway, Defendant lost control of his vehicle and slid into the southbound lane of Newburg Road, striking Plaintiffs' vehicle. 7. As a direct and proximate result of the accident, Plaintiffs incurred damages in the amount of $7,658.90. A copy of the estimate to repair Plaintiffs' vehicle is attached hereto and incorporated as Exhibit "A." 8. The aforementioned accident was caused as a result of the negligence, recklessness and carelessness of Defendant in that he: a. operated his vehicle at excessive speeds given the condition of the roadway; b. operated a vehicle in a careless, reckless, and negligent manner; C. failed to properly operate and control his vehicle; d. failed to operate the vehicle under the proper control so as to prevent striking Plaintiffs' vehicle; e. failed to keep a proper look out; f. failed to use due care under the circumstances; and g. operated the vehicle in disregard of the rules of the road, the ordinances of the local municipality and the laws of the Commonwealth of Pennsylvania. 9. At all times material hereto, Plaintiffs acted with due care and were not contributorily negligent. 10. As a direct and proximate result of the negligence of the Defendant, Plaintiffs have incurred damages in the amount of $7,658.90. WHEREFORE, Plaintiffs demand judgment against the Defendant in the amount of $7,658.90, plus costs, interest, and any other relief that the court deems appropriate. MARTSON LAW OFFICES By: "2.4'M J. Seth T. Mosebey, Esquire I.D. Number 203046 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff Date: EXHIBIT "A" DONEGAL INSURANCE GROUP 11.95 RIVER ROAD P.O. BOX 302 MARIETTA, PA 17547.0302 17 426-1931 FAX: 71 428-7023 "' ESTIMATE ""' 03131!2008 08:58 AM Owner Owner: KEVIN BENDER Address: 137 SHIPPENSBURG RD HonvWDay: (717)423-6981 City Stab Zip: SHIPPENSBURG, PA 17257 WorkMW. (717)477-1377 Control IMortnaNpn Claim 0: PAA-PA-01-080031879 Lost Dste/Tima: 0312812008 08:00 AM Deducdbie: $1,000.00 Fib # : ins. Company: Donegal Inewance Group Agent: Mary MoINn Address: Email: marymaiNr4donegaigroup.com Insured: KEVIN BENDER Address: Claire Rep: May Mahn Address: Email: marymaftnCdorwgalgroup.oom Loss Payee: NONE Insured .Policy # : PAA-OS49428 Lou Type: Collision Aeeounting S : 4338 Worle W. (800)877-0800x7503 Homs/Day: (717)423-M1 WorklD4y: (800)877-0800x7503 I0OP"n Inspection Drab Inspection Location: Address- City suit ZIP, Primary Impact: Drive": 031281;4008 03:16 PM STOUFFER AUTO SERVICE 1270 ORRSTOWN RD SHIPPENSBURG, PA 17267, Left Front Corner No Inspection Type: Field Contact: WoddDW. (717)532-84252 Assigned Data/rime- First Contact Dete/rims: Appraiser Name: JACK CHIARA Address: P.O. BOX 567 City Stab Zip: NEW CUMBERLAND, PA 17070 Address: 1270 ORRSTOWN RD City State Zip: SHIPPENSBURG, PA 17257 Target Complete Date/Time: Secondary Impact: Left Front Side Rental Assisted: Received Dabs/rune: 03128/2008 03:18 PM Appointment DaWTime: 03/31/200808:00 AM Appraiser License to : 416512 Wo"sy: (717)737-5757 FAX: (717)737-7501 WorttlDay: FAX: Days To Repair. 7 Remarks ALL SUPPLEMENTAL DAMAGE MUST BE APPROVED BY THE APPRAISER Vehicle 2002 Chrysler PT Cruiser Touring 4 DR Wagon o?n008 01.40 PM Paps 1 of 5 20oz y Pr CMr W TW* 4 DR Wagon cYir?,a P'A`APMat-o8?oa IS a3ls1rzaaeapse ma 4cyl Gasoline 2.4 4 Speed Automatic Lic.Plats: GTK-0713 Lie Stab: PA Lie Expire: vltt: 3CSFY58882T245526 Prod Deft: 1111116 pe: 72,542 Veh Inapt: Mileage Type: Actual Condition: Good Code: M72038 Ext. Color. BLACK Int. Colors Ext. Rtfintsh: Two-Stage Int. Refinish: Ext. Point Code: PX8JDX8 Irrt. Trim Code: Options Air Conditioning Chromed Alloy Wheels Dual Airbags Heated Power Mirrors Lighted Entry System Power Door Locks Privacy Glass Split Folding Roar Seat Tinted Glass Alarm System Comsat Disc Player Fog Lights Intermittent Wipers Overflow Console Power at"/ing Rear Window Defroster Tachomailer VdaurlClolh Seats Center Console Cruise C rdrd Front Mud Guards Keyless Entry System Power Brakes Power Windows Rear Window Wipen'Wooher Tilt Steering Wheel LIAeQpGuidoMCDescription WR.PSrt"06 Prise ADJ%I$%Hou+s R 1 EU 6 46 Bumper Assembly,Fronlt LIKE KIND B QUAL.PRT $450.00- +25.00 1 5 SM PARTS. LOCATED AT TRIPLE NICKLE 717-287-2500 QT 297905 , 2 N 29 FR Bumper Cvr Overhsu Additional Labor 1 4 SM 3 L 6 13 Cover,Front Bumper Refinish . 3.7 RF 2.6 Surfeca 0.d Trwoetage setup 0.5 Two=stags 4 1 5 L 49 Grills Assembly 4910 Grille Assembly Repair 0.51 SM Refinish 0.56 RF 0.3 3urlsce 6 RI 49 Grills Assembly 0.2 Two-siage R S I Assembly INC SM 7EU 41 46 Hooctiemp Assy,Halogen LT LASE KIND 8 QUAL.PRT $150.00' +25.00 0 3 SM PARTS LOCATED AT TRIPLE NICKLE 717-267-OW QT 297905 . 8 N 973 Headlamps Aim Additional Labor 0.4 SM 9 E 132 Panel,Hdlmp Mounting LT 4724640AB $67,50 1 3 SM 10 L 132 Panel,Hdlmp Mounting LT Refinish . 0.3 RF 0;3 Surface 11 EU 22 Lamp Assembly,Fog LT LIKE KIND b QUAL.PRT $50.00- +25.00 INC SM » PARTS LOCATED AT TRIPLE NICKLE 717:287-2500 QT 297905 12 E 54 Brac ket,Front Foglamp LT 5288869AC $11.10 INC SM 13 1 78 07 Rainf,innw Fender LT Repair 2 0' SM 14 L 78 Rainf,inner Fender LT Refinish . 0.3 RF 0.3 Surface 15 1 SET UP AND MEASURE Repair 2 0- SM 16 N FRONT END ALIGNMENT Additional Labor $49.95' . SM 17 EC CAR COVER Replace Economy $5.00- SM 18EC FLEX Ropisce Economy $8.00" SM 19EC CORROSION PROTECTION Replace Economy War SM 20EC PINSTRIPES - TAPED Replace Economy $12.00' 0 3' SM 21 EC CAULK/SEAM SEALER Replace Economy $10.00' . SM 22 1 23 1 WIRING COLLISION PULL Repair Repair 2.5- SM' - ' 24 1 113 07 Side Member,Front LT Repair 2.0 FR 2 5' SM 25 L 113 Side Member,Front LT Refinish . 0.3 RF 0.3 Surface 26EU 103 Fender, Front LT LIKE KIND & QUAL.PRT $150.00- +25.00 1 3 SM » PARTS LOCATED AT TRIPLE NICKLE 717-267-2500 QT 297905 . 27 L 103 Fender,Front LT Refinish 3.0 RF 2.1 Surface 0.5 Edge 0.4 Two-stage 03012006 01 :10 PM Pape 2 or 5 20M Chryder PT Cruiser Touring 4,1311 Vhgw Chft#: PM-PA41.00-0031879 03/312008 08:58 AM 28EU 138 Skirt,lnner Fender LT LIKE KIND & QUAL.PRT INC SM » INC W/LKO FENDER 29 E 134 Shield, Front Splash RT 4724SWC $23.20 0 3 SM 30 E 716 Column Assembly,Strg 4690891AC $184.00 . 2.7 ME 31 L 716 Column Assembly,Strg Refinish 0.7 RF 0.7 Surface 32 E 831 Clods Spring 4671876" $153.00 INC ME 33 E 838 Cvr,Stsering Wheel 4664253AD $163.00 INC ME 34 E 793 01 Airbag,Steering Wheel UV77WLSAC $595.00 INC ME 35 E 865 01 Cover,Pass Airbeg RN531 B7AD $118.00 1.6 ME 36 E 963 01 Airbag,instrument Pnl 4684262AF $575.00 INC ME 37 E 69001 Sestbalt,Front LT RL291LBAG $335.00 0 6 SM 38 E 891 01 Sestbei%Front RT RL2811.8AE $167.00 . 0.6 SM 39 E 69201 Budde,Frt Seatbelt LT TR541 L8AC $53.20 0.1 SM 40 E 693 01 Budde,Frt Se ftk RT TR541 LBAC $63.20 0.1 SM 41 EU 207 Door Assenrbly,Frorrt LT LIKE KIND 1& QUAL.PRT $350.00' +25.00 1.7 SM » PARTS LOCATED AT TRIPLE NICKLE 717-267-2500 QT 297905 42 L 207 Door Shell, Front LT Refinish 3.4 RF 2.0 Surface 1.0 Edge 0.4 Two-stage 43 RI 231 Prnl,lnner Door Trim LT R S I Assembly INC SM 44 RI 493 Mdg,Front Door Belt LT R & I Assembly 0 3 SM 45 RI 245 Applkius,Frt Door From LT R & I Assembly . 0.4 SM 46 RI 426 Mdg,Fmnt Door Side LT R d I Assembly 0.3 SM 47 E 299 WPIaa,Front Door LT 530301M $46.20 0.2 SM 48 RI 229 Mirror Oulsr RlC LT R & I Assambiy (Y.3 SM 48 RI 221 Lock,Front Door LT R & l Aeea1141y 0:4 SM 5D RI 223 Cyl,Front Door Lock LT R & I Assembly INC SM 51 RI 227 Handle, Front Door Ott LT R & I Assembly INC SM 52 EC MOUNT AND BALANCE Replace Economy $10.00• SM 53 EC VALVE STEM Replace Economy $1.50' SM 54 EC TIRE Replace Economy $110.00' SM Beftilment 20 PARTS LOCATED AT HENDERSON TIRE 717-56"726 54 home MC Mesaa" 01 CALL DEALER FOR EXAGT PART*1 PRICE 07 STRUCTURAL PART AS IDENTIFIED BY 1-CAR 10 INCLUDES ALIDATEX TIME TO CLEAR ENTIRE PANEL 13 INCLUDES 0.6 HOURS FIRST PANEL TW "TAGE ALLOWANCE 46 PRINTABLE ALTERNATE PARTS COMPARE @stlmate Total & Entries Gross Pans $2,544.40 Ottwr Parts $1,384.45 Paint Materials $244.00 Line Rom Markup $287.50 Parts & Material Total $4.440.35 Tax on Parts & Material 6.00091 $266.42 Labor Rata Repace Hra Repair Hire Total Kra Sheet Metal (SMM) $42.00 10.0 11.3 21.3 $894.60 MeehrElee (ME) $45.00 4.3 4.3 $193.50 Frame (FR) $48.00 2.0 2.0 $96.00 Refinish (RF) $42.00 12.2 12.2 $512.40 Paint 11111" lals $20.00 Labor Total 39.8 Hours $1.696.50 Tax on Labor ta 8.00096 $101.79 Towing $275.00 Storage $120.0 Gross Total $6,900.06 6 Less: Deductible $1,000.00- Less: Betterment & Tax $23.32- Net Total $5,876.74 TOTAL LOSS 031312008 0140 PM Page 3 or 5 A m INSURANCE AUM AUCTIONS Insurance Auto Auctions, Inc. Attn: Settlement Group RR2Box317 East Freedom, PA 16637 Phone: (814) 695-4776 Fax: (814) 895.311$ E-mail: IAA ASAP AhoonaQiaai.com PREBILL INVOICE: 3897488 INVOICE DATE: 04/04/2008 Payment Due Date : 411912008 Invoice To: Donegal Group - Marietta 1195 River Rd Box 302 Marietta, PA 17547-0302 Attn: Salvage Dept Af Aw Inform IAA Stock # ation 000-04106869 Outstanding Charoe IAA Branch: Altoona % ACV Fed. Tax I.D. 954455113 IAA har as Adjuster.- Mary Mathin - ---. - - - ?.. - ..? g . Insured: Advance Chg Service Fee $0.00 0.00 Owner: Kevin Bender Claim #: PAAPA01080031879 Total IAA Charge ($0.00) Policy * PAA0549428 Outside Charnes A vanr i Vehicle: 2002 CHRYSLER PT CRUISER d cr , W IAA AA Damage: Left Front/None Storage $180.00 2.40 VIN: 3CSFY58B82T245526 Advance Tow $275.00 3.67 ACV: $7,500.00 NICE Date: N/A Total Outside Charge $455.00) 6.07 Amount Due to IAA $4555 6.07% For proper credit, include Invoice number : 51104258321 on your payment check. El:trfed Days A Date 2f Event- nalysis Deft Di1LIE Loss 3/28/2008 - Assigned 3/31/2008 4 Released 4/1/2008 2 Pickup 4/212008 2 - Title Rec'd..' "- -0 ? .? _ , __ .. _ - ... ... Sale Doc. Recd N/A 0 Invoice 414/2008 3 Elapsed Total Days: 8 LM Doc. RP002e.ro 04/11/2008 10:57 AM E5C85 6826 VERIFICATION The foregoing Complaint is based upon information which has been gathered by our counsel in the preparation of the lawsuit. The language of the document is that of counsel and not our own. We have read the document and to the extent that it is based upon information which we have given to our counsel, it is true and correct to the best of our knowledge, information and belief. To the extent that the content of the document is that of counsel, we have relied upon counsel in making this verification. This statement and verification are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if we make knowingly false averments, we may be subject to criminal penalties. l Kevin Bender N cy ender F: \FILES\Clients\Donegal 3050\Cutrenl\537\3050; 537.coml .wpd n ?s C Lam.. f nV.. ra x*• w c.s9 tv -„ -Ti cal m SHERIFF'S RETURN - REGULAR CASE NO: 2008-04994 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND BENDER KEVIN ET AL VS SHENK WILLIAM M KENNETH GOSSERT , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon SHENK WILLIAM M the DEFENDANT , at 0958:00 HOURS, on the 23rd day of August 2008 at 109 TURNPIKE ROAD NEWBURG, PA 17240 by handing to CATHERINE SHENK, WIFE 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 CIA 18.00 Service 20.00 Postage .59 Surcharge 10.00 Sworn and Subscibed to before me this day of , So Answers: y All/ s R. Thomas Kline 08/25/2008 MARTSON LAW OFFICES By: A. D. George B. Faller, Jr., Esquire I.D. 49813 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, IN THE COURT OF COMMON PLEAS OF Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 08-4994 CIVIL TERM CIVIL ACTION - LAW WILLIAM M. SHENK, Defendant JURY TRIAL DEMANDED TO: WILLIAM M. SHENK, DEFENDANT NOTICE OF ENTRY OF DEFAULT JUDGMENT You are hereby notified that on the day of ZW( , 20 lb the following Judgment was entered against you in the above-captioned action: judgment in the amount of $7,658.90, plus interest and costs of suit as prayed for in the Complaint for failure to file an Answer to Plaintiffs' Complaint. Date:_ Prothonotary I hereby certify that the name and address of the proper person to receive this notice under Pa. R. Civ. P. 236 is: William M. Shenk 109 Turnpike Road Newburg, PA 17240 F.' FILES,Clients,3050 Donegal',Current?537'3050.537.pra.default judgment Created: 7 704 9:06AM Revised. 430, 10 4:37PM 3050.537 George B. Faller, Jr., Esquire I.D. 49813 Lf?"r` -3 '?+ 2 17 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER ., MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, Plaintiffs V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 08-4994 CIVIL TERM CIVIL ACTION - LAW WILLIAM M. SHENK, Defendant JURY TRIAL DEMANDED PRAECIPE TO THE CUMBERLAND COUNTY PROTHONOTARY: Enter default judgment in the above-captioned action in favor of Plaintiffs and against Defendant in the amount of $7,658.90, plus interest and costs of suit as prayed for in the Complaint, for failure to file an Answer to Plaintiffs' Complaint. I do hereby certify that a written notice of intention to file this Praecipe (in the form attached hereto) was mailed to the Defendant at the address indicated thereon, on February 24, 2009, which date was subsequent to the date default occurred and at least ten (10) days prior to the date of the Praecipe. By Dated: May 3, 2010 MARTSON LAW O George B. filler, Jr., Esquire I.D. No. 49813 Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs ???"d ?l I slll? Seth T. Mosebey, Esquire I.D. 203046 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, Plaintiffs V. WILLIAM M. SHENK, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 08-4994 CIVIL TERM CIVIL ACTION - LAW : JURY TRIAL DEMANDED IMPORTANT NOTICE TO: William M. Shenk DATE OF NOTICE: February 24, 2009 109 Turnpike Road, Newburg, PA 17240 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 (10) DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOUR WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. DAMAGES WILL BE ASSESSED AGAINST YOU IN THE AMOUNT OF THE REPAIR ESTIMATE UNLESS YOU FILE A WRITTEN PRAECIPE WITHIN TEN (10) DAYS REQUESTING A TRIAL ON DAMAGES. Cumberland County Lawyer Referral Service Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Telephone:(717) 249-3166 MARTSON LAW OFFICES By Seth T. Mosebey, Esq re Seth T. Mosebey, Esquire I.D. 203046 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, IN THE COURT OF COMMON PLEAS OF Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. WILLIAM M. SHENK, Defendant NO. CIVIL ACTION - LAW JURY TRIAL DEMANDED AFFIDAVIT OF APPRAISER I do depose and state that I am a licensed appraiser; that the appraisal of $8,177.90 attached hereto is true and correct and accurately sets forth the damages to the 2002 PT Cruiser owned by Kevin and Nancy Bender and; that I have been engaged in the appraisal business for years and am qualified and capable to evaluate the appraisal as attached; and the repairs were necessary and the value indicated thereon was the amount by which the damages to this automobile would fairly and reasonably have been evaluated. This statement and appraisal are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides t hot if 1 "'make knowingly false averments, I may be subject to criminal penalties. A I Print DONEGAL INSURANCE GROUP 1195 RIVER ROAD P.O. BOX 302 MARIETTA, PA 17547-0302 (717) 426-1931 FAX: (717) 426-7023 *" ESTIMATE 03131/2008 08:58 AM Owner Owner: KEVIN BENDER Address: 137 SHIPPENSBURG RD Moms/Day: (717)423-6961 Work/Day: (717)477-1377 City State Zip: SHIPPENSBURG, PA 17257 Control information Claim if : PAA-PA-01-08-0031879 Loss Daterrime: 03/2812008 08:00 AM Deductble: $1,000.00 F ile M : Insured Policy # : PAA-0549428 Loss Type: Collision Accounting # : 4338 ins. Company: Donegal Inswance Group Agent: Mary Mathin Address: Email: marymahn(odonegalgroup.com Insured: KEVIN BENDER Address: Claim Rep: Mary Mathin Address: Email: marymathin(odonegalgroup.com Loss Payee: NONE Work/Day: (800)877-06000503 Home/Day: (717)123-8961 WoddDsy: (800)877-0800x7503 Inspection Inspection Date: 03/2812008 03:18 PM Inspection Location: STOUFFER AUTO SERVICE Address: 1270 ORRSTOWN RD City State Zip: SHIPPENSBURG, PA 17257 Primary Impact: Left Front Comer Driveable: No Assigned Datsrrime: First Contact Daterrime: Appraiser Name: JACK CHIARA Address: P.O. BOX 567 City State Zip: NEW CUMBERLAND, PA 17070 Repairer Address: 1270 ORRSTOWN RD City State Zip: SHIPPENSBURG, PA 17257 Target Complete DstefTime: Remarks ALL SUPPLEMENTAL DAMAGE MUST BE APPROVED BY THE APPRAISER --Vehicle inspection Type: Field Contact: Work/Day: (717)532-8425x Secondary Impact: Left Front Side Rental Assisted: Received Date(Tims: 03/2812008 03:18 PM Appointment DetwTime: 031311200808:00 AM Appraiser Lieenee N : 416512 Work/Day: (717)737-5757 FAX: (717)737-7501 WorkiD (717)532-8425 FAX. Days To Repair: 7 i 2002 Chrysler PT Cruiser Touring 4 DR Wagon 71,3 •,*,UCS)' 40 Fln1 Page ' or S 2002 Chrysler PT Cruiser Taut g 4 OR Wagon 03rS12006 09 58 AM Clain A : PAA-PA-01-08-0031879 4cyi Gasoline 2.4 4 Speed Automatic Lic.Plste: GTK-9713 Lie State: PA Lic Expire: VIM: 3CSFY58B82T245526 Prod Date: Mileage: 72,542 Veh Insp* : Mileage Type: Actual Condition: Good Code: M7203B Ext. Color: BLACK Int Color. Ext. Refinish: Two-Stags Int Refinish: Ext. Paint Code: PX6/DX8 Int. Trim Code: Options Air Conditioning Chromed Alloy Wheels Dual Airbags Heated Power Mirrors Lighted Entry System Power Door Locks Privacy Glass Split Folding Rear Seat Tinted Glass Alarm System Compact Disc Player Fog Lights Intermittent Wipers Overhead Console Power Steering Rear Window Defroster Tachometer Velour/Cloth Saab Center Console Cruise Control Front Mud Guards Keyless Entry System Power Brakes Power Windows Rear Window Wiper/Washer Tilt Steering Wheel Damages Line Op Guide MC Description MFR.Part No. Price ADJ%S% How^s R 1 EU 6 46 Bumper Assambly,Front LIKE KIND & QUAL.PRT $450.00` +25.00 1.5 SM » PARTS LOCATED AT TRIPLE NICKLE 717-287-2500 QT 297906 2 N 29 Fri Bumper Cvr Overhau Additional Labor 1.4 SM 3 L 6 13 Cover,Front Bumper Refinish 3.7 RF 2.6 Surface 0.6 Two-stage setup 0.5 Two-stage 4 1 49 Grille Assembly Repair 0.5' SM S L 49 10 Grille Assembly Refinish 0.5' RF 0.3 Surface 0.2 Two-stags 6 RI 49 Grille Assembly R & I Assembly INC SM 7EU 41 48 Headlamp Asay,Halogen LT LIKE KIND & QUAL.PRT $150.00• +25.00 0.3 SM » PARTS LOCATED AT TRIPLE NICKLE 717-267-2500 QT 297905 8 N 973 Headlamps Aim Additional Labor 0.4 SM 9 E 132 Panel,Hdimp Mounting LT 472454GAS $67.50 1.3 SM 10 L 132 Panel,Hdimp Mounting LT Refinish 0.3 RF 0.3 Surface 11 EU 22 Lamp Assembly,Fog LT LIKE KIND & QUAL.PRT $50.00' -25 00 INC SM » PARTS LOCATED AT TRIPLE NICKLE 717-287-2500 QT 297905 12 E 54 Bracket,Front Foglamp LT 5288869AC $11.10 INC SM 13 1 78 07 Reinf,inner Fender LT Repair 2.0' SM 14 L 78 ReinfInner Fender LT Refinish 0.3 RF 0.3 Surface 15 1 SET UP AND MEASURE Repair 2.0• SM 16 N FRONT END ALIGNMENT Additional Labor $49.95' SM 17 EC CAR COVER Replace Economy $5.00• SM 18 EC FLEX Replace Economy $8.00' SM 19EC CORROSION PROTECTION Replace Economy $8 00' SM 20 EC PINSTRIPES - TAPED Replace Economy $12.00' 0 3' SM 21 EC CAULKISEAM SEALER Replace Economy $10.00' SM 22 1 WIRING Repair 2.5' SM' 23 1 COLLISION PULL Repair 2.0' FR' 24 1 113 07 Side Member,Front LT Repair 2.5' SM 25 L 113 Side Nlember,Front LT Refinish 0.3 RF 0.3 Surface 26EU 103 Fender, Front LT LIKE KIND & QUAL.PRT $150.00' -25.00 1.3 SM >> PARTS LOCATED AT TRIPLE NICKLE 717.267-2500 OT 297905 27 L 103 Fender, Front LT Refinish 3.0 RF 2.1 Surface 0.5 Edge 0.4 Two-stage ;?:3) .703 J' 40 FM F'npe 2 of 6 2002 Chrysler PT Cruiser TotmWg 4 OR Wagon Clakn# PAA-PA•01-08-0031878 0131 2 005 0&59 AM 28EU 138 Skirt,lnner Fender LT LIKE KIND & QUAL.PRT INC SM >> INC W/LKQ FENDER 29 E 134 Shield, Front Splash RT 4724804AC $23.20 0.3 SM 30 E 716 Column Assembly,Strg 4690691AC $184.00 2.7 ME 31 L 716 Column Assembly,Strg Refinish 0.7 RF 0.7 Surface 32 E 831 Clock Spring 4671875AS $153.00 INC ME 33 E 838 Cvr,Steering Wheel 4664253AD $163.00 INC ME 34 E 793 01 Airbag,Steering Wheel UV77WLBAC $595.00 INC ME 35 E 865 01 Cover,Pasa Airbag RNS3187AD $118.00 1.8 ME 36 E 963 01 Airbag,lnstrument Prnl 4664252AF $575.00 INC ME 37 E 69001 Seatbelt,Front LT RL2911.8AG $335.00 0.6 SM 38 E 691 01 Seatbelt,Front RT RL2811.8AE $167.00 0.6 SM 39 E 692 01 Budds,Frt SeatbeR LT TR541 L8AC $53.20 0.1 SM 40 E 693 01 Budde,Frt Seatbelt RT TR541 L8AC $53.20 0.1 SM 41 EU 207 Door Assembly,Front LT LIKE KIND & QUAL.PRT $350.00' +25.00 1.7 SM >> PARTS LOCATED AT TRIPLE NICKLE 717-267-2500 QT 297905 42 L 207 Door Shell,Front LT Refinish 3.4 RF 2.0 Surface 1.0 Edge 0.4 Two-stage 43 RI 231 Pnl,inner Door Trim LT R & 1 Assembly INC SM 44 RI 493 MIdg,Front Door Belt LT R & I Assembly 0.3 SM 45 RI 245 Applique,Frt Dbor From LT R & I Assembly 0.4 SM 46 RI 425 MIdg,Front Door Side LT R & I Assembly 0.3 SM 47 E 299 N/Plate, Front Door LT 5303581AA $46.20 0.2 SM 48 RI 229 Mirror,Outer R!C LT R & I Assembly 0.3 SM 49 RI 221 Lodk,Front Door LT R & I Assembly 0.4 SM 50 RI 223 Cyl,Front Door Lock LT R & I Assembly INC SM 51 RI 227 Handle,Front Door Otr LT R & I Assembly INC SM 52 EC MOUNT AND BALANCE Replace Economy $10.00• SM 53 EC VALVE STEM Replace Economy $1.50' SM 54 EC TIRE Replace Economy $110.00' SM Betterment 20 » PARTS LOCATED AT HENDERSON TIRE 717-564-4726 54 Items Mc Message 01 CALL DEALER FOR EXACT PART # ! PRICE 07 STRUCTURAL PART AS IDENTIFIED BY 1-CAR 10 INCLUDES AUDATEX TIME TO CLEAR ENTIRE PANEL 13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE 46 PRINTABLE ALTERNATE PARTS COMPARE Estimate Total & Entries Gross Parts $2,544.40 Other Parts $1.364.45 Paint Materials $244.00 Line Item Markup $287.50 Parts & Material Total $4,440.35 Tax on Parts & Material ® 6.000% $266.42 Labor Rate Replace Mrs Repair Mrs Total Mrs Sheet Metal (SM) $42.00 10.0 11.3 21 3 $894.60 Mech/Elec (ME) $45.00 4.3 4.3 $193,50 Frame (FR) $48.00 2.0 2.0 $96.00 Refinish (RF) $42.00 12.2 112 $512.40 Paint Materials $20.00 Labor Total 39 8 Hours $1.696.50 Tax on Labor 8.000% $101.79 Towing $275.00 Storage $120.00 Gross Total $6,900.06 Less: Deductible $1,000.00- Less: Betterment & Tax $23.32- Net Total $5,876.74 TOTAL LOSS )3, u! 40 !M Fa.)s3of 5 Claim: PAA-PA-01-08- Autosource Valuation 2002 Chrysler PT Cruiser Touring 40 Wagon AS Request: 22236946 0031879 ? arex Autosource Valuation Jack Chiara Donegal Insurance Group Marietta Branch 1195 River Road Marietta PA 17547 Claimant Insured Bender, Kevin Claim PAA-PA-01-08-0031879 Loss Date 03/28/2008 Loss Type Collision Policy PAA-0549428 Other 00 t W,igofi VIN 3C8FY58B82T245526 Decodes as 2002 Chrysler PT Cruiser Touring 4D Wagon Accuracy Decodes Correctly History Activity was reported o Autosource activity: (NONE). c Autotrak activity: (NONE). o Audatex/Estimating activity: Reported on 0311612007, claim number 1555030960D01 (customer information is not available). Loss date is 0311412007. o Sales history activity: (NONE) I Reported Phone Number Analysis 2002 Chrysler PT Cruiser Touring 4D Wagon No Vehicles Advertised at (717) 423-6961 No Vehicles Advertised at (717) 477-1377 wlu,mon Summary 2002 Ch r?sler PT CrUi,?er'ro Wagon uring 40 See N.A.D.A See Valuation Autosource/ Value Section Detail Section N.A.D.A. Bass Price $7,125 $7,435 $7,280 Engine Transmission Odometer 375 20 198 Equipment 0 165 83 Value Before Value Before Condition Adjs& Suggested Total Condition Adj. Version: 1 $7,500 $7,6201 $7,560 155 $7,715 General Sales Tax (p 96 `lo Title Fee r Page: 1 03/31/08 06.03 Claim: PAA-PA-01-08- Autosource Valuation 2002 Chrysler PT Cruiser Touring 4D Wagon AS Request: 22236946 0031879 The market value displayed may not reflect the activity detected by VINSOURCE and/or NICE research. Please contact client services at 1-800-391-3133 for review. Transfer Fee Deductible $-1,000.00 Net Adjusted Value Salvage/Other Detail Vetude Valuation 00 The TYPICAL VEHICLE represents the average mileage, condition, equipment level and estimated selling price of a vehicle of the same year, make, model, doors, edition, body and fuel typo as the LOSS VEHICLE and is representative of the market area. City/State Shippensburg, PA Shippensburg, PA Prtce $7,435 $7,435 Year 2002 2002 Make Chrysler Chrysler Model PT Cruiser PT Cruiser Edition Touring Touring Door 4D 413 Body Wagon Wagon Drive 2WD 2WD Engine 4 Cylinder 2.4 Engine 4 Cylinder 2.4 Engine 0 Transmission 4 Speed Automatic 4 Speed Automatic 0 Color Not Applicable Black Odometer 73,150 MI(Typical) 72,542 Mi(Actual) 20 Convenience Options Air Conditioning Air Conditioning Tilt Steering Wheel TiR Steering Wheel Cruise Control Cruise Control Rear Window Defroster Rear Window Defroster Other Optional Equipment Tinted Glass Tinted Glass Center Console Center Console Fog Lights Fog Lights Intermittent Wipers Intermittent Wipers Keyless Entry System Keyless Entry System Lighted Entry System Lighted Entry System Overhead Console Overhead Console Rear Window Wiper/Washer Rear Window Wiper/Washer Dual Airbags Dual Airbags Tachometer Tachometer Privacy Glass Privacy Glass Power Accessories Heated Power Mirrors Heated Power Mirrors Power Windows Power Windows Power Steering Power Steering Power Door Locks Power Door Locks Power Brakes Power Brakes RadWPhone/Alarm Options Compact Disc Player Compact Disc Player Version: 1 Page: 2 03131/08 06:03 Claim: PAA-PA-01-08- Autosou" Valuation 2002 Chrysler PT Cruiser Touring 4D Wagon AS Request: 22236946 0031879 Alarm System Alarm System Seat Options Split Folding Rear Seat Split Folding Rear Seat Velour/Cloth Seats Velour/Cloth Seats Wheel Options Aluminum/Alloy Wheels Chromed Alloy Wheels 165 Autosource Value Before Condition Adjustments 7,620 Seats Minor Wear Good 120 Carpets Minor Wear Good 30 int Trim Minor Damage Good 45 Glass Good Good Headliner Good Good Body Minor Damage Minor Damage Paint Minor Wear Minor Wear Ext Trim Good Minor Damage -40 Engine Minor Wear Minor Wear Transmission Minor Wear Minor Wear Front Tires Good Good Rear Tires Good Good Total Condition Adjustments 155 r $7,775 General Sales Tax ` 6.000% 468.50 Title Fee 4 The market value displayed msY not Transfer Fee; reflect the activity detected by VINSOURCE andlor NICE research. Deductible -1,000.00 Net Adjusted V21ue ....................... . .. .. . ... Salvage/Other ° - ` The market area identified has multiple tax jurlsdictlons. Piease see valuation notes for explanation. AD A Value- r D Wagon *`N.A.D.A. Vehicle Description: 2002 CHRY PT Cruiser-4 Co. Wagon 4D Touring N.A.D.A. values are as of March, 2008 from the Eastern Edition. Bass Value $7,125 Mechanical Engine $0 Transmission $0 Equipment Aluminum/Alloy Wheels Included Equipment Subtotal $0 Mileage: 72,542 Mi $375 Version: 1 Page: 3 03/31/08 06:03 Claim: PAA-PA-01-08- Autosource Valuation 2002 Chrysler PT Cruiser Touring 413 Wagon AS Request: 22236946 0031879 $7,500 These current N.A.D.A. values are furnished under license from NADASC. All values Copyright Cd NADASC 2008. The values in the N.A.D.A. guide assume a vehicle In clean condition. Appropriate deductions should be made to put a vehicle in salable condition. Special Note on Older Vehicles: N.A.D.A.'s editors believe that most optional equipment has little or no value on older vehicles. This is especially true: of options that cost relatively little to begin with and which deteriorate with age or use. Valuation Notes rr o Adjustments of Special Note " No special adjustments were made for this vehicle. o Information provided by Donegal Insurance Group d Loss vehicle description was provided by Donegal Insurance Group All values are in U.S. dollars. o Autoscurce Valuation Process tl Over 2,400,000 vehicles are entered weekly into the database used for researching this value. This database Includes dealer inspected, dealer Inventory, dealer advertised, phone verified and advertised private party vehicles. The originating search area for this valuation was Shippensburg, Pennsylvania. The market area identifled has multiple tax jurisdictions. Autosouroe was unable to Identify which county or city was applicable to the total loss vehicle. However, special tax calculation rules apply to vehicle sales in this jurisdiction (such as limits, caps, exemptions, etc.) and Autosource was able to correctly establish the tax amount of $467 o Other Adjustments or Comments A mileage adjustment of 3.54 cents per mile/kilometer has been applied. This adjustment is based on the vehicle year, vehicle category and market area. Mileage adjustments are capped at 40% of the vehicle's starting value. Engirm Options " 4 Cylinder 2.4 Engine Other Optional Equipment Anti-lock Brakes Special Factory Paint Center Console Dual Airbags Fog Lights Intermittent Wipers Keyless Entry System Lighted Entry System Overhead Console Privacy Glass Roof/Luggage Rack Rear Window Wiper/Washer Side Airbags Tachometer Traction Control System Tinted Glass Woodgrain Applique Wheel Options Aluminum/Alloy Wheels Version: 1 Transmission Options STD 5 Speed Manual STD ` 4 Speed Automatic $825 Power Accessories $600 Heated Power Mirrors STD $200 Power Drivers Seat $100 STD Power Brakes STD STD Power Door Locks STD STD Power Steering STD STD Power !Mndows STD STD Convenience Options STD ' Air Conditioning STD STD • Cruise Control $235 STD ' Rear Window Defroster STD $175 ' Tilt Steering Wheel STD STD Radio/Phone/Alarm Options $350 ' Alarm System STD STD " Compact Disc Player STD Compact Disc W/Tape $100 STD Seat Options $895 • Split Folding Rear Seat STD " Velour/Cloth Seats STD STD Roof Options Page: 4 03(31 t08 06:03 George B. Faller, Jr., Esquire I.D. 49813 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, IN THE COURT OF COMMON PLEAS OF Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. WILLIAM M. SHENK, Defendant NO. 08-4994 CIVIL TERM CIVIL ACTION - LAW JURY TRIAL DEMANDED AFFIDAVIT AS TO MILITARY SERVICE COMMONWEALTH OF PENNSYLVANIA ) :SS. COUNTY OF CUMBERLAND George B. Faller, Jr., Esquire, being duly sworn according to law, deposes and says that he has authority to make this affidavit on behalf of his client, and to the best of his knowledge, information and belief, the Defendant above named is not in the military service of the United States of America, that he has knowledge that the said Defendant is now living at: 109 Turnpike Road, Newburg, Pennsylvania 17240. Said Defendant's place Sworn to and subscribed before me this day of 20 (C . a iy\ Notary Public COMMONWEALTH OF PENNSYLVANIA Nmriw seal MellSSA A, 5001ty, Notary PUNIC Cadiste eom, Cumbwdand County CommIalon Explt+kc Jan. 19, 2014 McMbrlr; Pfnrl YIVAnW At"aIlOn or Notaries is unknown. George B. Faller, JV, Esquire George B. Faller, Jr., Esquire I.D. 49813 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiffs KEVIN BENDER and NANCY BENDER, IN THE COURT OF COMMON PLEAS OF Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 08-4994 CIVIL TERM CIVIL ACTION - LAW WILLIAM M. SHENK, Defendant JURY TRIAL DEMANDED AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS George B. Faller, Jr., Esquire, being duly sworn according to law, deposes and says that he is an employee of MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, attorneys for the Plaintiffs in the above-captioned matter and that pursuant to the provisions of the Pennsylvania Rules of Civil Procedure, a notice of intention to enter default judgment against the Defendant was given to him by mail on February 24, 20091 11 ' ?. George B. F er, Jr., Esquire Sworn to and subscribed before me this day of j"O(_, 20 V). 1 Notary Public COMNIGNWEALrM OF PENNSYLVANIA Notarial S Notary eal Public Melissa A. W1011Y, Carlisle goro, Curn? an. 19, County My Commission E)O 2014 anla Association of Notaries Member, Penns/h+ CERTIFICATE OF SERVICE I, Melissa A. Scholly, an authorized agent of MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, hereby certify that a copy of the foregoing Praecipe was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: Mr. William M. Shenk 109 Turnpike Road Newburg, PA 17240 MARTSON LAW OFFICES B ?- ?-? 'V f?' Grbc' 0 - 1-k("-(C (' , - y Meliss A. Scholly Ten East High Street Carlisle, PA 17013 (717) 243-3341 Dated: May 3, 2010