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Home My WebLink About12-20564 r r f _. .. f . T j C.D c' 4 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION Plaintiff vs. GARY ERB Defendant No. IA- c20540 a-1vil (erJ4 COMPLAINT IN CIVIL ACTION FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: Michael J. Dougherty, 76046 WELTMAN, WEINBERG & REIS CO., L.P.A. 325 CHESTNUT STREET, SUITE 501 PHILADELPHIA, PA 19106-2614 215-599-1500 FAX: 215-599-1505 ALLSTATE INSURANCE COMPANY WWR#9533604 Q 4ID5.15 Pp A co, ioy34398 0 a? 7,3.W/ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ALLSTATE INSURANCE COMPANY Plaintiff VS. GARY ERB Defendant No. NOTICE TO DEFEND YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE ACTION WITHIN TWENTY (20) DAYS AFTER THIS COMPLAINT AND NOTICE ARE SERVED, BY ENTERING A WRITTEN APPEARANCE PERSONALLY OR BY AN ATTORNEY AND FILLING 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 JUDGEMENT 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 PEOPERTY OR OTHER RIGHTS IMPORTANT TO YOU. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO THE TELEPHONE OR THE OFFICE SET FORTH BELOW TO FIND WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 1-800-990-91.08 717-249-3166 c WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Michael J. Dougherty, Esquire Pa. Identification No. 76046 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File #09533604 ALLSTATE INSURANCE COMPANY vs. GARY ERB Attorney for Plaintiff(s) Court of Common Pleas Cumberland County NO. CIVIL ACTION - COMPLAINT 1. Plaintiff is a business organization licensed and authorized to conduct business in the State of Virginia with a place of business located at 3800 Electric Road, Roanoke, Virginia 24018. 2. Defendant, Gary Erb, is an adult individual who at all time pertinent hereto resided at 7 Larken Lane, Mt. Holly Springs, Pennsylvania 17065. 3. Allstate issued a policy of insurance whereby Allstate agreed to insure the motor vehicle involved in this incident ("Insured Vehicle"), owned by Plaintiff's insured. 4. On or about December 9, 2011, Defendant was the owner and operator of a motor vehicle which vehicle did negligently, recklessly and/or carelessly collide with the Plaintiff Insured's vehicle at or near Gettysburg Pike and West Lizburn Road, Mechanicsburg, Pennsylvania. 5. The negligence and/or carelessness of the Defendant consisted of the following: I t a. Failing to have his motor vehicle under such control as the situation warranted; b. Operating his motor vehicle in complete disregard of the point and position of Plaintiff's vehicle; c. Failing to keep a proper lookout; d. Traveling too fast for conditions; e. Disregarding traffic control devices; f. Failing to abide by the Rules of the Road and the Motor Vehicle Code of Pennsylvania; g. Being otherwise negligent under the circumstances; and, h. Being negligent as a matter of law as may be relevant through discovery and/or at the time of trial. 6. As a direct and proximate result of Defendant's negligence, the Allstate Insured's vehicle sustained property damage and/or incurred rental charges in the total amount of $6,609.03. See attached as Exhibit 1" a copy of the damage documentation which documents Plaintiff further intends to introduce at the arbitration in this matter. 7. Pursuant to the insurance policy issued by Allstate and as a result of the aforesaid payment, Allstate became subrogated to the claim of its Insured against Defendant. WHEREFORE, Plaintiff demands Judgment against Defendant in the amount of $6,609.03 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A i Michael J. Dougherty, Esquire PA I. D. # 76046 325 Chestnut Street Suite 501 Philadelphia, PA 19106 (215) 599-1500 WWR#09293502 EXHIBIT 1 Report Date: 12/19/2011 Payment Ledger Policy Holder: ROBERT J MILLS Total Amount Paid $6,109.03 Participant: ROBERT MILLS Medical Deductible: $0.00 Date of Loss: 12/09/2011 Co-payment Amount $0.00 Claim Number: 0228675666 Payment/Credit Payee/Payor Check# Amount Date 12/16/2011 ROBERT 7. MILLS 547683565 $ 6,109.03 ALLSTATE INSURANCE COMPANY HARRISBURG MARKET CLAIM OFFICE 6345 FLANK DRIVE HARRISBURG, PA 17112 PHONE: 800.726.8890 SUPPLEMENT REQUEST FAX LINE: 1.866.587.9857 I - ESTIMATE - 12/16/2011 02:56 Ph Owner Owner: ROBERT MILLS Address: 2109 BEACON CIR Work/Day: (717)691-9188 City State Zip: MECHANICSBURG, PA FAX: 17055-6170 Email: MLROBE7@AOL.COM Control information ? w '- _T_ _______ Claim #: 0002286756661301 Loss Date/Time: 12/09/2011 Deductible: $500.00 Insured Policy # : 000052530383 Loss Type: Collision Ins. Company: Allstate Insurance Company Insured: ROBERT MILLS Address: 2109 BEACON CIR City State Zip: MECHANICSBURG, PA 17055-6170 Email: MLROBE7@AOL.COM Work/Day: (717)691-9188 FAX: ? Inspection Inspection Date: 12/16/2011 02:57 PM Inspection Type: Field Inspection Location: lawrence chevy Contact: Primary Impact: Left Front Corner Secondary Impact: Driveable: No Rental Assisted: Assigned Date/Time: Received Date/Time: 12/16/2011 02:55 PM Appraiser Name: LANNY KEMBLE Appraiser License # : 150461 Address: 6345 FLANK DRIVE Work/Day: (800)726-8890x8512 Cell: (717)579-2108 City State Zip: Harrisburg, PA 17112 FAX: (717)541-8494 Repairer Repairer: LAWRENCE CHEVREOLET GEO INC Contact: CARL CRONE Address: 6445 CARLISLE PIKE POB 510 Work/Day: (717)766-0284 City State Zip: MECHANICSBURG, PA 17055 FAX: (717)918-2999 Vehicle 2011 Chevrolet Impala LT 4 DR Sedan 6cyl 3.5 liter flex 4 Speed Automatic 12/16/2011 03:34 PM Page 1 of 2011 Chevrolet Impala LT 4 DR Sedan Claim #: 0002286756661301 12/16/2011 02:56 M Lic.Plate: EGP4743 Lic Expire: Prod Date: Veh Insp# : Condition: Ext. Color: black Ext. Refinish: Two-Stage Options AM/FM CD Player Aluminum/Alloy Wheels Bucket Seats Cruise Control Dual Zone Auto A/C Fog Lights Illuminatd Visor Mirrors Leather Steering Wheel Power Brakes Power Mirrors Rear Bench Seat Remote Starter Stability Cntrl Suspensn Theft Deterrent System Tire Pressure Monitor Velour/Cloth Seats Air Conditioning Anti-lock Brakes Cargo/Trunk Mat Daytime Running Lights Emergency S.O.S. System Halogen Headlights Intermittent Wipers Lighted Entry System Power Door Locks Power Steering Rear Window Defroster Side Airbags Strg Wheel Radio Control Tilt Steering Wheel Traction Control System Wood Interior Trim Lic State: PA VIN: 2G1 WBSEKXB1103700 Mileage: 12,440 Mileage Type: Actual Code: U4173B Int. Color: Int. Refinish: Alarm System Auto Headlamp Control Center Console Dual Airbags Floor Mats Head Airbags Keyless Entry System MP3 Player Power Drivers Seat Power Windows Rem Trunk-L/Gate Release Sport Suspension Tachometer Tinted Glass Trip Computer XM Satellite Radio Dam?ages Line Op Guide MC Description MFR.Part No. Price ADJ% B% Hours R Stripes And M 1 RI ouldi 219 nas MIdg,Front Door Side LT R & I Assembly 0.2 SM Front Bumper 2 E 6 46 Cover,Front Bumper 89025048 GM Part $330.83 -10.00 1.5 SM 3 L 6 13 Cover,Front Bumper Refinish 4.6 RF 3.3 Surface 0.6 Two-stage setup 0.7 Two-stage 4 E 5 Reinf,Front Bumper 25957549 GM Part $126.12 2.0 SM 5 L 5 Reinf,Front Bumper Refinish 0.6 RF 0.6 Surface 6 E 17 46 Filler,Front Bumper LT 10339892 GM Part $27.92 INC SM 7 E 7 Absorber,Front Bumper 15886100 GM Part $197.57 INC SM 8 1 20 Brkt,Front Bumper Mtg LT Repair 0.5* SM 9 L 20 Brkt,Front Bumper Mtg LT Refinish 0.3 RF 0.3 Surface Front E nd Pa nel An d Lamps 10 E 41 46 Headlamp Assy,Halogen LT 25958359 GM Part $286.95 INC SM 11 N 973 Headlamps Aim Additional Labor 0.4 SM 12 N 975 Fog Lamps Aim Additional Labor 0.3 SM 13 E 1139 Harness,Frt Lamp Wirin 20875313 GM Part $128.09 ME 14 E 32 46 Lamp Assembly,Fog LT 10335108 GM Part $115.45 0.3 SM Radiato r Sup port 15 1 73 07 Panel,Radiator Supt Repair 2.5* SM High Strength Steel 16 L 73 Panel,Radiator Supt Refinish 0.5* RF 12/16/2011 03:34 PM Page 2 of 2011 Chevrolet Impala LT 4 DR Sedan Claim # : 000228675666D01 12/16/2011 02:56 PP 0.5 Surface Front Body And Wi ndsh ield 17 E 83 46 Panel,Hood 89023526 GM Part $434.96 0.8 SM 18 L 83 Panel,Hood Refinish 5.0 RF 3.1 Surface 1.3 Edge 0.6 Two-stage 19 RI 86 Pad,lnsulator Hood R & I Assembly 0.5 SM 20 E 103 46 Fender,Front LT 89023525 GM Part $190.96 1.9 SM 21 L 103 Fender,Front LT Refinish 2.3 RF 1.5 Surface 0.5 Edge 0.3 Two-stage 22 TE 105 011 Guard,Fender Mud Partial Replace Price $49.00 SM 23 ET 106 Guard,Fender Mud LT Partial Replace Labor INC SM 24 SB 143 Windshield,Shaded Sublet Repair $35.00" SM » Call Glass Express 1-88 8-513-0010 25 E 145 Arm,Wiper Blade LT 10333725 GM Part $43.12 0.2 SM Front Body 26 E Interior 79 She 07 etmetal Reinf,inner Fender LT 89025201 GM Part $129.93 2.9 SM 27 L 79 Reinf,lnner Fender LT Refinish 0.4 RF 0.4 Surface 28 E 117 07 Reinf,inner Fender LT 15258329 GM Part $71.52 2.0 SM 29 L 117 Reinf,inner Fender LT Refinish 0.3 RF 0.3 Surface 30 E 131 07 Reinf,lnner Fender LT 10337443 GM Part $11.98 INC SM 31 L 131 Reinf,lnner Fender LT Refinish 0.2 RF 0.2 Surface 32 E 113 46 Skirt,lnner Fender LT 10333703 GM Part $23.69 INC SM Engine And 33 E Compo 786 nent s Housing,Air Cleaner 15871616 GM Part $93.19 INC ME Wheels 34 PC 1154 Wheel,Front LT Replace PXN Reconditioned $139.98 0.3 SM Front Suspe nsion 35 N 985 Brake Bleed Additional Labor 0.5 ME 36 E 1691 Hose,Front Brake LT 15242632 GM Part $34.86 0.4 ME 37 E 653 Arm,Lower Control OF 20977507 GM Part $169.25 0.8 ME 38 EP 701 Link Kit,Front Stab LT COMPETITIVE PART $11.24 INC ME 39 EP 665 Shaft Assembly,Axle OF COMPETITIVE PART $172.09 0.7 ME Steerina 40 EP 712 End,Tie Rod Outer L/F COMPETITIVE PART $26.86 0.1 ME 41 EP 714 End,Tie Rod Inner L/F COMPETITIVE PART $23.36 1.8 ME Roof 42 1 341 Panel,Roof Repair 1.0' SM 43 L 341 10 Panel,Roof Refinish 2.4' RF 2.0 Surface 0.4 Two-stage 44 RI 334 Glass Panel,Roof R & I Assembly 0.3 SM 45 RI 278 Mldg,Roof Side LT R & I Assembly 0.3 SM 46 RI 279 Mldg,Roof Side RT R & I Assembly 0.3 SM 47 RI 378 Base,Antenna R & I Assembly 0.4 SM Front Doors 48 1 411 Pnl,Front Door Outer LT Repair 2.0" SM 49 L 411 Pnl,Front Door Outer LT Refinish 1.5' RF 1.5 Surface 12/16/2011 03:34 PM Page 3 of I f t 2011 Chevrolet Impala LT 4 DR Sedan Claim # : 000228675666D01 12116/2011 02:56 PP INC Two-stage 50 RI 197 Mldg,Front Door Belt LT R & I Assembly 1.0 SM 51 E 229 Mirror,Outer R/C LT 20759191 GM Part $181.80 INC SM 52 L 229 Mirror,Outer R/C LT Refinish 0.6 RF 0.5 Surface 0.1 Two-stage 53 RI 227 Handle,Front Door Otr LT R & I Assembly 0.2 SM Quarter And Rocker Pan el 54 1 182 Panel,Bodyside Otr Upr LT Repair 1.0* SM 55 L 182 Panel,Bodyside Otr Upr LT Refinish 1.3 RF 1.1 Surface 0.2 Two-stage 56 E 156 MIdg,Rocker Panel LT 19180827 GM Part $189.34 INC SM 57 L 156 MIdg,Rocker Panel LT Refinish 1.6 RF 1.3 Surface 0.3 Two-stage 58 RI 156 MIdg,Rocker Panel LT R & I Assembly INC SM Deck Lid And Back Glass 59 1 368 Back Glass,Heated Repair 0.2* SM » back tape Manual Entries 60 SB FRONT END ALIGNMENT Sublet Repair $59.95* SM 61 EC Flex Additive COMPETITIVE PART $8.00* SM 62 EC Rustproofing COMPETITIVE PART $10.00* SM 63 1 Set-Up And Measure Repair 1.5* FR* 64 1 Unibody-Frame Alignment Repair 3.0* FR* 65 1 Tire-Left Front,Balanced Repair 0.3* SM 66 EC COVER CAR EXTERIOR COMPETITIVE PART $5.00* SM 67 SB Hazardous Waste Removal Sublet Repair $3.00* SM 68 EC Eagle LS-2 LF COMPETITIVE PART $132.00 SM » GOODYEAR 225/55R17 706486153 0 10 95T » Tire Rack » South Bend IN (800) 445-0179 69 1 brake hose brkt Repair 0.2* SM* 70 EC brake fluid COMPETITIVE PART $4.50* SM* 71 1 retape moulding Repair 0.3* SM* 72 SB inspection stickers Sublet Repair $11.50* SM* 72 Items MC Message 01 CALL DEAL ER FOR EXACT PART # / PRICE 07 STRUCTURAL PART AS IDENTIFIED BY I-CAR 10 INCLUDES AUDATEX TIME TO CLEA R ENTIRE PANEL 13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE 46 PRINTABLE ALTERNATE PARTS COMPARE Estimate Total & Entries Gross Parts $2,836.53 Other Parts $533.03 Paint Materials $350.00** Line Item Discount $33.08- Parts & Material Total $3,686.48 Tax on Parts & Material @ 6.000% $221.19 Labor Rate Replace Repair Hrs Total Hrs Hrs Sheet Metal (SM) $45.00 15.1 8.7 23.8 $1,071.00 12/16/2011 03:34 PM Page 4 of 2011 Chevrolet Impala LT 4 DR Sedan Claim #, 000228675666D01 12/16/2011 02:56 PP Mech/Elec (ME) $45.00 3.8 0.5 4.3 $193.50 Frame (FR) $45.00 4.5 4.5 $202.50 Refinish (RF) $45.00 21.6 21.6 $972.00 Paint Materials $23.00 Labor Total 54.2 Hours Tax on Labor @ 6.000% Sublet Repairs Tax on Sublet @ 6.000% Gross Total Less: Deductible Net Total Customer Owes Alternate Parts Y/12/05/00/07/07 CUM 12/05/00/07/07 Zip Code: 17112 NE HBG S 1ST 2/11 Requested Review On: 12/16/2011 03:34 PM Audatex Estimating 6.0.626 ES 12/16/2011 03:34 PM REL 6.0.626 DT 10/01/2011 DB 12/08/2011 Copyright (C) 2011 Audatex North America, Inc. $2,439.00 $146.34 $109.45 $6.57 $6,609.03 $500.00- $6,109.03 $500.00 ** USER-ESTABLISHED THRESHOLD FOR PAINT MATERIALS HAS BEEN REACHED AND CALCULATED IN THIS ESTIMATE. ANY ADDITIONAL MATERIALS MAY REQUIRE FURTHER APPROVAL. ** 3.2 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO-STAGE REFINISH FORMULA. ESTIMATE CALCULATED USING THE 2.5 HOUR MAXIMUM ALLOWANCE FOR TWO-STAGE REFINISH OF NON-FLEX, EXTERIOR SURFACES. IMPORTANT INFORMATION ABOUT ALLSTATE'S CHOICE OF PARTS POLICY THIS ESTIMATE MAY LIST PARTS FOR USE IN THE REPAIR OF YOUR VEHICLE THAT ARE MANUFACTURED BY A COMPANY OTHER THAN THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. THESE :PARTS ARE COMMONLY REFERRED TO AS AFTERMARKET PARTS OR COMPETITIVE PARTS, AND MAY INCLUDE COSMETIC OUTER BODY CRASH PARTS SUCH AS HOODS, FENDERS, BUMPER COVERS, ETC. ALLSTATE GUARANTEES THE FIT AND CORROSION RESISTANCE OF ANY AFTERMARKET/COMPETITIVE OUTER BODY CRASH PARTS THAT ARE LISTED ON THIS ESTIMATE AND ACTUALLY USED IN THE REPAIR OF YOUR VEHICLE FOR AS LONG AS YOU OWN IT. IF A PROBLEM DEVELOPS WITH THE FIT OR CORROSION RESISTANCE OF THESE PARTS, THEY WILL BE REPAIRED OR REPLACED AT ALLSTATE'S EXPENSE. THIS GUARANTEE IS LIMITED TO THE REPAIR OR REPLACEMENT OF THE PART. HOWEVER, IF YOU CHOOSE NOT TO USE ONE OR MORE OF THE AFTERMARKET/COMPETITIVE OUTER BODY CRASH PARTS THAT MAY BE LISTED ON THIS ESTIMATE IN THE REPAIR OF YOUR VEHICLE, ALLSTATE WILL SPECIFY THE USE OF ORIGINAL EQUIPMENT MANUFACTURER PARTS, EITHER NEW OR RECYCLED AT ALLSTATE'S OPTION, AT NO ADDITIONAL COST TO YOU. ALLSTATE DOES NOT SEPARATELY GUARANTEE THE PERFORMANCE OF ORIGINAL EQUIPMENT MANUFACTURER PARTS, AND MAKES NO REPRESENTATION ABOUT THE AVAILABILITY OF ANY MANUFACTURER'S GUARANTEE. TO ALL REPAIR FACILITIES: BEFORE USING AN AFTERMARKET SHEETMETAL PART, BE SURE TO LOOK FOR THE CAPA SEAL. THIS IS NOT AN AUTHORIZATION FOR REPAIR. SUPPLEMENTS MUST BE APPROVED PRIOR TO REPAIR. IF YOUR CAR IS OF UNITIZED CONSTRUCTION, IN SOME CASES THE REPAIR SHOP MAY NEED SPECIAL EQUIPMENT TO PROPERLY REPAIR THE CAR. YOU SHOULD DETERMINE IF THE SHOP YOU SELECT TO 12/16/2011 03:34 PM -- Page 5 of 2011 Chevrolet Impala LT 4 DR Sedan Claim #: 000228675666D01 COMPLETE THE REPAIRS IS PROPERLY EQUIPPED. ALLSTATE WILL NOT BE RESPONSIBLE FOR ANY RELATED TOWING SERVICES OR STORAGE CHARGES, KNOWN AT THE TIME OF APPRAISAL, AFTER AFTER WHICH THE CHARGES WILL BE THE RESPONSIBILITY OF THE CONSUMER. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS. IF THE USE OF AN AFTERMARKET CRASH PART VOIDS THE EXISTING WARRANTY ON THE PART BEING REPLACED OR ANY OTHER PART, THE AFTERMARKET CRASH PART SHALL HAVE A WARRANTY EQUAL TO OR BETTER THAN THE REMAINDER OF THE EXISTING WARRANTY. WARRANTIES APPLICABLE TO THE AFTERMARKET CRASH PARTS ARE PROVIDED BY THE MANUFACTURER OR. THE DISTRIBUTOR OF THESE PARTS NOT THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES. IT IS TO OUR MUTUAL INTEREST THAT YOU RECEIVE PROMPT AND COURTEOUS SERVICE ALONG WITH QUALITY REPAIR WORK AT A FAIR PRICE. IF YOU HAVE A PREFERENCE FOR A PARTICULAR SHOP, YOUR ADJUSTER WILL WRITE OR APPROVE AN ESTIMATE OF REPAIRS WITH THAT SHOP BASED ON COMPETITIVE PRICES IN THE AREA. INFORMATION REGARDING REPAIR FACILITIES, WHICH MAY BE ABLE TO REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT, IS AVAILABLE FROM YOUR ADJUSTER OR INSURER. HOWEVER, THERE IS NO REQUIREMENT TO USE ANY SPECIFIED SHOP. COSTS ABOVE THE APPRAISED AMOUNT MAY BE THE RESPONSIBILITY OF THE VEHICLE OWNER. ALL SUPPLEMENTS MUST BE APPROVED PRIOR TO REPAIR. AFTERMARKET CRASH PARTS ARE IDENTIFIED IN THE ESTIMATE WITH SYMBOL "EC", "EP," (COMPETITIVE PART) AND "EU" (RECYCLED PART). AN "AFTERMARKET CRASH PART" IS A NON-ORIGINAL MANUFACTURER (NON-OEM) REPLACEMENT PART, EITHER NEW OR USED, FOR ANY OF THE NON-MECHANICAL PARTS THAT GENERALLY CONSTITUTE THE EXTERIOR OF THE MOTOR VEHICLE, INCLUDING INNER AND OUTER PANELS. NEW, ORIGINAL EQUIPMENT MANUFACTURER, REPLACEMENT PARTS ARE IDENTIFIED BY THE LETTER "E" AND CAN BE LOCATED AT THE ORIGINAL EQUIPMENT MANUFACTURER PARTS DEALER. ADJUSTER: LICENSE # DATE Op Codes 12/16/2011 02:56 PP = User-Entered Value E = Replace OEM NG = Replace NAGS EC = COMPETITIVE PART OE = Replace PXN OE Srpls UE = Replace OE Surplus ET = Partial Replace Labor EP = COMPETITIVE PART EU = RECYCLED PART TE = Partial Replace Price PM= Replace PXN Reman/Reblt UM= Replace Reman/Rebuilt L = Refinish PC = Replace PXN Reconditioned UC = Replace Reconditioned TT = Two-Tone SB = Sublet Repair N = Additional Labor BR = Blend Refinish I = Repair IT = Partial Repair CG= Chipguard RI = R & I Assembly P = Check AA = Appearance Allowance RP= Related Prior Damage This report contains proprietary information of Audatex and may not be disclosed to any third party (other than ? J' ludat .A the insured, claimant and others on a need to know basis in order to effectuate the claims process) without Audatex's prior written consent. d 5C)lera <Vrtr?+i..tFr Copyright (C) 2011 Audatex North America, Inc. Audatex Estimating is a trademark of Audatex North America , Inc. 12/16/2011 03:34 PM Page 6 of 2011 Chevrolet Impala LT 4 DR Sedan Claim # : 000228675666D01 12/1612011 02:56 PP Estimate Summary Page LANNY KEMBLE Gross Total $6,609.03 Less: Deductible $500.00- Net Total $6,109.03 Customer Owes $500.00 Audatex Estimating 6.0.626 ES 12/16/2011 03:34 PM REL 6.0.626 DT 10/01/2011 DB 12/08/2011 Copyright (C) 2011 Audatex North America, Inc. ALLSTATE INSURANCE COMPANY SUPPLEMENT REQUEST SHEET IN ORDER TO REVIEW YOUR SUPPLEMENT REQUEST, PLEASE COMPLETE THE FOLLOWING INFORMATION THOROUGHLY AND FAX IT TO 1.866.587.9857 BY SUBMITTING THIS FORM, THIS IS NOT AN AUTHORIZATION TO REPAIR. ALL SUPPLEMENTS MUST HAVE PRIOR APPROVAL. FAILURE TO DO SO WILL RESULT IN NON- PAYMENT OF A NON-APPROVED SUPPLEMENT. DATE ORIGINAL ADJUSTER: CLAIM NUMBER: ( ) SUPPLEMENT #1 (_) SUPPLEMENT #2 (_) SUPPLEMENT #3 (PLEASE CHECK THE BOX THAT APPLIES TO THE NUMBER OF SUPPLEMENT.) CUSTOMER NAME: IS THE VEHICLE AT THE SHOP AND READY FOR INSPECTION WITHIN 24HRS? ( ) YES ( ) NO ARE THE DAMAGES VISIBLE? ( ) YES ( ) NO VEHICLE TORN DOWN: ( ) YES ( ) NO YEAR: MAKE: SHOP NAME: SHOP ADDRESS: CITY: STATE: PHONE: ( ) ZIP CODE: NATURE OF THE SUPPLEMENT: (PLEASE SUPPLY DESCRIPTION OF SUPPLEMENT REQUEST) ( ) PARTS: ( ) LABOR: ( ) PARTS INCREASE: ( ) OTHER: MODEL: CONTACT: APPROXIMATE TOTAL SUPPLEMENT AMOUNT: $ 12/16/2011 03:34 PM Page 7 of Audatex Alternate Parts Locate Report Vehicle 2011 Chevrolet Impala LT 4 DR Sedan 6cyl 3.5 liter flex 4 Speed Automatic Options AM/FM CD Player Aluminum/Alloy Wheels Bucket Seats Cruise Control Dual Zone Auto A/C Fog Lights Illuminatd Visor Mirrors Leather Steering Wheel Power Brakes Power Mirrors Rear Bench Seat Remote Starter Stability Cntrl Suspensn Theft Deterrent System Tire Pressure Monitor Velour/Cloth Seats Air Conditioning Anti-lock Brakes Cargo/Trunk Mat Daytime Running Lights Emergency S.O.S. System Halogen Headlights Intermittent Wipers Lighted Entry System Power Door Locks Power Steering Rear Window Defroster Side Airbags Strg Wheel Radio Control Tilt Steering Wheel Traction Control System Wood Interior Trim Alarm System Auto Headlamp Control Center Console Dual Airbags Floor Mats Head Airbags Keyless Entry System MP3 Player Power Drivers Seat Power Windows Rem Trunk-L/Gate Release Sport Suspension Tachometer Tinted Glass Trip Computer XM Satellite Radio Line Part Description Supplier Part Number Substituted For OEM Supplier Code CLS SRC Part Number 34 Wheel,Front LT 5333 9598242 > 4 R 3 5333 9598242 1 R 3 38 Link Kit,Front Stab LT MRC18257HD 10403402 > 3 1 39 Shaft Assembly,Axle L/F NMD959254 20859642 > 3 1 20859642 20859642 2 M 3 40 End,Tie Rod Outer L/F MRCES3453 26086579 > 3 1 41 End,Tie Rod Inner L/F MRCES3103 26021769 > 3 1 > = ESTIMATE TOTAL IS BASED ON PRICE QUOTED BY THIS SUPPLIER ;Key to Classification / Source Codes CLS = Classification Code C - CAPA CERTIFIED PART QUOTED BY LISTED SUPPLIER M - REMANUFACTURED / REBUILT PART R - RECONDITIONED PART S - OEM SURPLUS PART SRC = Source Code 1 - NON ORIGINAL EQUIPMENT MANUFACTURER PART 3 - ORIGINAL EQUIPMENT MANUFACTURER (OEM) PART Detailed Distributor List 1 PXN3555 THE WHEEL WAREHOUSE (800)941-6400 4600 GATEWAY CIRCLE (937)291-2332 KETTERING, OH 45440 12/16/2011 03:35 PM Page 1 of 2 2011 Chevrolet Impala LT 4 DR Sedan PXN4118 PARTS HARVESTER P.O. BOX 966 WHITEWRIGHT, TX 75491 PXN6106 NAPA PARTS CALL YOUR LOCAL NAPA STORE 1-800-LET-NAPA, GA 30339 PXN6604 HBCP & WHL NTWD RCND 11449 ST CHARLES ROCK ROAD BRIDGETON, MO 63044 Audatex Estimating 6.0.626 ES 12/16/2011 03:35 PM REL 6.0.626 DT 10/01/2011 DB 12/08/2011 Zip Code: 17112 Search Area: Copyright (C) 2011 Audatex North America, Inc. (800)333-4996 (800)538-6272 (800)333-5101 (314)291-5101 NE HBG S 1ST 2/11 This report contains proprietary information of Audatex and may not be disclosed to any third party (other than the insured, claimant and others on a need to know basis in order to effectuate the claims process) without Audatex's A-tldc tex prior written consent. a S?31era1• essmpartp+ Copyright (C) 2011 Audatex North America, Inc. Audatex Estimating is a trademark of Audatex North America, Inc. 12/16/2011 03:35 PM Page 2 of 2 es.. t, .? *J ,,?.?-.? r ?' t? ?A VERIFICATION I, Michael J. Dougherty, Esquire, attorney for the Plaintiff(s) do hereby swear and affirm that the averments in the attached Complaint are true and correct to the best of my knowledge, information and/or belief. These averments are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. r Michae J. Dougherty Date 2 L HOMO JAR i 2012 APP I I PI i s 3' - WELTMAN, WEINBERG? 14*3 -N BY: Michael Dougherty I.D. No. 76046 325 Chestnut Street Suite 501 Philadelphia, PA 19106 Phone: (215) 599-1500 Fax: (215) 599-1505 File # 9533604 MJD/KNW Attorney for Plaintiff(s) ALI,STATE INSURANCE COMPANY Cumberland County Court of Common Pleas VS. No.: 12-2056 CIVIL TERM GARY ERB PRAECIPE TO DISMISS WITHOUT PREJUDICE TO THE PROTHONOTARY: Kindly dismiss the above matter without prejudice . WELTMAN, WEINBERG & REIS CO., L.P.A. 1chael Dougherty, Esquire Attorney for Plaintiff 11111111111111111111111111111111111111111 I I I I 1111111111111 "1111111 GARY ERB 7 LARKEN LANE MOUNT HOLLY SPRINGS, PA 17065 SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff - Jody S Smith Chief Deputy k a 1 All if. L l i'JI .. k, V diti f Richard W Stewart Solicitor Allstate Insurance Company Case Number vs. Gary Erb 2012-2056 SHERIFF'S RETURN OF SERVICE 04/03/2012 07:31 PM - Shawn Gutshall, Deputy Sheriff, who being duly sworn according to law, states that on April 3, 2012 at 1931 hours, he served a true copy of the within Complaint and Notice, upon the within named defendant, to wit: Gary Erb, by making known unto Charles Erb, Son of Defendant at 7 Larken Lane, Mount Holly Springs, Cumberland County, Pennsylvania 17065 its contents and at the same time handing to him personally the said true and correct copy of the same. 4? S N SH EPUTY SHERIFF COST: $35.00 April 10, 2012 SO ANSWERS, f? RON R ANDERSON, SHERIFF