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Home My WebLink About12-6571 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff ?a_?QJ7I ofvd No: VS. COMPLAINT IN CIVIL ACTION HOWARD MENTZER Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: Benjamin W. Lawrence,209032 WELTMAN, WEINBERG & REIS CO., L.P.A. 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106-2614 215-599-1500 FAX: 215-599-1505 09751553 C Y Jer HOH S auk cq.? ?b-)»?oP raw IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff VS. Civil Action No HOWARD MENTZER Defendant COMPLAINT AND 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 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 OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. 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. LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249-3166 WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire Pa. Identification No.209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File #09751553 Attorney for Plaintiff(s) STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY Court of Common Pleas Cumberland County vs. HOWARD MENTZER NO. CIVIL ACTION - COMPLAINT Plaintiff is a business organization licensed and authorized to conduct business in the State of Illinois with a place of business located at P. O. Box 2371, Bloomington, Illinois 61702. 2. Defendant, Howard Mentzer, is an adult individual who at all time pertinent hereto resided at 122 East Liberty Avenue, Carlisle, Pennsylvania 17013. 3. State Farm issued a policy of motor vehicle insurance whereby State Farm agreed to insure the motor vehicle involved in this incident ("Insured Vehicle"), owned by Plaintiff's insured. 4. On or about July 30, 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 Trindle Road, Carlisle, Pennsylvania. 5. The negligence and/or carelessness of the Defendant consisted of the following: 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 Plaintiffs 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 State Farm Insured's vehicle sustained property damage and/or incurred rental charges in the total amount of $11,896.64. 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 State Farm and as a result of the aforesaid payment, State Farm became subrogated to the claim of its Insured against Defendant. WHEREFORE, Plaintiff demands Judgment against Defendant in the amount of $11,896.64 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A. Benjamin W. wrei PA 1. D. # 20 32 325 Chestn t Street , Esquire Suite 501 Philadelphia, PA 19106 (215) 599-1500 WWR#09293502 I•rXR BIT 1 STATE FARM INSURANCE COMPANIES LIKE A GOOD NEIGHBOR, STATE FARM IS THERE 1 STATE FARM DRIVE CONCORDVILLE, PA 19339 PHONE (888) 713-4694 -- FAX ALL SUPPLEMENT REQUESTS TO (800) 916-0342 *** ESTIMATE *** 08/03/201.1 04:03 PM Owner Owner: BRENDA MYERS Address: 5 STONEY KNOLL IN City State Zip: CARLISLE, PA 17015-9494 Home/Day: (717)243-9982 Work/Day: (717)790-8579 Control Information Claim # : 38-M173-97301 Loss Date/Time: 07/30/2011 Loss Type: Collision Deductible: $250.00 Ins. Company: State Farm Insured: BRENDA MYERS Work/Day: (717)790-8579 Home/Day: (717)243-9982 Claim Rep: Ext 4111 Claim Rep Work/Day: (888)713-4694 Inspection Inspection Date: 08/03/2011 04:01 PM Inspection Type: Field Inspection Location: IAA HBG Address: 5515 SUSQUEHANNA TRL City State Zip: MANCHSTER, PA 17345 Primary Impact: Rollover Driveable: Yes Received Date/Time: 08/03/2011 10:04 AM Appointment Date/Time: 08/03/2011 09:26 AM Appraiser License # 139406 Contact: DAVE STAPLES Work/Day: (800)839-8050 Remarks ESTIMATE WAS PREPARED BY DAVE STAPLES ( ELECTRONIC SIGNATURE ) SUPPLEMENTAL REQUEST MUST BE FAXED TO 1-800-916-0342 PRIOR TO STARTING THOSE REPAIRS.OR IF NO FAX CALL 1-800-839-8050 EXT.8526 ANY SUPPLEMENT TO THIS ESTIMATE REQUIRES THE APPROVAL OF A STATE FARM REPRESENTIVE PRIOR TO THE PERFORMANCE OF THAT REQUEST XXXX NO OTHER RECYCLED PARTS ARE AVAILIBLE OR COST EFFECTIVE XXXX GLASS INSTALLED QUOTED AUTO GLASS TECH 717 843-4455 YORK PA RECYCLED PART AVAILIBLE LKQ 250 AUTOWRECKER HARISVILLE OH 800-334-9811#4330337 Vehicle 2004 Honda Pilot EX 4 DR Wagon 6cyl Gasoline 3.5 5 Speed Automatic Lic.Plate: Lic Expire: Lic State: PA VIN: 2HKYF18474H512622 2004 Honda Pilot EX 4 DR Wagon 08/04/2011 10:20 AM Page 1 of 6 Claim # : 38-M173-97301 08/03/2011 Prod Date: Mileage: 140,658 Veh Insp## Mileage Type: Actual Condition: Code: H7123B Ext. Refinish: Two-Stage Ext. Color: RED ROCK EFFECT Ext. Paint Code: R519P (B),-4=(H) Int. Refinish: Two-Stage Int. Color: SADDLE Int. Trim Code: NOT AVAILABLE Options 4-Wheel Drive 8 Passenger Seating Alarm System Aluminum/Alloy Wheels Anti-lock Brakes Center Console Climate Control For A/C Compact Disc W/Tape Cruise Control Dual Air Conditioning Dual Airbags Fog Lights Garage Door Opener Intermittent Wipers Keyless Entry System Lighted Entry System Mud/Splash Guards Overhead Console Power Brakes Power Door Locks Power Drivers Seat Power Mirrors Power Steering Power Windows Privacy Glass Rear Spoiler Rear Window Defroster Rear Window Wiper/Washer Reverse Sensing System Roof/Luggage Rack Running Boards Side Airbags Skid Plates Strg Wheel Radio Control Tachometer Tilt Steering Wheel Tinted Glass Trip Computer Velour/Cloth Seats Damages In# --- Op -- GDE ---- Description -------------------- MFR.Part No. ---- Price AJ% B$ HRS R 1 RI 6 Front Bumper Cover R ------------ R & I Assembly -------- ---- ---- ---- 1.1 -- SM 2 I 6 Cover,Front Bumper Repair 0.5* SM 3 L 6 Cover,Front Bumper Refinish 3.5 RF MC 13 2.4 Surface 0.6 Two-stage setup 0.5 Two-stage 4 RI 82 Defl,Front Bumper R & I Assembly 0.3 SM 5 RI 9 Frame,License Plate R & I Assembly 0.2 SM 6 E 41 Headlamp Assembly IT 33151S9VA01 256.95 INC SM 7 RI 42 Headlamp Assembly RT R & I Assembly 0.4 SM 8 N 973 Headlamps Aim ADDITIONAL OPERA 0.4 SM 9 E 83 Panel,Hood 60100S9VA90ZZ 487.15 1.4 SM 10 L 83 Panel,Hood Refinish 5.0 RF 3.0 Surface 1.2 Edge 0.8 Two-stage 11 E 103 Fender,Front IT 60261S9VA90ZZ 297.28 1.6 SM 12 L 103 Fender,Front IT Refinish 2.8 RF 1.8 Surface 0.5 Edge 0.5 Two-stage 13 I 104 Fender,Front RT Repair 0.3* SM 14 L 104 Fender,Front RT Refinish 2.0* RF MC 10 1.6 * Surface 0.4 Two-stage >> REFINISH WITHIN PANEL BOUNDRIES 15 RI 152 M1dg,Fender Side L/F R & I Assembly 0.2 SM 16 RI 153 M1dg,Fender Side R/F R & I Assembly 0.2 SM 17 RI 139 Guard,Fender Mud IT R & I Assembly INC SM 2004 Honda Pi lot EX 4 DR Wagon 08/04/2011 10:20 AM Page 2 o f 6 Claim ## : 38-M173-97301 08/03/2011 18 RI 140 Guard,Fender Mud RT R & I Assembly 0.1 SM 19 PC 917 Wheel,Front LT RECOND PART 180.50 0.3 SM 20 PC 919 Wheel,Rear LT RECOND PART 180.50 0.2 SM 21 N 970 Susp Align,4 Wheel ADDITIONAL OPERA 75.00* 0.0* ME 22 E 381 Board,Running LT 08L33S9V10041 200.88 0.6 SM MC 01 23 EU 207 Door Assembly,Fro LT RECYCLED PART 830.00* +33.00 3.4 SM 24 L 207 Door Shell,Front LT Refinish 3.6 RF 2.0 Surface 1.0 Edge 0.6 Two-stage 25 EU 573 M1dg,Front Door S LT RECYCLED PART INC* 0.3 SM 26 L 573 M1dg,Front Door S LT Refinish 0.5 RF 0.5 Surface INC Two-stage 27 EU 229 Mirror,Outer R/C LT RECYCLED PART 115.00* +33.00 INC SM 28 L 229 Mirror,Outer R/C LT Refinish 0.6 RF 0.5 Surface 0.1 Two-stage 29 RI 227 Handle,Front Door LT R & I Assembly INC SM 30 I 289 Pnl,Rear Door Out LT Repair 3.0* SM 31 L 289 Pnl,Rear Door Out LT Refinish 1.7* RF 1.7 * Surface INC Two-stage >> REFINISH WITHIN PANEL BOUNDRIES 32 E 339 W/Strip,Rear Door LT 72865S9VA01 50.95 0.3 SM 33 RI 353 M1dg,Rear Door Be LT R & I Assembly 0.3 SM 34 RI 535 M1dg,Rear Door Si LT R & I Assembly 0.3 SM 35 RI 307 Pnl,Inner Door Tr LT R & I Assembly INC SM 36 RI 305 Handle,RR Door Ou LT R & I Assembly 1.0 SM 37 E 341 Panel,Roof 6210OS9V305ZZ 1894.33 19.9 SM 38 L 341 Panel,Roof Refinish 3.8 RF 3.8 Surface INC Two-stage 39 E 331 M1dg,Roof Side LT 74318S9VA10ZA 28.52 INC SM 40 E 332 M1dg,Roof Side RT 74308S9VAIOZA 28.52 INC SM 41 E 346 M1dg,Roof Side LT 74333S9VA10ZA 10.05 INC SM 42 E 577 Rail,Luggage Rack LT 75260S9VA10ZA 193.47 INC SM 43 E 578 Rail,Luggage Rack RT 75250S9VA10ZA 238.88 INC SM 44 E 883 Headliner,Roof 8320OS9VAOIZB 793.85 INC SM MC 01 45 E 389 Pnl Assembly,Quar LT 04646S9V405ZZ 1010.01 15.6 SM 46 L 389 Pnl Assembly,Quar LT Refinish 3.5 RF 2.3 Surface 1.0 Edge 0.2 Two-stage 47 I 390 Pnl Assembly,Quar RT Repair 4.0* SM 48 L 390 Pnl Assembly,Quar RT Refinish 2.4 RF 2.4 Surface INC Two-stage 49 E 397 Door,Fuel Filler LT 6391OS9VAOOZZ 28.38 INC SM 50 L 397 Door,Fuel Filler LT Refinish 0.3 RF 0.3 Surface INC Two-stage 51 SB 395 Glass,Quarter Tin LT Sublet Repair 275.23* SM >> INCLUDES TAX 52 RI 396 Qtr Glass R & I RT R & I Assembly 1.0 SM 53 TE 442 Guard,Mud Partial Replace 44.22 SM MC 01 54 EU 479 Tailgate Assembly RECYCLED PART 805.00* +33.00 2.8 SM 55 L 479 Shell,Tailgate Refinish 3.7 RF 2004 Honda Pi lot EX 4 DR Wagon 08/04/2011 10:20 AM Page 3 of 6 Claim # : 38-M173-97301 08/03/2011 2.1 Surface 1.3 Edge 0.3 Two-stage 56 E 519 N/P1ate,Tailgate 75722S9VA01 35.60 0.2 SM 57 RI 486 Pnl,T/G Inner Trim R & I Assembly INC SM 58 EU 533 Taillamp Assembly LT RECYCLED PART 95.00* +33.00 INC SM 59 RI 534 Taillamp Assembly RT R & I Assembly 0.3 SM 60 EU 565 Bumper,Rear RECYCLED PART 165.00* +33.00 INC SM 61 E 566 Cover,Rear Bumper 04715S9VA90ZZ 434.82 1.5 SM 62 L 566 Cover,Rear Bumper Refinish 3.1 RF 2.6 Surface 0.5 Two-stage 63 EU 567 Absorber,Rear Bumper RECYCLED PART INC* INC SM 64 E 560 Step,Rear Bumper 71510S9VA00ZA 37.70 INC SM 65 E 360 Defl,Rear Bumper 71502S9VA00ZB 39.20 INC SM 65 Items MC Message 01 CALL DEALER FOR EXACT PART # / PRICE 10 INCLUDES AUDATEX TIME TO CLEAR ENTIRE PANEL 13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE Estimate Total & Entries Gross Parts Other Parts Paint Materials Line Item Markup Parts & Material Total Tax on Parts & Material $6,110.76 $2,446.00 $949.00 $663.30 $10,169.06 a 6.000% $610.14 Labor Rate Replace Hrs Repair Hrs Total Hrs Sheet Metal (SM) $46.00 53.5 8.2 61.7 $2,838.20 Mech/Elec (ME) $46.00 Frame (FR) $55.00 Refinish (RF) $46.00 36.5 36.5 $1,679.00 Paint Materials $26.00 Labor Total 98.2 Hours $4,517.20 Tax on Labor Q 6.000% $271.03 Sublet Repairs $275.23 Gross Total $15,842.66 Less: Deductible $250.00- Net Total $15,592.66 Alternate Parts Y/02/02/00/00/00 CUM 02/02/00/00/00 Zip Code: 17070 HARRISBURG Audatex Estimating 6.0.514 ES 08/04/2011 10:20 AM REL 6.0.514 DT 07/01/2011 Copyright (C) 2010 Audatex North America, Inc. 4.5 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. SM-SHEET METAL ME-MECH/ELEC FR-FRAME RE-REFINISH SY-SYSTEM THIS IS AN ESTIMATE. REPAIR FACILITIES MUST INSPECT THE VEHICLE TO DETERMINE IF ANY REPAIRS NOT LISTED ARE REQUIRED, AND TO CONTACT STATE FARM BEFORE MAKING SUCH REPAIRS. REPAIRER ALSO IS RESPONSIBLE FOR CONDUCTING ANY NECESSARY INSPECTION AND SAFETY CHECKS PRIOR TO AND AFTER COMPLETING REPAIRS. 2004 Honda Pilot EX 4 DR Wagon 08/04/2011 10:20 AM Page 4 of 6 Claim # : 38-M173-97301 08/03/2011 IF THIS APPRAISAL HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS, AND 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. 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. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO INJURE OR DEFRAUD ANY INSURER FILES AN APPLICATION OR CLAIM CONTAINING ANY FALSE, INCOMPLETE OR MISLEADING INFORMATION SHALL, UPON CONVICTION, BE SUBJECT TO IMPRISONMENT FOR UP TO SEVEN YEARS AND PAYMENT OF A FINE OF UP TO $15,000. Op Codes * = User-Entered Value E = NEW PART NG = Replace NAGS EC = ** NON-OEM PART ET = Partial Replace Labo EP = ** NON-OEM PART EU = RECYCLED PART TE = Partial Replace Pric PM = REMAN/REBUILT PART UM = REMAN/REBUILT PART L = Refinish PC = RECOND PART UC = RECOND PART TT = Two-Tone SB = Sublet Repair N = ADDITIONAL OPERATION BR = Blend Refinish I = Repair IT = Partial Repair CG = Chipguard RI = R & I Assembly P = Check RP = RP-RELATED PRIOR 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 prior written consent. Copyright (C) 2010 Audatex North America, Inc. 2004 Honda Pilot EX 4 DR Wagon 08/04/2011 10:20 AM Page 5 of 6 Claim # : 38-M173-97301 08/03/2011 Estimate Summary Page Gross Total Less: Deductible Net Total $15,842.66 $250.00- $15,592.66 Audatex Estimating 6.0.514 ES 08/04/2011 10:20 AM REL 6.0.514 DT 07/01/2011 Copyright (C) 2010 Audatex North America, Inc. YOU ARE UNDER NO REQUIREMENT TO USE ANY SPECIFIED REPAIR SHOP. ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR INSURANCE OR A 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. FAILING TO PRESENT THIS ESTIMATE TO THE REPAIRING FACILITY BEFORE A REPAIR MAY RESULT IN ADDITIONAL EXPENSE TO YOU. COPY OF THE FORM(S) WAS SENT/GIVEN TO THE CONSUMER ON: 2004 Honda Pilot EX 4 DR Wagon 08/04/2011 10:20 AM Page 6 of 6 QUALITY REPLACEMENT PARTS REPORT Vehicle 2004 Honda Pilot EX 4 DR Wagon 6cyl Gasoline 3.5 5 Speed Automatic Options 4-Wheel Drive 8 Passenger Seating Aluminum/Alloy Wheels Anti-lock Brakes Climate Control For A/C Compact Disc W/Tape Dual Air Conditioning Dual Airbags Garage Door Opener Intermittent Wipers Lighted Entry System Mud/Splash Guards Power Brakes Power Door Locks Power Mirrors Power Steering Privacy Glass Rear Spoiler Rear Window Wiper/Washer Reverse Sensing System Running Boards Side Airbags Strg Wheel Radio Control Tachometer Tinted Glass Trip Computer Alarm System Center Console Cruise Control Fog Lights Keyless Entry System Overhead Console Power Drivers Seat Power Windows Rear Window Defroster Roof/Luggage Rack Skid Plates Tilt Steering Wheel Velour/Cloth Seats Ln## Part Description Supplier Part Number Sub OEM Part Supp C S code --- -------------------- -------------------- -------------------- ---- - - 19 Wheel,Front LT 20 Wheel,Rear LT 63849XXGC 42700S9VA51 > 1 R 3 ALY63849U 42700S9VA51 2 R 3 63849XXGC 42700S9VA51 > 1 R 3 ALY63849U 42700S9VA51 2 R 3 > = 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 PXN6196 WHEEL COLLISION RCND (800)292-7467 7286 PENN DRIVE (610)837-8792 BATH, PA 18014 2 PXN6349 TRANSWHEEL RCND (800)892-3733 10417 FERGUSSON LANE #2000 (301)223-4855 WILLIAMSPORT, MD 21795 Audatex Estimating 6.0.514 ES 08/04/2011 10:20 AM REL 6.0.514 DT 07/01/2011 Zip Code: 17070 Search Area: HARRISBURG Copyright (C) 2010 Audatex North America, Inc. 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 prior written consent. 08/04/2011 10:20 AM Page 1 of 2 2004 Honda Pilot EX 4 DR Wagon Copyright (C) 2010 Audatex North America, Inc. Audatex Estimating is a trademark of Audatex North America, Inc. 08/04/2011 10:20 AM Page 2 of 2 3 7/30/2011 7/30/2011 0307 81002 1 51.47 3.96 26 4 7/30/2011 7/30/2011 032 7205 1 729.9 79.22 39 5 7/30/2011 7/30/2011 032 7102 1 430.36 47.0 39 6 7/30/2011 7/30/2011 0352 7125 1 1,570.80 202.4 39 7 7/30/2011 7/30/2011 045 99284 25 1 1,220.841 232.45 39 TOTAL SUBMITTED CHARGES 4,043.47 TOTAL APPROVED AMOUNT 565.131 MOUNT NOT PAYABLE 0.0 DEDUCTIBLE N APPORTION MENT/PRO RATA 0.0 PAID AMOUNT 565.1 A A ko INSIIRANC IP REMITTANCE: 9043995 DATE: 02/28/2012 AW1V AIK.IIVND Insurance Auto Auctions,lnc. Attn: Settlement Group 100 Industrial Way Conshohocken, PA 19428-1058 Phone: (610) 277-0894 Fax: (610) 277-9276 E-mail: IAA-ASAP-Philadelphia@iaai.com Tax ID #: 954455113 Remittance Payable To : State Farm Mutual Automobile Ins Co PO Box 122 Concordville, PA 19331 Attn: Salvage Dept Check Amount High Bid Salvaae Info Stock #: rmation 000-08512643 Branch: Harrisburg Insured: BRENDA MYERS Owner: BRENDA MYERS Claim #: 38M173973 Year: 2004 Make/Model: HONDA/PILOT VIN: 2HKYF18474H512622 ACV: $11594 Pick Uo Information MAJOR SELECT 269 MULBERRY DR MECHANICSBURG, PA 17050 Seller DirecVBuver Information Resale Cert#: 65369244 (PA) Henderson Auto Inc. 802 Mount Pleasant Rd Scottdate, PA 15683-1123 Date of Events Loss Date 07/30/2011 Assigned 08/01/2011 Released 08/01/2011 Pickup 08/02/2011 Title Received 12/23/2011 Sale Doc. Received 01/05/2012 Auction Date 02/22/2012 Buyer Payment Date 0212412 0 1 2 Reported to NICB 02!282012 IM Doc. RP002 SF.rpt $948.00 $1,700.00 Pool Charaes Pool Fee $122.00 Total $122.00 Advance Chases Tow $450.00 Storage $180.00 Total $630.00 Payment Amount $948.00 030'62012 ?? ?, ? ""? ?,_ ?..:.? "' It l ,. fir x ?? h xv, 5 `. 7 07M am- F d _ ? - I ?VvS I 9 ny 3{ 4? ?? "b F ? w c nK ti.;:. '? 4 ?, e f :,_ ' ?a r 5 w ? n?E?m}? 4 ? ?. i' ? f ? % o '4? ^? S t ? - i ? "' '? & ? ? ¢? ? 8 ' ? , "'? ^f%"? tib y ?- 4 ?.,. ??? ?? r 41 ?e { T a: Y. NIN ? .. ?? 7 A7, R 4 ? ? p . kYq? ? F h-??" ¦ W ?` -;? ,? ;- .? ?? ' .w? s?>- „ ,; .R ? a ? ?. i ? ??,? ' ?? C VERIFICATION I, Benjamin W. Lawrence, 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. Benjamin)IV. Lawrence Date 16 01) ? _ _ _-r SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor ~~~~,rn ct ~urn~~~~~~~ ~}FF'i~E "F TFtE $t~4RIFF ~;L~D-0~~lG ~~ r~~ ~R~rHO~~ -~~~z ZDI2 MOY -9 AFi & 36 GUM@ERIAhlD COUIVI'Y PENNSYE.IIANIA State Farm Mutual Automobile Ins. Co. Case Number vs. Howard Mentzer 2012-6571 SHERIFF'S RETURN OF SERVICE 11/07/2012 08:36 PM -Deputy Dennis Fry, being duly sworn according to law, served the requested Complaint & Notice by "personally" handing a true copy to a person representing themselves to be the Defendant, to wit: Howard Mentzer at 122 E. Liberty Avenue, Carlisle Borough, Carlisle, PA 17013. DEN FRY, DE~ SHERIFF COST: $46.00 November 08, 2012 SO ANSWERS, .. `~--~ RON R ANDERSON, SHERIFF i=) Coup tySr.nte SI?er:fi, 7*~~ersort, Inc. WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire Attorney for Plaintiff 12- 3" I.D. No. 209032 `" - 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 -~? co t ?P,,. Fax: 215.599.1505 File # 9751553 ca :Z..:.: c, W , } STATE FARM MUTUAL } Cumberland County AUTOMOBILE INS. CO., } Court of Common Pleas Plaintiff } } vs. } Civil Division } Howard Mentzer, } No. 12-6571 Defendants } PLAINTIFF'S REPLY TO DEFENDANT'S NEW MATTER AND CORSSCLAIM 8 - 9. Denied. Defendant's averment is a conclusion of law to which no responsive pleading is required. As way of further response, after reasonable investigation Plaintiff is without sufficient information to form a belief as to the truth or falsity of Defendant's averments. Strict proof is therefore required at time of trial. WHEREFORE, Plaintiff demands that judgment be entered in its favor and against Defendant. WELTMAN, WEINBERG & REIS CO., L.P.A. By INYniamin W. Lawrence, Esquire Attorney for Plaintiff VERIFICATION I, Benjamin W. Lawrence, Esquire, attorney for the Plaintiff(s) do hereby swear and affirm that the averments in the attached Reply to New Matter 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. Benjamin W. Lawrence, Esq. Date fIE f RO TH040E.OFFIC - TAR 2813 SAP 24 P tl /' `3 CUt'gFRLA � �PEAS YCOUN Y IN THE COURT OF MON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION :STATE FARM MUTUAL AUTO INS Plaintiff No. 12-6571 VS. STIPULATION OF THE PARTIES FOR PAYMENT AND FOR THE ENTRY OF JUDGMENT BY CONSENT HOWARD MENTZER Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF ' THIS PARTY: Benjamin W. Lawrence, Esquire PA I.D. #209032 WELTMAN, WEINBERG& REIS CO., L.P.A. 325 Chestnut Street Suite 501 Philadelphia, PA 19106 (215) 599-1500 WWR# 9751553 Y PHI LMS OVA 6 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS CZ -v Plaintiff X M r vs. Civil Action No 12-6571 -<> <C:) - �- HOWARD MENTZER =C Defendant c>> STIPULATION OF THE PARTIES FOR PAYMENT AND FOR THE ENTRY OF JUDGMENT BY CONSENT TO THE PROTHONOTARY: Kindly enter Judgment in favor of Plaintiff and against the Defendant, HOWARD MENTZER, above- named, in the amount of$3,345.30 pursuant to the Stipulation of the Parties for Payment and for the Entry of Judgment by Consent, as follows: 1. Defendant admits indebtedness to Plaintiff in the amount of$3,345.30. 2. To secure the repayment of said indebtedness, Defendant agrees that Judgment.by Consent will be entered in favor of the Plaintiff and against the Defendant, HOWARD MENTZER, in the amount of $3,345.30 plus continuing interest thereon at the statutory rate of 6.000% per annum from the date of judgment, and costs. 3. Plaintiff agrees not to execute on its Judgment so long as Defendant causes to be delivered to Plaintiff the following payments: (a) $50.00 due by August 5, 2013 and continuing monthly until the amount of$3,345.30 is paid in full. 4. All payments are to be made payable to the order of"STATE FARM MUTUAL AUTO INS" 5. The first payment due under this agreement is to be received at the offices of Weltman, Weinberg & Reis, Co., L.P.A., 325 Chestnut Street Suite 501, Philadelphia, PA 19106. All future payments are to be mailed to the offices of Weltman, Weinberg & Reis, Co., P.O. Box 5430, Cleveland, OH 44101-0430. 6. In the event of default, each payment received shall be first attributed to costs, interest and then to principal. 7. Time is of the essence of this agreement and should the Defendant fails to have in the hands of Plaintiff or Plaintiff's counsel any payment in full within five (5) calendar days of the stated due date, then Plaintiff shall be immediately free to issue Execution as well as pursue all other remedies, in law or in equity, to collect the full balance of the Judgment entered hereunder plus appropriate additional interest and costs. 8. No act or omission of the Plaintiff,nor of anyone alleged to be acting on its behalf, shall constitute a waiver, estoppel, or any other excuse for non-performance of any duty undertaken by the Defendant in this Stipulation which the parties agree is final and complete. Intending to be legally bound,the parties set their hands and seals this i day of , 20_� . WELTMAN, WEINBERG & REIS CO., L.P.A. By: Benjamin . Lawrence, Esquire PA I.D. #209032 WELTMAN, WEINBERG& REIS CO., L.P.A. 325 Chestnut Street Suite 501 Philadelphia, PA 19106 WWR# 9751553 Y PHI DKM HOWARD MENTZE 122 EAST LIBERTY AVENUE CARLISLE, PA 17013 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff vs. Civil Action No. 12-6571 HOWARD MENTZER Defendant PRAECIPE FOR J-UDGMENT BY CONSENT T!l TLTT) 171 /'1TT.T(1TT/1T A T?V ` Kindly enter Judgment against Defendant, HOWARD MENTZER, in the amount of$3,345.30 plus costs, based upon the consent of the parties. CONSENTED TO: WELTMAN, WEINBERG & REIS CO., L.P.A. By: Attorney for Plaintiff HOWARD MENTZER 122 EAST LIBERTY AVENUE CARLISLE,PA 17013 WWR# 9751553 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff VS. Civil Action No. 12-6571 HOWARD MENTZER Defendant NOTICE OF JUDGMENT OR ORDER TO: ( )Plaintiff (xx) Defendant ( ) Garnishee You are hereby notified that the following Order or derQJ�gment was entered against you (xx) Assum�� psit Judgment in the amount of$3,345.30 plus costs. ( ) Trespass Judgment in the amount of$ plus costs. ( ) If not satisfied within sixty(60) days, your motor vehicle operator's license and/or registration will be suspended by the Department of Transportation, Bureau of Traffic Safety, Harrisburg, PA. (xx) Entry of Judgment of ( ) Court Order ( ) Non-Pros ( ) Confession ( ) Default ( ) Verdict ( ) Arbitration ( ) Award (XX) By Consent Prothonotary HOWARD MENTZER 122 EAST LIBERTY AVENUE CARLISLE, PA 17013 r.3 c. By: PROTHONOTARY (OR DEPUTY)