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HomeMy WebLinkAbout09-7564PAUL F. D'EMILIO, ESQUIRE ATTORNEY I.D. #16654 M. SCHOFIELD, JR., ESQUIRE A?Ul- TORNEY I.D. #81894 905 W. SPROUL ROAD, SUITE 105 SPRINGFIELD, PA 19064 (610) 338-0338 THIS IS AN ARBITRATION MATTER ATTORNEY FOR PLAINTIFF STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY AS SUBROGEE OF KEVIN L. KAUFFMAN . 112 E. WASHINGTON STREET DTB 8 BLOOMINGTON, IL 61701 VS. BENAKA INC. 7 LAWRENCE STREET NEW BRUNSWICK, NJ 08901 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 MAY BE ENTERED AGAINST YOU BY THE COURT WITHOUT FURTHER NOTICE FOR ANY MONEY CLAIMED IN THE COMPLAINT OR FOR ANY OTHER CLAIM OR RELIEF REQUESTED BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER„ 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 ELIGit3LE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 S. Bedford Street Carlisle, PA 17013 (717) 249-3166 (800) 990-9108 COMMON PLEAS COURT OF CUMBERLAND COUNTY NO. N -'7-%4 04-vil-Em CIVIL ACTION "ISO LE HAN DEMANDADO A LISTED EN LA CORTE. SI USTED QUIERE DEFENDERSE DE ESTAS DEMANDAS EXPUESTAS EN LAS PAGINAS SIGUIENTES, USTED TIENE (20) DIAS DE PLAZO A PARTIR DE LA FECHA DE LA DEMANDA Y LA NOTIFICACION. LISTED DEBE PRESENTAR UNA APARIENCIA ESCRITA 0 EN PERSONA 0 POR ABOGADO Y ARCHIVAR EN LA CORTE SUS DEFENSAS 0 SUS OBJECIONES A LAS DEMANDAS ENCONTRA DE SU PERSONA. SEA AVISADO QUE SI USTED NO SE DEFIENDE, LA CORTE TOMARA MEDIDAS Y PUEDE ENTRAR UNA ORDEN CONTRA LISTED SIN PREVIO AVISO 0 NOTIFICACION 0 POR CUALQIER QUEJA 0 ALIVIO QUE ESPEDIDO EN LA PETICION DE DEMANDA. USTED PUEDE PERDER DINERO, SUS PROPIEDADES 0 OTROS DERECHOS IMPORTANTES PARA USTED. LLEVE ESTA DEMANDA A UN ABOGADO INMEDIATAMENTE. SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE PARA PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITAABAJO PARAAVERIGUAR DONDE LISTED PUEDE CONSEGUIR ASISTENCIA LEGAL. Cumberland County Bar Association 32 S. Bedford Street Carlisle, PA 17013 (717) 249-3166 (800) 990-9108 PAUL F. D'EMILIO, ESQUIRE ATTORNEY I. D. #16654 PAUL M. SCHOFIELD, JR., ESQUIRE ATTORNEY I.D. #81894 905 W. SPROUL ROAD, SUITE 105 SPRINGFIELD, PA 19064 (610) 338-0338 THIS IS AN ARBITRATION MATTER ATTORNEY FOR PLAINTIFF STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY AS SUBROGEE OF KEVIN L. KAUFFMAN 112 E. WASHINGTON STREET DTB 8 BLOOMINGTON, IL 61701 VS. COMMON PLEAS COURT OF CUMBERLAND COUNTY NO. D 9- 75G ?Pu? ??"?` BENAKA INC. 7 LAWRENCE STREET CIVIL ACTION NEW BRUNSWICK. NJ 08901 NOTICE UNDER THE FAIR DEBT COLLECTION PRACTICES ACT, 15 U.S.C. §1601 (AS AMENDED) THE PENNSYLVANIA UNFAIR TRADE PRACTICES ACT AND CONSUMER PROTECTION LAW, 73 PA.CON.STAT.ANN. §201, ET. SEQ. ("THE ACTS") IN AS MUCH AS THE ACTS MAY APPLY, PLEASE BE ADVISED THAT THIS COMMUNICATION IS FROM A DEBT COLLECTOR. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. COMPLAINT The Plaintiff, State Farm Mutual Automobile Insurance Company, by its attorney Paul F. D'Emilio, Esquire, bring this action upon a cause whereof the following is a statement: 1. The Plaintiff, State Farm Mutual Automobile Insurance Company, ("Plaintiff') is a Corporation authorized to do business in the Commonwealth of Pennsylvania, with a address of 112 E. Washington Street, DTB 8, Bloomington, IL 61701. Plaintiff brings this action as subrogee of Kevin L. Kauffman, ("Insured") under a policy of insurance issued by Plaintiff. 2. Defendant, Benaka Inc. is a corporation, organized and existing under the laws of New Jersey, with its principal place of business at 7 Lawrence Street, New Brunswick, NJ 08901. 3. At all times hereinafter mentioned Defendant acted through their agents, servants, workmen and employees them and there engaged in the business of the Defendant within the course and scope of their employment. 4. On or about April 24, 2009, Defendant's agents, servants, workmen and employees were working on a roof and spraying adhesive at the Navy Base North End of Building 313, Mechanicsburg, Pennsylvania when they over sprayed causing damages to Plaintiffs Insured's vehicle and causing damages hereinafter set forth. 5. Plaintiff avers that the personal property of the Insured was damaged as a result of the occurrence hereinbefore mentioned, the reasonable costs of repairs thereto being is Seven Thousand Forty Eight and 32/100 ($7,048.32) Dollars plus the cost of a rental vehicle being Six Hundred and 00/100 ($600.00) Dollars for a total of Seven Thousand Six Hundred Forty Eight and 32/100 ($7,648.32) Dollars. A true and correct copy of the estimate and rental bill is attached hereto, made part hereof and marked Exhibit "A." 6. The occurrence referred to above, damage and loss of Insured were the result of negligence, carelessness and/or the negligent acts or omissions of Defendant and its agents, servants, workmen, and/or employees. Said negligence included without limitation are the following: a. Carelessly and negligently failed to follow the appropriate steps to contain any over-spray; b. Carelessly and negligently failed to properly protect vehicles from over- pray; C. Carelessly and negligently failed to expose vehicles of hazards associated with said adhesive; and d. Otherwise failed to use due care under the circumstances. WHEREFORE, Plaintiff demands judgment against the Defendants upon each count in an amount not in excess of Fifty Thousand and 00/100 ($50,000.00) dollars together with costs of suit. Paul F. D'Emilio, Esquire Identification No.: 16654 e-mail address: pauld@demiliolaw.com /" ral M. Schofield, Jr., Esquire Identification No.: 81894 e-mail address: pauls@demiliolaw.com 905 W. Sproul Road, Suite 105 Springfield, PA 19064 Telephone No.: 610-338-0338 Fax No.: 610-338-0303 10/12/2009 MON B-25 FAX 610 338 0303 Law Off. Of Paul D' Emilio 14006/007 VERIFICATION , Subrogation Representative with-State-Farm Mutual Automobile Insurance Company in the above captioned matter verifies that the facts contained in the foregoing Complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. DATE: /D -) 0 Dq 07/06/2009 AT 11:18 AM JOB NUMBER: 3078 34360 MAJOR'S SELECT COLLISION CENTERS FEDERAL ID #:251871655 QUALITY COLLIISSIOON REPPAAIRDAND REFINISHING MECHANICSBURG, PA 17055 (717)766-4461 FAX: (717)766-4194 SUPPLEMENT OF RECORD 2 WITH SUMMARY WRITTEN BY: LEE CADWALLADER #180979 07/06/2009 11:15 AM ADJUSTER: CAITLIN RODGERS INSURED: KEVIN KAUFFMAN CLAIM #38-L696-27101 OWNER: KEVIN KAUFFMAN POLICY # ADDRESS: 2223 BRIGADE RD DEDUCTIBLE: ENOLA, PA 17025-1471 DATE TE OF LOSS: COMPREHENSIVE 12:00 AM EVENING: (717)805-2487 POINT OF IMPACT: DAY: (717)605-7821 INSPECT MAJOR'S SELECT COLLISION CENTERS BUSINESS: (717)766-4461 LOCATION: 269 MULBERRY DRIVE MECHANICSBURG, PA 17055 INSURANCE STATE FARM INSURANCE COMPANIES DAYS TO REPAIR COMPANY: ONE STATE FARM DRIVE CONCORDVILLE, PA 19339 VEHICLE DROP OFF PROMISE DATE:06/22/20095/26/REPAIR COMPLETION START DATED06/26/20092009 VEHICLE PICK UP/RETURN DATE:06/26/2009 Exhibit "A" 07/06/2009 AT 11:18 AM JOB NUMBER: 3078 34360 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-FI 2D CNVT BLUE INT:TAN ___ _______ __________ ___________ NO. OP. DESCRIPTION ------------- _........... _________ QTY EXT. ......... _____________ PRICE LABOR ........... _________ PAINT -- ---- 4 ----- S01 ------ - FRONT BUMPER 0 3 0 5 S01 REPL ADD FOR H'LAMP WASHER 1 5* 2.8 N 6* S02 RPR BUMPER COVER W/HEADLAMP WASHER . 1 1 7 S01 ADD FOR CLEAR COAT . 8 Sol G 3 3 9 SOl BUMPER ASSY O/H L . * 10* S01 R&I GRILLE . INC 11 SOl FRONT LAMPS 0 3* 12* S01 R&I RT HEADLAMP ASSY . 3* 0 13* S01 R&I LT HEADLAMP ASSY . 1* 0 0.2 14* S01 RPR RT WASHER NOZZLE DARK BLUE . * 2 0 15* S01 REP. LT WASHER NOZZLE DARK BLUE 0.1 . 16 SOl HOOD 2,p+ 3.2 N 17* S02 RPR HOOD 1 0 18 S01 R&I SEAL AIR INTAKE DUCT . 0 3 19 SOl R&I FRONT MOLDING . 20 S01 FENDER 1.0* 2.2 N 21* S02 RPR RT FENDER -0 4 22 S01 OVERLAP MAJOR ADJ. PANEL 1 0* 2 2 N 23* S02 RPR LT FENDER -0 4 24 S01 OVERLAP MAJOR ADJ. PANEL 25 S01 R&I RT FENDER LINER INCL 26 S01 R&I LT FENDER LINER INCL. 27 S01 WINDSHIELD 0 4 28 S02 REPL GLASS LEXUS 3 1 877 . .62 29* S02 SUBL GLASS LEXUS 3 1 .75* INCL. 30 SOl R&I RT SIDE MOLDING INCL 31 SOl R&I LT SIDE MOLDING INCL 32 Sol R&I UPPER MOLDING . 3 0 33 S01 R&I RT WASHER NOZZLE DARK BLUE . 3 0 34 S01 R&I LT WASHER NOZZLE DARK BLUE . 35 S02 ELECTRICAL 1 148 5 00* M 0 36* S02 REPL BATTERY . . 37 SOl ROOF 4 0 38 S01 R&I HEADLINER ECRU . 39 SOl REPL RT CORNER TRIM 1 23 .55 40 S01 RETRACTABLE TOP 0 3 41 SOl R&I REAR HEADER . 4 0 42 S01 R&I RT UPPER QTR TRIM . 0 4 43 S01 R&I LT UPPER QTR TRIM . 44 S01 R&I RT SIDE TRIM FRONT 0.3 3 0 45 S01 R&I LT SIDE TRIM FRONT . 46* S01 SUBL BACK GLASS LEXUS 1 93 .75* 47 S01 PILLARS, ROCKER & FLOOR 1 0* 1 3 N 48* S02 RPR RT ROCKER MOLDING DARK BLUE . * . 1 3 N 49* S02 RPR LT ROCKER MOLDING DARK BLUE 1.0 . 50 S01 R&I RT ROCKER MOLDING DARK BLUE 0.5 51 SOl R&I LT ROCKER MOLDING DARK BLUE 0.5 2002 LEXU SC 430 8-4.3L-Fl 2D CNVT BLUE INT:TAN PA PROD DATE : 04/2002 ODOMETER: 52802 VIN: JTHFN48Y620029520 LIC AUTOMATIC TRANSMISSION : GBL6962 OVERDRIVE TRACTION CONTROL POWER DRIVER SEAT POWER PASSENGER SEAT BUCKET SEATS POWER STEERING LEATHER SEATS HEATED SEATS TELESCOPIC WHEEL STEERING WHEEL CONTROLS TILT WHEEL POWER BRAKES 4 WHEEL DISC BRAKES ANTI-LOCK BRAKES (4) REAR DEFOGGER POWER WINDOWS ALUMINUM/ALLOY WHEELS AM RADIO FM RADIO STEREO CD CHANGER/STALKER SEARCH/SEEK CD PLAYER POWER TRUNK/TAILGATE AIR CONDITIONING POWER LOCKS CRUISE CONTROL DRIVER AIR BAG PASSENGER AIR BAG FRONT SIDE IMPACT AIR BAG CONSOLS/STORAGE WOOD INTERIOR TRIM POWER MIRRORS KEYLESS REONTRY CLEAR COAT PAINT FOG LAMPS _________ ____ ___________________________ __________________________ NO. OP. _____________ DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------- 1# SOl ATTEMPTED REPAIRES CLAY BAR, 1 8.0 WET SAND, AND BUFF N 2# REFINISHING SUPPLYS 1 45.00 0 3 3# PRE WASH . 07/06/2009 AT 11:18 AM 34360 JOB NUMBER: 3078 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-FI 2D CNVT BLUE INT:TAN __ _____ NO. __ OP. __________ ________ DESCRIPTION __ __________________ QTY EXT. _PRICE_LABOR .. ________________ _________ . PAINT _____ _ ____ 52* SOl _____ R&I __________________ RT W/S PILLAR TRIM INCL. 53 S01 R&I LT W/S PILLAR TRIM INCL. 54 S01 DOOR 1 0* 2.1 N 55* S02 RPR RT DOOR SHELL . - 0 4 4 56 SOS OVERLAP MAJOR ADJ. PANEL * N 57* S02 RPR IT DOOR SHELL 1.0 2. 4 -0 58 SOl OVERLAP MAJOR ADJ. PANEL * . 59* S01 R&I RT ACCESS COVER 0.1 1* 0 60* S01 R&I IT ACCESS COVER . 0 3 61 SOl R&I RT MIRROR FILLER . 3 0 62 S01 63 S01 R&I REPL LT MIRROR FILLER RT BELT W'STRIP 1 89.66 . 0.3 64 S01 REPL LT BELT W'STRIP 1 89.66 0.3 5* 0 1 0 N 65* S02 RPR RT MIRROR ASSY DARK BLUE . 5* 0 . 0 1 N 66* S02 RPR LT MIRROR ASSY DARK BLUE . 5 0 . 67 S01 R&I RT R&I OUTSIDE HANDLE . 68 SOl R&I LT R&I OUTSIDE HANDLE 0.5 69 S01 R&I RT R&I TRIM PANEL 0.5 70 S01 R&I LT R&I TRIM PANEL 0.5 71* S02 R&I RT REAR COVER DARK BLUE 0.5* 72 S02 REFN RT REAR COVER DARK BLUE 0.5 73 S02 OVERLAP MINOR PANEL -0.2 74* S02 R&I LT REAR COVER DARK BLUE 0.5* 0 5 75 S02 REFN LT REAR COVER DARK BLUE . 76 S02 OVERLAP MINOR PANEL -0.2 77 S0l QUARTER PANEL 5* 1 2.5 N 78* S02 RPR RT QUARTER PANEL . 4 -0 79 S01 OVERLAP MAJOR ADJ. PANEL 1 5* . 2 5 N 80* S02 RPR LT QUARTER PANEL . . 4 -0 81 SOl OVERLAP MAJOR ADJ. PANEL . 82 S01 R&I RT WEATHERSTRIP 0.2 2 0 83 SOl R&I IT WEATHERSTRIP . 0 5 84 S01 R&I FUEL DOOR . 0.2* 0.3 N 85* S02 RPR FUEL DOOR ' 1 49 45 0.2 86 SOl STRIP REPL RT BELT W ' . 45 1 49 0.2 87 S01 88 SOl REEL STRIP LT BELT W REAR BODY & FLOOR . 5 0 89 S01 R&I PACKAGE TRAY BLACK . 0 3 90 S01 R&I UNDER COVER . 1 0 91 S01 R&I RT COVER EXTN BLACK . 0 1 92 SOl R&I LT COVER EXTN BLACK . 93 SOl R&I FRONT TRIM 0.3 1 0 94 SOl R&I RT SIDE TRIM . 1 0 95 S01 R&I LT SIDE TRIM . 2 4 96 S01 O/H BUMPER ASSY . INCL 97 S01 R&I REAR PANEL TRIM . 1 0 98 S01 R&I RT SIDE COVER . 1 0 99 S01 R&I LT SIDE COVER . 07/06/2009 AT 11:18 AM JOB NUMBER: 3078 34360 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 B-4.3L-FI 2D CNVT BLUE INT:TAN __________ __________ ESCRIPTION _ __________________ LABOR PRICE QTY EXT. _________ PAINT NO. OP. D ------ _ - ________---- .. _ - ----- ... . _____ ----------- 100 S01 ----- R&I ------------------------- RT SIDE TRIM PANEL INCL. INCL 101 S01 R&I LT SIDE TRIM PANEL . 2 0 102 S01 R&I COVER TOOL BOX . 2 0 103 S01 R&I REAR COVER W/RUN FLAT TIRES . INCL. 104 S01 R&I REAR SILL PLATE 0.1 105 S01 R&I JACK ASSY 1 3 0 106# SO1 D&R REAR BODY WIRING . 107 Sol TRUNK LID 1 61.11 0.2 108 Sol REPL EMBLEM 1 5* 2 4 N 109* S02 RPR TRUNK LID W/O SPOILER -0 4 110 Sol OVERLAP MAJOR ADJ. PANEL 5 0 . 111# Sol REMOVE OLD ADHESIVE TAPE ON 1 . 112 S01 REPL DECK LID NAMEPLATE "LEXUS" 1 28.73 0.2 113 S01 REPL NAMEPLATE "SC" 1 19.17 0.2 2 0 114 S01 REPL NAMEPLATE "430" 1 22.10 . 0 1 115 S01 R&I SPOILER DARK BLUE . 5* 0 1.2 N 116* S02 RPR SPOILER DARK BLUE 1 . 0.3 117# S01 CLEAN AND RETAPE SPOILER 4 0 118 S01 R&I TRUNK LID TRIM . 119 Sol REAR LAMPS 0.3 120 S01 R&I RT TAIL LAMP 0.3 121 Sol R&I IT TAIL LAMP INCL. 122 Sol R&I RT BACKUP LAMP INCL. 123 Sol R&I IT BACKUP LAMP INCL 124 S01 R&I RT LICENSE LAMP . INCL 125 S01 R&I IT LICENSE LAMP . 5 0 126 S01 R&I HIGH MOUNT LAMP BEIGE 0 2x . 0.3 N 127* S02 RPR HIGH MOUNT LAMP BEIGE , 2 5 128 S01 CLEAR COAT 129 Sol REAR BUMPER 1 5* 3.0 N 130* S02 RPR BUMPER COVER . 1 2 131 S01 ADD FOR CLEAR COAT 132# S02 WASH AND VACUUM 1 00 1 8 133# S02 FLEX AGENT . 4 4 7 56 N 134# S02 REPL PUSH CLIPS . 1.5 135# S02 DENIB 136# S02 AUTHORIZATION TO SECURE FINAL ______ 1 _____ __ ___ _ _________ SUBTOTALS 1702.56 55.2 35.9 LINE 2 SUPPLYS INCLUDS CLAY BAR, BUFFING COMPOUND, SWIRL REMOVER, GLAZE. LINE 6 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 17 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 21 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 23 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 48 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 49 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL 07/06/2009 AT 11:18 AM JOB NUMBER: 3078 34360 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-FI 2D CNVT BLUE INT:TAN ANY PERSON WGLICATION FOR INSURANCE OR STATEMENTT OFCCLAIMPANY OR PURPOSE OF CONTAINING OR PERSON FILES AN APP AINFORMATION MATERIALLY CONCERNING INFORMATION ANY FACT MATERIAL LT THERETO T COMMITS A MISLEADING, FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND CIVIL PENALTIES. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO IDED DESCRIBE D-DIAGNOSTIC R EELECTCRDCD-ADF FSCRAME =APPROXIMATE E PRDONE ICE BR BODY PARTS LABOR BE REPAIRED PART A G=GLASS M=MECHANICAL P:PAINT LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED LINE ILON QUAL RECYNQUALJITYNRECYCLED PARTL QUAL OP-OPERATION REPQUALITY NUMBER QTY=QUANTITY REPLACEMENT PART COP REPL PARTS=COMPETITIVE REPLACEMENT PARTS RECOD=RECONDITION REFN=REFINISH REPL-REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT W/_ WITH/ . -=DATALINE BASE ENTRY WITH AFTEIRMARKET DATABASE INFORMATION WAS "h] TO LINE NAGS=NATIONAL IONAL AUTO GLASS SPECIFICATIONS. MQVP=MANUFACTURER'S QUALITY PARTS EITHER AND OPTIONALLY TI SOURCED OR OTHERWISE OEM=ORIGINAL PROVDEED WITH EQUIPMENT SOME EU UNIQUE PRICING OR DISCOUNT. NWCPP=NATIONWIDE CRASH PARTS PROGRAM. E THE ATTACHED STE VEHICCLE NOTED AT APPRAISAL THE TIME F OFH INSPECTION NECESSARY TO VISIBLE DAMAGE TO TH PRAISED RETURN THE OUNT MAY BE VEHICLE THE RESTO ITS PONSIBILITYA OF D THCONDITION. COST E VEHICLE OWNERS ABOVE THERE THE IS NO REQUIREMENT THAT THE VEHICLE OWNER USE ANY SPECIFIED REPAIR SHOP. INFORMATION AM REGARDING REPAIR FACILITIES RICH WILL BE ABLE TO REPAIR THE VEHICLE FOR THE APPRAISED SPECIFIED, THEY AMOUNT ARIS AVAILABLE E REQUIREDD TO R BE OF E LIINSURANCE KE KIND USED PARTS BEINGS REPLACED. INCIDENTAL CHARGES SUCH AS TOWING, PROTECTIVE CARE, CUSTODY, STORAGE, DEPRECIATION, BATTERY AND TIRE REPLACEMENT ARE NOTED WHEN APPLICABLE. 07/06/2009 AT 11:18 AM 34360 JOB NUMBER: 3078 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-FI 2D CNVT BLUE INT:TAN LINE 55 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 57 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 65 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 66 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 78 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 80 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 85 RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 109: RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LIE 116: RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 127: RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE EAN COAL LINE 130: RPR TIME IS NEEDED TO REMOVE ETCHING MARK LEFT IN THE CLEAN COAL LINE 134: IN HOUSE KENT ESTIMATE NOTES: CUSTOMER DROPD OFF 5/26 FOR US TO DO SOME TESTS ON AND THEN START REPAIRS WET CLAYBAR DANSAND AND BUFF DONE D BUFFED CLEAR STILL PRINTED HAD DAN COONS F LOBUT CLEAR OK AT ANDREEED CHECKED MIL THICKNESS TOO THIN ON CLEAR NEEDS REPAINTED PARTS BODY LABOR 55.2 MRS ®$ 44.00/HR 1702. 2428. 56 80 LA PAINT BOR 35.9 MRS 44 .00/HR 1 SUPPLIES PAINT 39.1 RS __ ®$ _ _ _ 24.00/HR ___ 938. _____ 40 __ __________________ SUBTOTAL ________ _ _ _ $ 6649. 36 SALES TAX $ 6649. _______ 36 ___ 0 6.0000& __ 398. _____ 96 __ __________________ GRAND TOTAL ______ $ 7048. 32 ADJUSTMENTS: 0 00 DEDUCTIBLE -- --- ---------- ------ . -- ------------------ CUSTOMER PAY ----------- $ $ 0 7048 .00 32 INSURANCE PAY . *xxxxx -x WARRANTY>*xx*x***** MAJOR'S BODY SHOP, INC. AGREES TO PERFORM REPAIRS TO YOUR VEHICLE THAT SERVE TO RESTORE THE DAMAGED AREAS TO PRE-ACCIDENT CONDITION IN TERMS OF SAFETY, FUNCTION AND APPEARANCE. THIS LIMITED LIFETIME WARRANTY IS FOR AS LONG AS YOU OWN YOUR CAR. OTHER PARTS AND YOUR WILLSUPPLMATCHIER OURIPAINTYSYSTEMRHA ISNAAELIFETIMESWARRRAONTY. GASKAFOREFUR ERPAINT DETAILS. THIS IS AN ESTIMATE ONLY. ADDITIONAL DAMAGE MAY BE FOUND ONCE REPAIRS ARE STARTED. SHOP MUST NOTIFY OWNER OF ADDITIONAL PARTS OR LABOR REQUIRED. IT IS PARTS, RESPONSIBILITY THE INCN INCREASES I AND LABOR. SHOP VEHICLE IS OWNER OT RESPONSIBLE FORTADDITIONALL COSPARTS PRICE . 07/06/2009 AT 11:18 AM 34360 JOB NUMBER: 3078 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-Fl 2D CNVT BLUE INT:TAN ITEMS ARE DERIVED FROM RTHEAGUIDE ESTIMATING GUIDE. 000 DATA DATE 06/01/2009, AND THE PARTS SELECTED ARE OEM-PARTS MANUFACTURED BY THE VEHICLES ORIGINAL EQUIPMENT MANUFACTURER. OEM PARTS ARE AVAILABLE AT OE/VEHICLE DEALERSHIPS. OPT OEM (OPTIONAL OEM) OR ALT OEM (ALTERNATIVE OEM) PARTS ARE OEM PARTS THAT MAY BE PROVIDED BY OR TROUGH ALTERNATE SOURCES OTHER THAN THE OEM VEHICLE DEALERSHIPS. OPT OEM OR ALT OEM PARTS MAY REFLECT SOME SPECIFIC, SPECIAL, OR UNIQUE PRICING OR DISCOUNT. OPT OEM OR ALT OEM PARTS MAY INCLUDE "BLEMISHED" AND/OR S LABOR ASTERISK THE L PARTSDEALERSHIPS. PARTS PROVIDED O**D) S INDTHROUGH OEM ICATES THATVEHICLE R INFORMATION DOUBLE ASTERISK ( PROVIDED BY MOTOR MAY HAVE BEEN MODIFIED OR MAY HAVE COME FROM AN ALTERNATE DATA SOURCE. TILDE SIGN (-) ITEMS INDICATE MOTOR NOT-INCLUDED LABOR OPERATIONS. NON-ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET PARTS ARE DESCRIBED AS AM, QUAL REPL PARTS OR COMP REPL PARTS WHICH STANDS FOR COMPETITIVE REPLACEMENT PARTS. USED PARTS ARE DESCRIBED AS LKQ, QUAL RECY PARTS, RCY, OR USED. RECONDITIONED PARTS ARE DESCRIBED AS RECOND. RECORED PARTS ARE DESCRIBED AS RECORE. NAGS PART NUMBERS AND BENCHMARK PRICES ARE PROVIDED BY NATIONAL AUTO GLASS SPECIFICATIONS. LABOR OPERATION TIMES LISTED ON THE LIE WITH THE NAGS INFORMATION ARE MOTOR SUGGESTED LABOR OPERATION TIES. NAGS LABOR OPERATION TIMES ARE NOT INCLUDED. POUND SIGN (#) ITEMS INDICATE MANUAL ENTRIES. SOME 2009 VEHICLES CONTAIN MINOR CHANGES FROM THE PREVIOUS YEAR. FOR THOSE VEHICLES, PRIOR TO RECEIVING UPDATED DATA FROM THE VEHICLE MANUFACTURER, LABOR AND PARTS DATA FROM THE PREVIOUS YEAR MAY BE USED. THE PATHWAYS ESTIMATOR HAS A COMPLETE LIST OF APPLICABLE VEHICLES. PARTS NUMBERS AND PRICES SHOULD BE CONFIRMED WITH THE LOCAL DEALERSHIP. CCC PATHWAYS - A PRODUCT OF CCC INFORMATION SERVICES INC. 07/06/2009 AT 11:18 AM JOB NUMBER: 3078 34360 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-Fl 2D CNVT BLUE INT:TAN DEFRA ANY WHO NSURAN O EREPERSON FILESWANGAPPLICATION FORDINSURANCE OR S AT IEMENT OFCCLAIMPANY OR INFORMATIN MATERIALLY CON CONCERNING ANY FACT MATfi IAL THERETO COMMITS AE OF MMIISLAEADING, ANY FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON O CRIMINAL AND CIVIL PENALTIES. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIBE WORK TO BE DONE OR PARTS O BE REPAIRED OR REPLACD:D=DISCONTINUED PART A=APPROXIMATE PRICE B=BODY LABOR D=DIAGNOSTIC E-ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT INCL=I MISCEST=ESTIMA.MISCETLLANEOUSE EXT. OP OPERATION NONLIMEED REPLACEMENT Q PART I COMP U REPLE PARTS=COMPETITIVE REPLACEMENT PARTS QUALITY RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT W/ WITH/ #=MANUAL LINE ENTRY --OTHER [IE..MOTORS DATABASE INFORMATION WAS CHANG$DI. —-DATABASE LINE WITH AFTERMARKET N=NOTES ATTACHED O LINE NAGS-NATIONAL AUTO GLASS SPECIFICATIONS. MQVP=MANUFACTOER'S QUALITY OTHERWISE R PROVIDED WITH EQUIPMENT SOME UNIQUUEE PRICINGTOREITHER AND OPTIVONALLYTI SOURCED PROGRAM.OPT DISCOUNT. NWCPP=NATIONWIDE CRASH PARTS PROGRAM. ATTACHED COST OF RE FOR VISIBLE DAMAGESTO THE VEHICLE NOTED ATPTHESTIMEFOFHINSPECTION NECESSARY TOE RETURN THE VEHICLE TO ITS PREDAMAGED CONDITION. COSTS ABOVE THE APPRAISED AMOUNT MAY BE THE RESPONSIBILITY OF THE VEHICLE OWNER. THERE IS NO REQUIREMENT THAT THE VEHICLE OWNER USE ANY SPECIFIED REPAIR SHOP. INFORMATION REGARDING REPAIR FACILITIES WHICH WILL BE ABLE O REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT IS AVAILABLE FROM THE INSURANCE COMPANY. IF USED PARTS ARE SPECIFIED, THEY ARE REQUIRED O BE OF LIKE KIND AND QUALITY TO THOSE BEING REPLACED. INCIDENTAL CHARGES SUCH AS TOWING, PROTECTIVE CARE, CUSTODY, STORAGE, DEPRECIATION, BATTERY AND TIRE REPLACEMENT ARE NOTED WHEN APPLICABLE. 10 07/06/2009 AT 11:18 AM 34360 JOB NUMBER: 3078 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-FI 2D CNVT BLUE INT:TAN ESTIMATE BASED ON MOTOR CRASH ESTIMATING GUIDE. UNLESS OTHERWISE NOTED ALL ITEMS ARE DERIVED FROM THE GUIDE ARB8935, CCC DATA DATE 06/01/2009, AND THE PARTS SELECTED ARE OEM-PARTS MANUFACTURED BY THE VEHICLES ORIGINAL EQUIPMENT MANUFACTURER. OEM PARTS ARE AVAILABLE AT OE/VEHICLE DEALERSHIPS. OPT OEM OEM) PARTS OEM ALT THAT (OPTPROVIDED BYpOR TTHROUGH( ALTERNATEVSOURCESPOTHHERATHAN THE OEM VEHICLEY BE DEALERSHIPS. OPT OEM OR ALT OEM PARTS MAY REFLECT SOME SPECIFIC, SPECIAL, OR UNIQUE PRICING OR DISCOUNT. OPT OEM OR ALT OEM PARTS MAY INCLUDE "BLEMISHED" PARTS THROUGH OEM DOUBLEOASVIDED BY TERISK O(-*)SINDICATES THAT VEHIE: PARTSLAND/ORSLABORTINFORMATIONR HAVE 14AY HAVE FROM PROVDATA SOURCER MAYLDE SIGNS((--)MITEMSEINDICATE MOTORCNOT- NCLUDD?LABORATE ArrmzmAR ODHESCCRIBED ASNAM,OQUALNREELQPARTSS ORMCOMPARS LEPARTSS WHICH STANDSSFORE COMPETITIVE REPLACEMENT PARTS. USED PARTS ARE DESCRIBED AS LKQ, QUAL RECY PARTS, PARTS ARE DESCRIBED AS RECONDITIONED NAGS PART NUMBERSRANDDBEENNCHMARRKDPRICES ARE PROVIDED BY NATIONAL AUTO GLASS SPECIFICATIONS. LABOR OPERATION TIMES LISTED ON THE LINE WITH THE NAGS INFORMATION ARE MOOR SUGGESTED LABOR OPERATION TIMES. NAGS LABOR OPERATION TIMES ARE NOT INCLUDED. POUND SIGN (#) ITEMS INDICATE MANUAL ENTRIES. SOME 2009 VEHICLES CONTAIN MINOR CHANGES FROM THE PREVIOUS YEAR. FOR THOSE VEHICLES, PRIOR TO RECEIVING UPDATED DATA FROM THE VEHICLE MANUFACTURER, LABOR AND PARTS DATA FROM THE PREVIOUS YEAR MAY BE USED. PRICES SHOULD BE CONFIRMED WITHPTHEC APPLICABLE VEHICLES. PARTS THE NNUMBEASS AND ESTIMATOR CCC PATHWAYS - A PRODUCT OF CCC INFORMATION SERVICES INC. 11 Rental Invoice 07/06/2009 AT 11:18 AM 34360 ALTERNATE PARTS USAGE AFTERMARKET PARTS AFTERMARKET SELECTION METHOD: AUTOMATICALLY LIST NO. OF TIMES USER WAS NOTIFIED THAT AN AFTERMARKET PART WAS AVAILABLE: OPTIONAL OEM PARTS OPTIONAL OEM SELECTION METHOD: MANUALLY LIST NO. OF TIMES USER WAS NOTIFIED THAT AN OPTIONAL OEM PART WAS AVAILABLE: RECONDITIONED PARTS RECONDITIONED SELECTION METHOD: MANUALLY LIST NO. OF TIMES USER WAS NOTIFIED THAT A RECONDITIONED PART WAS AVAILABLE: JOB NUMBER: 3078 SUPPLEMENT OF RECORD 2 WITH SUMMARY 2002 LEXU SC 430 8-4.3L-Fl 2D CNVT BLUE INT:TAN NO.. OF AFTERMARKET PARTS THAT APPEAR IN THE FINAL ESTIMATE: NO. OF OPTIONAL OEM PARTS THAT APPEAR IN THE FINAL ESTIMATE: NO. OF RECONDITIONED PARTS THAT APPEAR IN THE FINAL ESTIMATE: RECYCLED PARTS NO. OF TIMES USER WAS NOTIFIED THAT A RECYCLED PART WAS AVAILABLE: NO. OF RECYCLED PARTS THAT APPEAR IN THE FINAL ESTIMATE: Rental vendor MkINNINA000 Detail , 1W-Pd- r(570C) A CAR RENT Daeefle11o1r Rab Amount - - ENTERPRISE MECHANICSBURG. PA 17050 25,55 53720 717.691-0390 24 DAYSG 19.99 159.92 5 DATSa 2.00 64.00 W PTATAX 1 VRT 2.00 12.45 1 SALESTAX 5.00 37.34 nw- hNformetlat Cblm Nu "' 35L59 271 In-.d Name: KAUFFMAN. KEVIN ToblTkbt CNarpes: $910.91 136 16 RsrlMr Nona: KAUFFMAN, KEVIN TOM AmWM R*Owmd: . $ 171.73 5 Driver Name: Dab of Lose: 042412009 Tdd NOW W ON— Told Amount Due: 5690.00 Rental InrormeUOn ttteM Itdortttetlon pi? BIN Spn : 031252009 Tex Ms^nkww is 284525440 8111 EN Date: 06252009 Rems To Adreee: 2625 MARKET PLACE HARRISBURG HARRISBURG. PA 17110 Imoioe Number: 570CD0084a1 Group mncn Laotbn: 5799 12 (2?) TUr* [,-t AMY 20001` OV -2 P 1: 2 a CUt _ ?: ,: N ?Y FLI 478.60 PO Arr4 Gc,? Qlvla