Loading...
HomeMy WebLinkAbout13-1547 C.tJ ..aw I I 6 cn _. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff No: ��j - 1517 0 vs. COMPLAINT IN CIVIL ACTION ERICK SNYDER 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 20037372 C Y Jer DKM ( D 4 103.7 NA Al'ty c� 1101 gist 0 J-88 i4a IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff vs. Civil. Action No ERIC'K SNYDER 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 Attorney for Plaintiff(s) Pa. Identification No.209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File #20037372 } STATE FARM MUTUAL AUTOMOBILE } INSURANCE COMPANY } Court of Common Pleas } CUMBERLAND County } } vs. } } ERICK SNYDER } NO. CIVIL ACTION — COMPLAINT 1. 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. 2. Defendant is an adult individual who at all time pertinent hereto resided at 15 PEACOCK DR, CARLISLE, PA17015. 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 October 2, 2012 Defendant was the operator of a motor vehicle which vehicle did negligently, recklessly and /or carelessly collide with the Plaintiff Insured's vehicle at or near Routes 581 and 83, Camp Hill, 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 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 State Farm Insured's vehicle sustained property damage and /or incurred rental charges in the total amount of $5,487.73. 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 $5,487.73 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A. Ben mio'W. Lawrence, Esquire P "# 209032 32 hestnut Street Suite 501 Philadelphia, PA 19106 (215) 599 -1500 WWR #20037372 APPLE COLLISION CENTER Workfile ID: 757892cf Federal ID: 23- 2257255 SERVING ALL OF YOUR COLLISION AND AUTOBODY NEEDS 1090 B MARBROOK LANE, YORK, PA 17404 Phone: (717) 852 -9592 FAX: (717) 852 -0640 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Written By: DYLAN MARTIN, 558040, 10/18/2012 1:17:08 PM Insured: MOOK, ASHLEY Policy #: Claim #: 38 -1P59 -19001 Type of Loss: COLL- Collision Date of Loss: 10/2/2012 12:00:00 AM Days to Repair: 0 Point of Impact: 05 Right Rear Owner: Inspection Location: Insurance Company: HOOK, ASHLEY APPLE COLLISION CENTER STATE FARM INSURANCE COMPANIES 169 IRVING RD 1090 B MARBROOK LANE COC ESTIMATICS SERVICE CENTER YORK, PA 17403 -3731 YORK, PA 17404 ( 717) 600 -8148 Evening Repair Facility ( 717) 793 -0410 Cellular (717) 852 -9592 Day Vehicle Drop Off Date: 10/08/2012 Promise Date: 10/17/2012 Repair Start Date: 10/08/2012 Repair Completion Date: 10/18/2012 Vehicle Pick Up/ Return 10/18/2012 Date: VEHICLE Year: 2003 Body Style: 4D SED VIN: 1.HGCM66533AO46428 Mileage in: 196608 Make: HOND Engine: 6- 3.OL -Fl License: HCA8157 Mileage Out: Model: ACCORD EX Production Date: 2/2003 State: PA Vehicle Out: 10/17/2012 Color: SILVER Int: BLACK Condition: Sob #: TRANSMISSION Tilt Wheel Aluminum /Alloy Wheels Passenger Air Bag Automatic Transmission Telescopic Wheel RADII) Front Side Impact Air Bags Overdrive Steering Wheel Controls AM Radio Console /Storage Traction Control BRAKES FM Radio Diaital Clock SEATS Power Brakes Stereo Intermittent Wipers Power Drver Seat 4 Wheel Disc Brakes Search /Seek EXTERIOR Power Passenger Seat Anti -Lock Brakes (4) CD Changer /Stacker Power Mirrors Bucket Seats ROOF INTERIOR Dual Mirrors Leather Seats Electric Glass Sunroof Power ocks Body Side Moldings Heated Seats GLASS Power Trunk/Tailgate Alarm Reclining Seats Rear Defogger Air Conditioning Keyless Entry STEERING Power Windows Cruise Control PAINT Power Steering WHEELS Driver Air Bag Clear Coat Paint 10/18/2012 1:17:09 PM 017631 Page 1 Supp lement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.0L -FI SILVER Line Oper Description Part Number Qty Extended Labor Paint _ Price $ 1 WHEELS _ 2 R&I RT /Rear R &I wheel m 0.1 NOTE: R &I FOR ACCESS TO REAR INNER QUARTER 3 ROOF 4 R &I RT Roof molding 0.6 NOTE: R&I FOR RIGHT ROOF RAIL REFINISH 5 PILLARS, ROCKER & FLOOR 6 Bind RT Aperture panel USA & Mex bit s 1.6 NOTE: BLEND DUE TO RIGHT QUARTER REPLACEMENT FOR ACCURATE COLOR MATCH 7 Repi NIB SANDING -DEBIB 1 0.1 3 R&I RT Rocker molding SE, EX satin 0.8 silver 9 R&-I RT Body w'strip rear graphite 0.3 10 R &I RT Rear sill plate outer graphite 0.2 11 REAR. DOOR R &I RT R &I door assy 1.0 NOTE: R &I FOR QUARTER REPLACEMENT 13 Rpr RT Outer panel 1.0 2.0 NOTE: TIME IS TO REPAIR LIGHT WAVE AND REAR EDGE OF RIGHT REAR DOOR 14 Repl NIB SANDING -DEBIB 1 0.1 15 R&I RT Belt w'strip EX, LX, SE 0.3 16 R &I RT Body side mldg satin silver 03 17 R&I RT Handle, outside LX, EX satin 0.9 silver 18 R &I RT R &I trim panel 0.5 19 R &I RT Water deflector USA & Mexico 0.1 built 20 BACK: GLASS 21 R&I Back glass Honda USA & Mexico Incl. built 22 QUARTER PANEL 23 Repl LKQ RT quarter section +25% 04636SDA306ZZ 1 443.75 17.5 3.6 NOTE: CHUCK'S AUTO PARTS DOUGLASSVILLE, PA 610 - 689 -9545 SPOKE W JAMES, QT #23968 24 Overlap Major Adj. Panel _0 25 T Repl CORROSION PROTECTION 1 0.3 26 T Repi NIB SANDING -DEBIB 1 0.3 27 - Rpr Test ft Ikq quarter 1.0 28 R &I RT Splash shield 0 29 Repl LKQ RT Gutter 63320SDAAOOZZ 1 Incl. Incl. 0.5 .;0 Overlap Minor Panel 0 31 R &I Mudguard -RT RR 0 32 R &I M ud guard -LT RR 0.7 33 REAR BODY & FLOOR 10/18/2012 1:17:09 PM 017631 Page 2 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER 34 Repi Rear body panel USA & Mex bit 6610OSDAAOOZZ 1 32112 6.5 1.2 NOTE: REPALCE DUE TO RIGHT SIDE DAMAGED AND NON REPAIRABLE, RIGHT INNER STRUCTURE OF REAR BODY KINKED 35 Overlap Major Adj. Panel -0 36 Add for Inside 0.6 37 Deduct for Overlap 1.5 38 a Repl CORROSION PROTECTION 1 0.3 39 Rep] NIB SANDING -DEBIB 1 Q 40 R &I Rear panel trim Incl. 41 R&I RT Trunk side trim Incl. 42 R &I LT Trunk side trim Incl. 43 R&I Spare cover 0.1 44 Rpr Rear floor pan USA built Federal 2.0 1.5 NOTE: TIME IS TO REPAIR RIGHT REAR CORNER OF FLOOR AFTER PULL AND AFTER QUARTER REMOVED 45 T PARTIAL REFINISH DEDUCTION 1 -0.3 46 Repl RT Insulator 74641SDAAOO 1 60.73 NOTE: REPLACE DUE TO BEING TORN AT REAR 47 TRUNK LID 48 R &I R &I trunk lid 0,7 49 Rpr Trunk lid 1.5 23 NOTE: TIME IS TO REPAIR RIGHT LOWER CORNER OF TRUNK LID 50 Overlap Major Adj. Panel -0.4 51 PARTIAL REFINISH ADJSUTMENT 1 -0 52 x Repl CORROSION PROTECTION 1 0.3 1 �3 Repl NIB SANDING -DEBIB 1 0 54 R &I Weatherstrip USA & Mexico built Incl. 55 Repi Emblem "H" factory installed 75701SDAOOO 1 18.38 0.?_ 56 Repi Nameplate "Accord" factory 75722SDAAOO 1 17.40 0.2 installed 57 Repi Nameplate "EX" factory 75731S84A20 1 10.98 0.2 58 R &I Trunk lid trim 0 59 REAR LAMPS 60 R &I RT Tail lamp 03 61 R &I LT Tail lamp 0 62 Repi RT Turn & stop lamp 33501SDAA01 1 148.73 Ind. NOTE: RIGHT TAIL LAMP LOCATED AT CHUCKS, BUT NOT COST EFFECTIVE AFTER MARKUP $115.00 + 25% CHUCK'S .AUTO PARTS DOUGLASSVILLE, PA 610 - 689 -9545 SPOKE W JAMES, QT #239681 63 REAR, BUMPER 64 O/H rear bumper 1.6 65 < :> Repl Bumper cover 047155DAA90ZZ 1 365.32 Incl. 3.0 NOTE: REPALCE DUE TO RIGHT SIDE MISSING AT TEARDOWN 66 Overlap Major Non -Adj. Panel -02 67 Deduct for Rear Bumper R&I 1.0 68 Clear Coat 25 69 Repl NIB SANDING -DEBIB 1 0.3 70 Repl RT Side support 71593SDAA01 1 11.55 0.2 1011812012 1 :17:09 PM 017631 Page 3 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.0L -FI SILVER 71 Repl Energy absorber 7157OSDAA00 1 46.52 Incl. NOTE: REPLACE DUE TO ABSORBER SPLIT 72 Repl RT Side support screw 90126SR4000 2 8.60 73 R &I Reinf beam USA & Mex bit Incl. 74 Repl Nameplate "V6" factory 75731S87A00 1 12.80 Incl. 75 Repl WASH AND VACUUM INTEROR 1 Incl. I $29.99 VALUE 76 Repl CAR COVER 1 6.00 0.2 77 Repi HAZARDOUS WASTE REMOVAL 1 3.00 T 78 Repi SEAM SEALER PER TUBE 1 36.00 79 Repi TIPS FOR SEAM SEALER PER 1 1.00 PIECE 80 Repi URETHANE KIT FOR WINDOW 1 18.00 81 Repl RE -TAPE MLDGS 1 5.00 0.4 82 Repi ADHESIVE REMOVAL 1 0.1 83 Repl SET -UP PARTIAL 1 1.0 NOTE: SET UP TO PULL RIGHT REAR CORNER OF QUARTER 84 Repi PULL UNIBODY /FRAME TO 1 2.0 F SPECIFICATIONS 85 Y Repi FLEX ADDITIVE FOR BUMPER 1 8.00 REFINISH 86 Repi A/M SPOT WELD DRILL BITS 1 24.00 87 R.efn TOUCH -UP BOLTS 0.1 88 QUARTER SLEEVES 1 1.0 89 MASK INTERIOR 1 6.00 0.1 40 LARGE PANEL ADHESIVE 1 25.00 NOTE: PANEL ADHESIVE NEEDED FOR RIGHT QUARTER REPLACEMENT 91 # MIXING NOZZLES 1 2.00 92 RESET ELECTRONICS 1 0.2 93 - D &R BATTERY 1 0.1 NOTE: DISCONNECT BATTERY FOR WELDING 94 LKQ TRIM TIME 1 3.0 NOTE: TIME IS TO TRIM LKQ QUARTER FROM QUARTER SECTION 95 ACID BRUSH 1 1.00 96 Repl SOUND DEADENING 1 5.00 0.1 97 S01 Repl RT Bumper cover bracket 7150SSDAA00 1 13.82 Incl. NOTE: PART MISSING 98 S02 FINA EVENT LOG 1 SUBTOTALS 1,620.70 44.0 18.8 1011812012 1 :1, 09 PM 017631 Page 4 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HAND ACCORD EX 4D SED 6- 3.0L -FI SILVER ESTIMATE TOTALS Category Basis R ate Cost $ Parts 1,617.70 Body Labor 43.0 hrs @ $ 48.00 /hr 2,064.00 Paint Labor 18.8 hrs @ $ 48.00 /hr 902.40 Frame Labor 2.0 hrs @ $ 48.00 /hr 96.00 Paint Supplies 19.0 hrs @ $ 26.00 /hr 494.00 Miscellaneous _ _ 3.00 S ubtotal _ 5,177.10 Sales Tax $ 5,177.10 @ 6. 310.63 Grand Total 5,487.73 Deductible _ 250.00 CUSTOMER PAY _ 250.00 I NSURANCE PAY 5,237.73 10/18/2012 1:17:09 PM 017631 Page 5 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6-- 3.OL -FI SILVER SUPPLEMENT SUMMARY Line i Oper Description Part Number Qty Extended Labor Paint Price $ Added Items 98 # S02 FINAL EVENT LOG 1 SUBTOTALS 0.00 0.0 0.0 TOTALS SUMMARY Category Basis Rat Cost $ Parts 0.00 Paint Supplies 0.2 hrs @ $ 26.00 /hr 5.20 Additional Supplement Materials /Supplies -5.20 S ubtotal 0.00 CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate 5,473.08 DYLAN MARTIN Supplement S01 14.65 DYLAN MARTIN Supplement S02 0.00 DYLAN MARTIN Job Total: $ 5,487.73 CUSTOMER PAY: $ 250.00 INSURANCE PAY: $ 5,237.73 THIS ESTIMATE IS BASED ON VISUAL DAMAGE ONLY.IF ADDITIONAL DAMAGE IS FOUND ESTIMATE TOTALS ARE SUBJECT TO CHANGE. APPLE COLLISION GIVES A WARRANTY ON WORKMANSHIP & REFINISHING FOR AS LONG AS OWNER RETAINS OWNERSHIP OF REPAIRED VEHICLE 10/1812012 2:17:09 PM 017631 Page 6 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER 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 THE PERSON TO 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 TO BE REPAIRED OR REPLACED: 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 FST= ESTIMATE EXT. PRICE =UNIT PRICE MULTIPLIED BY THE QUANTITY INCL= INCLUDED MISC = MISCELLANEOUS NON- ADJ =NON ADJACENT O /H= OVERHAUL OP= OPERATION NO =LINE NUMBER QTY = QUANTITY 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 CHANGED]. * *= DATABASE LINE WITH AFTERMARKET N =NOTES ATTACHED TO LINE NAGS= NATTC"At Gtl"S SPECIFICATIONS. MQVP= MANUFACTURER'S QUALITY AND VALIDATION PROGRAM.OPT OEM= ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT. THE ATTACHED ESTIMATE REPRESENTS AN APPRAISAL OF THE COST OF REPAIR FOR THE VISIBLE DAMAGE TO - THE VEHICLE NOTED AT THE TIME OF INSPECTION NECESSARY TO 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 TO REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT IS AVAILABLE FROM THE INSURANCE COMPANY. IF USED PARTS ARE SPECIFIED, THEY ARE REQUIRED TO 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. 10/18/201, PM 017631 Page 7 Supplement of Record 2 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER stimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ARG4437, CCC Data Date 10/9/2012, 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 through 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" parts provided by OEM's through OEM vehicle dealerships. Asterisk ( *) or Double Asterisk ( * *) indicates that the parts and /or labor information provided by MOTOR may have been modified or may have came from an alternate data source. Tilde sign ( —) items indicate MOTOR Not - Included Labor operations. The symbol ( < >) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non - Original Equipment Manufacturer aftermarket parts are described as AM. Used parts are described as LKQ, RCY, or USED. Reconditioned parts are described as Recond. Rebored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. !_abor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign ( #) items indicate manual entries. >ome 2012 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 CCC ONE � has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local :ealership. 1 he following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to ce repaired or replaced: YMBOLS FOLLOWING PART PRICE: ,m Mechanical component. s =MOTOR Structural component. T= Miscellaneous Taxed charge category. X =Miscellaneous Non -Taxed charge category. - YMBOLS FOLLOWING LABOR: D= Diagnostic labor category. E= Electrical labor category. F =Frame labor category. G =Glass labor category. P I — Mechanical labor category. S= Structural labor category. (numbers) 1 through 4 =User Defined Labor Categories. f- )THF_R SYMBOLS AND ABBREVIATIONS: Adj. Adjacent. Algn.= Align. ALU= Aluminum. A /M= Aftermarket part. Bind= Blend. BOR =Baron steel. CAPA= Certified Automotive Parts Association. D &R= Disconnect and Reconnect. HSS =High Strength Steel. HYD= Hydroformed Steel. Incl.= Included. LKQ =Like Kind and Quality. LT =Left. MAG= Magnesium. Non -Adj. =Non Adjacent. NSF =NSF International Certified Part. O /H= Overhaul. Qty= Quantity. Refn = Refinish. Repl = Replace. R &I == Remove and Install. R &R= Remove and Replace. Rpr= Repair. RT= Right. SAS = Sandwiched Steel. '-ect =Section. Subl= Sublet. UHS =Ultra High Strength Steel. N= Note(s) associated with the estimate line. CCC ONE Estimating - A product of CCC Information Services Inc. The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR = Bureau of Automotive Repair. EPA= Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR= Paintless Dent Repair. VIN = Vehicle Identification Number. 10/18/2012 1 :17:09 PM 017631 Page 8 APPLE COLLISION CENTER Workfile ID: 757892cf Federal ID: 23- 2257255 SERVING ALL OF YOUR COLLISION AND AUTOBODY NEEDS 1090 B MARBROOK LANE, YORK, PA 17404 Phone: (717) 852 -9592 FAX: (717) 852 -0640 Supplement of Record 1 with Summary Customer: MOOK, ASHLEY Job Number: Written By: DYLAN MARTIN, 558040, 10/18/2012 8 :41:10 AM insured: MOOK, ASHLEY Policy #: Claim #: 38 -1P59 -19001 Type of Loss: COLL- Collision Date of Loss: 10/2/2012 12:00:00 AM Days to Repair: 0 Point of Impact: 05 Right Rear Owner: Inspection Location: Insurance Company: MOOK, ASHLEY APPLE COLLISION CENTER STATE FARM INSURANCE COMPANIES 169 IRVING RD 1090 B MARBROOK LANE COC ESTIMATICS SERVICE CENTER YORK, PA 17403 -3731 YORK, PA 17404 717) 600 -8148 Evening Repair Facility 7 171 793 -0410 Cellular (717) 852 -9592 Day Vehicle Drop Off Date: 10/08/2012 Promise Date: 10/17/2012 Repair Start Date: 10/08/2012 VEHICLE Year: 2003 Body Style: 4D SED VIN: 1HGCM66533A046428 Mileage In: 196608 Make: HONE) Engine: 6- 3.OL -Fl License: IICA8157 Mileage Out: Model: ACCORD EK Production Date: 2/2003 State: PA Vehicle Out 10/17/2012 Color: SILVER Int: BLACK Condition: Job #: TRANSMISSION Tilt Wheel Aluminum /Alloy Wheels Passenger Air Bag Automatc Transmission Telescopic Wheel RADIO Front Side Impact Air Bags Overdriv -e Steering Wheel Controls AM Radio Console /Storage Traction Control BRAKES FM Radio Digital Clock SEATS Power Brakes Stereo Intermittent Wipers Power Driver Seat 4 Wheel Disc Brakes Search /Seek EXTERIOR Power Passenger Seat Anti -Lock Brakes (4) CD Changer /Stacker Power M Bucket Sears ROOF INTERIOR Dual Mirrors Leather Seats Electric Glass Sunroof Power Locks Body Side Moldings Heated Seats GLASS Power Trunk/Tailgate Alarm Reclining Seats Rear Defogger Air Conditioning Keyless E:ntrj STEERING Power Windows Cruise Control PAINT Power Steering WHEELS Driver Air Bag Clear Coat Paint 10/'18/2012 8:41:10 AM 017631 Page 1 Supplement of Record 1 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.01--FI SILVER Line Oper Description Part Number Qty Extended Labor Paint Price $ 1 WHEELS 2 R &I RT /Rear R&I wheel m 0.1 NOTE: R &I FOR ACCESS TO REAR INNER QUARTER 3 ROOF 4 R &I RT Roof molding 0.6 NOTE: R&I FOR RIGHT ROOF RAIL REFINISH 5 PILLARS, ROCKER & FLOOR 6 Blnd RT Aperture panel USA & Mex blt s 1.6 NOTE: BLEND DUE TO RIGHT QUARTER REPLACEMENT FOR ACCURATE COLOR MATCH 7 Repi NIB SANDING -DEBIB 1 0.1 8 R &I RT Rocker molding SE, EX satin 0.8 silver 9 R &I RT Body w'strip rear graphite 03 10 R &I RT Rear sill plate outer graphite 4,2 it REAR DOOR 12 R &I RT R &I door assy 1.0 NOTE: R &I FOR QUARTER REPLACEMENT 13 Rpr RT Outer panel 1.0 2.0 NOTE: TIME IS TO REPAIR LIGHT WAVE AND REAR EDGE OF RIGHT REAR DOOR 14 s Repl NIB SANDING -DEBIB 1 0.1 15 R &I RT Belt w'strip EX, LX, SE 0.3 16 R &I RT Body side mldg satin silver 0.3 17 R &I RT Handle, outside LX, EX satin 0A silver is R &I RT R &I trim pane) 0.5 19 R &I RT Water deflector USA & Mexico 0 built 20 BACK GLASS 21 R &I Back glass Honda USA & Mexico I ntl. built 22 QUARTER PANEL 23 Repi LKQ RT quarter section +25% 04636SDA306ZZ 1 443.75 17.5 3.6 NOTE: CHUCK'S AUTO PARTS DOUGLASSVILLE, PA 610 - 689 -9545 SPOKE W JAMES, QT #239681 24 Overlap Major Adj. Panel -0 25 Repl CORROSION PROTECTION 1 0.3 26 - Repl NIB SANDING -DEBIB 1 0.3 27 Rpr Test fit Ikq quarter 1.0 28 R &I RT Splash shield 02 29 Repl LKQ RT Gutter 63320SDAA04ZZ 1 Incl. Inc l. 0.5 34 Overlap Minor Panel -0.2 31 R &I Mudguar -RT RR 0 R &I Mud guard -LT RR 0.2 33 REAR BODY & FLOOR 1 0118/2012 8:41: 1 0 AM 017631 Page 2 y Suppiement of Record I with Summary • Job Number: C 1116mer: MMK, ASHLEY Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER 30 Repl Rear body panel USA & Mex blt 6610OSDAAOOZZ 1 322.12 6.S 1.2 NOTE_ MpM RIGHT SIDE DAMAGED AND NON REPAIRABLE, RIGHT INNER STRUCTURE= OF REAR BODY KINKED -0.4 35 Overlap Major Adj. Panel 9.6 3 Add fbr Inside 1.'S 37 Deduct for Overlap 1 0.3 38 # Repl CORROSION PROTECTION 0.1 39 # Repl NIB SANDING -DEBIB 1 Incl. 40 R&I Rear panel trim Incl. 4; R&I RT Trunk side trim Incl. R &I LT Trunk side trim 0.1 R &I Spare cover 2,0 1.5 14 Rpr Rear Floor pan USA built Federal NOTE: TIME IS TO REPAIR RIGHT REAR CORNER OF FLOOR AFTER PULL AND AFTER QUARTER REMOVED 1 -0.3 w PARTIAL REFINISH DEDUCTION Repi RT Insulator 74641SDAAOO 1 60.73 NOTE: REPLACE DUE TO BEING TORN AT REAR TRUNK LID 0 R &I R &I trunk lid 1.5 2.3 Rpr Trunk lid NOTE: TIME IS TO REPAIR RIGHT LOWER CORNER OF TRUNK LID -O.4 Overlap Major Adj. Panel 1 -0.2 PARTIAL REFINISH ADISUTMENT 1 # Repl CORROSION PROTECTION 0.3 1 Repl NIB SANDING -DEBIB T R &I VVeatherstrip USA & Mexico built Ind. 0.2 ;5 Rep! Emblem "H" factory installed 75701SDAOOO 1 18.38 0.2 56 Repl Nameplate "Accord" factory 75722SDAAOO 1 17.40 12 installed 57 Repl Nameplate "EX" factory 75731S84A20 1 10.98 0.2 0.3 58 R &I Trunk lid tr,m 59 REAR LAMPS 0.3 60 R &I RT Tail lamp 0.3 61 R &I LT Tail lamp 62 Repl RT Turn & stop lamp 33501SDAA01 1 148.73 Incl. NoTE: R;e6M TAIL LAMP LOCATED AT CHUCKS, BUT NOT COST EEFECTIVE AFTER MARKUP $11.5.00 + 25 CHUCK'S AUTO PARTS DOUGLASSVILLE, PA 610 -689 -9545 SPOKE W JAMES, QT #239681 53 REAR BUMPER 1.6 64 D/H rear bumper 65 Rep! Bumper cover 04715SDAA90ZZ 1 365.32 Incl. 3.0 NOTE: REPLLCE DUE TO RIGHT SIDE MISSING AT TEAR.DOWN -0.2 66 Overlap Major Non -Adj, Panel Deduct for Rear Bumper R&I 1.Ci 67 2.5 68 Clear Coat SAYOING -DEBIB 1 0.3 l 70 Rem RT SMe support 71593SDAA01 1 11.55 0.2 10(18j2012 8:41:10 AM 017631 Page 3 Supplement of Record 1 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER 71 Rep! Energy absorber 7157OSDAA00 1 46.52 Incl. NOTE: REPLACE DUE TO ABSORBER SPLIT 72 Real RT Side support screw 90126SR4000 2 8.60 73 R &I Reinf beam USA & Mex bit Incl. 74 Repi Nameplate "V6" factory 75731S87A00 1 12.80 Incl. 75 4 R 4A WASH AND VACUUM INTEROR 1 Incl. Incl. $29.99 VALUE 76 Repl CAR COVER 1 6.00 0.2 77 Repl HAZARDOUS WASTE REMOVAL 1 3.00 T 78 Repi SEAM SEALER PER TUBE 1 36.00 79 Repi TIPS FOR SEAM SEALER PER 1 1.00 PIECE 80 - Repl URETHANE KIT FOR WINDOW 1 18.00 81 Repl RE -TAPE MLDGS 1 5.00 0.4 82 Repl ADHESIVE REMOVAL 1 0.1 83 Rep) SET -UP PARTIAL 1 1.0 NOTE: SET UP TO PULL RIGHT REAR CORNER OF QUARTER 84 Repi PULL UNIBODY /FRAME TO 1 2.0 F SPECIFICATIONS 85 = Repi FLEX ADDITIVE FOR BUMPER 1 8.00 REFINISH 36 "* Repl AfM SPOT WELD DRILL BITS 1 24.00 87 Refn TOUCH -UP BOLTS 0.1 88 # QUARTER SLEEVES 1 1.0 89 r MASK INTERIOR 1 6.00 0.1 90 LARGE PANEL ADHESIVE 1 25.00 NOTE: PANEL ADHESIVE NEEDED FOR RIGHT QUARTER REPLACEMENT 91 - MIXING NOZZLES 1 2.00 92 - RESET ELECTRONICS 1 0.2 93 D &R BATTERY 1 0.1 NOTE: DISCONNECT BATTERY FOR WELDING 94 LKQ TRIM TIME 1 3.0 NOTE: TIME IS TO TRIM LKQ QUARTER FROM QUARTER SECTION 95 - ACID BRUSH 1 1.00 96 x Repi SOUND DEADENING 1 5.00 0.1 97 501 " iii Bumper cover bracket 71505SDAA00 1 13.82 Ind. NOTE: PART MISS SUBTOTALS 1620.70 45.0 18.8 10/18/2012 8!41 :t0 Ah1 017631 Page 4 S of R ecord 1 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 40 SED 6.- 3.OL -FI SILVER ESUMATE TOTALS Category Basis Rate Cost $ Paris 1,617.70 Body Labor 43.0 hrs @ $ 48 -00 /hr 2,064.00 Paint Labor 18.8 hrs @ $ 48.00 /hr 902.40 Frame Labor 2.0 hrs @ $ 48.00 !hr 96.00 Paint Supplies 19.0 hrs @ $ 26.00 /hr 494.00 Miscellaneous 3.00 Subtotal 5,177.10 Sales Tax $ 5,177.10 @ 6.00 310.63 Grand Total 5,487.73 Deductible 250.00 Deductible Credit 0.00 CUSTOMER PAY 250.00 INSURANCE PAY 5,237.73 10/18/2012 8:41:10 AM 017631 Page 5 Supp lement of Record 1 with Summary Customer:. MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER SUPPLEMENT SUMMARY Line Oper Description Part Number . Qty Extended Labor Paint pdae; Added Items 97 S01 Repl RT Bumper cover bracket 71505SDAAOO 1 13.82 Incl. NOTE: PART MISSING., SUBTOTALS 13.82 0.0 0.0 TOTALS SUMMARY Category Basis Rate Cost $ Parts 13.82 Paint Supplies 0.00 Subtotal - - - - -- 13.82 Sales Tax $ 13.82 @ 6.00 0 10 0.83 Total Supplement Amount _ 14.65 NET COST OF SUPPLEMENT 14.65 CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate 5,47308 DYLAN MARTIN Supplement S01 14.65 DYLAN MARTIN Job Total: $ 5,487.73 CUSTOMER PAY: $ 250.00 INSURANCE PAY: $ 5,237.73 THIS ESTIMATE IS BASED ON VISUAL DAMAGE ONLY.IF ADDITIONAL DAMAGE IS FOUND ESTIMATE TOTALS ARE SUBJECT TO CHANGE. APPLE COLLISION GIVES A WARRANTY ON WORKMANSHIP & REFINISHING FOR AS LONG AS OWNER RETAINS OWNERSHIP OF REPAIRED VEHICLE 10/18/2012 8:41: tO AM 017631 Page 6 Supp of Record 1 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6-3.OL -FI SILVER 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 - HE PERSON TO CRIMINAL AND CIVIL PENALTIES. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIOE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: D= DISCONTINUED PART A= APPROXIMATE PRICE B =BODY LABOR D= DIAGNOSTIC E= ELECTRICAL F =FRAME G =GLASS M= MECHANICAL P =PAINT LABOR S= STRUCTURAL ' =TAXED MISCELLANEOUS X =NON TAXED MISCELLANEOUS ADJ= ADJACENT ALGN =ALIGN A/M =AFTER MARKET 3LND =BLEND CAPA= CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D &R= DISCONNECT AND RECONNECT EST= ESTIMATE EXT. PRICE =UNIT PRICE MULTIPLIED BY THE QUANTITY INCL= INCLUDED MISC = MISCELLANEOUS NON -ADJ =NON ADJACENT O /H= OVERHAUL OP= OPERATION NO =LINE NUMBER QTY = QUANTITY 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 CHANGED]. * *= DATABASE LINE WITH AFTERMARKET N =NOTES ATTACHED TO LINE NAGS = NATIONAL AUTO GLASS SPECIFICATIONS. MQVP= MANUFACTURER'S QUALITY AND VALIDATION PROGRAM.OPT OEM= ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT. HE ATTACHED ESTIMATE REPRESENTS AN APPRAISAL OF THE COST OF REPAIR FOR 7W V157"tE- DAMAGE TO HE VEHICLE NOTED AT THE TIME OF INSPECTION NECESSARY TO RETURN THE VEHICLE TO ITS PREDAMAGED CONDITION. COSTS ABOVE THE APPRAISED AMOUNT MAY BE THE RESPONSIBILITY OF THE VEHICLE OWNER. HFRE IS NO REQUIREMENT THAT THE VEHICLE OWNER USE ANY SPECIFIED REPAIR SHOP. INFORMATION REGARDING REPAIR FACILITIES WHICH WILL BE ABLE TO REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT IS AVAILABLE FROM THE INSURANCE COMPANY. IF USED PARTS ARE SPECIFIED, THEY ARE REQUIRED TO BE OF _IKE KIND AND QUALITY TO THOSE BEING REPLACED. INCIDENTAL CHARGES SUCH AS TOWING, PROTECTIVE :ARE, CUSTODY, STORAGE, DEPRECIATION, BATTERY AND TIRE REPLACEMENT ARE NOTED WHEN APPLICABLE. ' 8:41 10 AM 017631 Page 7 Supplemen of Record 1 with Summary Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.0L -FI SILVER Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ARG4437, CCC Data Date 10/9/2012, 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 through 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" parts provided by OEM's through OEM vehicle dealerships. Asterisk ( *) or Double Asterisk ( * *) indicates that the parts and /or labor information 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. The symbol ( < >) indicates the refinish operation WILL NOT be performed as a separate procedure rom the other panels in the estimate. Non - Original Equipment Manufacturer aftermarket parts are described as AM. Used parts are described as LKQ, 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 line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign ( #) items indicate manual entries. `tome 2012 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 CCC ONE estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. the following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to he repaired or replaced: SYMBOLS FOLLOWING PART PRICE: m =MOTOR Mechanical component. s =MOTOR Structural component. T= Miscellaneous Taxed charge category. X= Miscellaneous Non -Taxed charge category. SYMBOLS FOLLOWING LABOR: D= Diagnostic labor category. E= Electrical labor category. F =Frame labor category. G =Glass labor category. M =Mechanical labor category. S= Structural labor category. (numbers) 1 through 4 =User Defined Labor Categories. OTHER SYMBOLS AND ABBREVIATIONS: Adj.= Adjacent. Algn.= Align. ALU= Aluminum. AIM= Aftermarket part. Bind =Blend. BOR =Boron steel. CAPA-Certified Automotive Parts Association. D &R= Disconnect and Reconnect. HSS =High Strength Steel. HYD= Hydroformed Steel. Incl.= Included. LKQ =Like Kind and Quality. LT =Left. MAG= Magnesium. Non -Adj. =Non Adjacent. NSF =NSF International Certified Part. O /H= Overhaul. Qty = Quantity. Refn= Refinish. Repl ==Replace. R &I= Remove and Install. R &R= Remove and Replace. Rpr= Repair. RT= Right. SAS= Sandwiched Steel. t >ect= Section. Subl= Sublet. UHS =Ultra High Strength Steel. N= Notes) associated with the estimate line. CCC ONE EstknatOg - A product of CCC Information Services Inc. The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR = Bureau of Automotive Repair. EPA= Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR= Paintless Dent Repair. VIN = Vehicle Identification Number. 10/18/2012 "1:10 AM 017631 Page 8 APPLE COLLISION CENTER Workfile ID: 757892cf Federal ID: 23- 2257255 SERVING ALL OF YOUR COLLISION AND AUfOBODY NEEDS 1090 B MARBROOK LANE, YORK, PA 17404 Phone: (717) 852 -9592 FAX: (717) 852 -0640 Estimate of Record Customer: MOOK, ASHLEY Job Number: Written By: DYLAN MARTIN, 558040, 1015/2012 3 :49:44 PM Insured: MOOK, ASHLEY Policy #: Claim #: 38 -1P59- :.9001 Type of Loss: COLL - Collision Date of Loss: 10/2/2012 12:00:00 AM Days to Repair: 0 Point of Impact: 05 Right Rear Owner: Inspection Location: Insurance Company: MOOK, ASHLEY APPLE COLLISION CENTER STATE FARM INSURANCE COMPANIES 169 IRVING RD 1090 B MARBROOK LANE COC ESTIMATICS SERVICE CENTER (ORK, PA 17403 -3731 YORK, PA 17404 ,717) 600 -8148 Evening Repair Facility (717) 793 -0410 Cellular (717) 852 -9592 Day Vehicle Drop Off Date: 10/08/2012 Promise Date: 1011712012 Repair Start Date: 10/08/2012 VEHICLE rear: 2003 Body Style: 4D SED VIN: 1HGCM66533AO46428 Mileage In: 196608 Make: HOND Engine: 6- 3.OL -FI License: HCAS157 Mileage OuL Mode{: ACCORD EX Production Date: 2/2003 State: PA Vehicle Out: 1011712012 Cnlor: SILVER Int: BLACK Condition: lob h: TRANSMISSION Tilt Wheel Aluminum /Alloy Wheels Passenger Air Bag Automatic Transmission Telescopic Wheel RADIO Front Side Impact Air Bags Overdrive Steering Wheel Controls AM Radio Console,/Storage Traction Control BRAKES FM Radio Digital Clock SEATS Power Brakes Stereo Intermittent Wipers Power Driver Seat 4 Wheel Disc Brakes Search /Seek EXTERIOR Power Passenger Seat Anti -Lock Brakes (4) CD Changer /Stacker Power Mirrors Bucket Seats ROOF INTERIOR Dual Mirrors Leather Seats Electric Glass Sunroof Power Locks Body Side Moldings Heated Seats GLASS Power Trunk/Tailgate Alarm Reclining Seats Rear Defogger Air Conditioning Keyless Entry STEERING Power Windows Cruise Control PAINT Power Steering WHEELS Driver Air Bag Clear Coat Paint tO /5 /2012 3:49:44 PM 017631 Page 1 Estimate of Record Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER Line Oper Description Part Number Qty Extended Labor Paint Price $ WHEELS 2 R&I RT /Rear R &I wheel m 0.1 NOTE: R &I FOR ACCESS TO REAR INNER QUARTER 3 ROOF 4 R &I RT Roof molding 0.6 NOTE: R&I FOR RIGHT ROOF RAIL REFINISH 5 PILLARS, ROCKER & FLOOR 6 Bind RT Aperture panel USA & Mex bit s 1.6 NOTE: BLEND DUE TO RIGHT QUARTER REPLACEMENT FOR ACCURATE COLOR MATCH 7 # Repl NIB SANDING -DEBIB 1 0.1 8 R&I RT Rocker molding SE, EX satin 0.8 silver 9 R&I RT Body w'strip rear graphite 0.3 10 R &I RT Rear sill plate outer graphite 0.2 11 REAR DOOR 12 R &I RT R &I door assy 1.0 NOTE: R &I FOR QUARTER REPLACEMENT 13 Rpr RT Outer panel 1.0 2.0 NOTE: TIME IS TO REPAIR LIGHT WAVE AND REAR EDGE OF RIGHT REAR DOOR 14 Repi NIB SANDING -DEBIB 1 0.1 15 R&I RT Belt w'strip EX, LX, SE 0.3 16 R &I RT Body side midg satin silver 0.3 17 R &I RT Handle, outside LX, EX satin 0.9 silver 18 R &I RT R &I trim panel 0.5 19 R &I RT Water deflector USA & Mexico 0.1 built 20 BACK GLASS 21 R &I Back glass Honda USA & Mexico Incl. built 22 QUARTER PANEL 23 Repi LKQ RT quarter section +25% 04636SDA306ZZ 1 443.75 17.5 3.6 NOTE: CHUCK'S AUTO PARTS DOUGLASSVILLE, PA 610 - 689 -9545 SPOKE W JAMES, QT #239681 24 Overlap Major Adj. Panel -0.4 25 Repi CORROSION PROTECTION 1 03 26 - Repl NIB SANDING -DEBIB 1 0.3 27 - Rpr Test fit Ikq quarter 1.0 28 R &I RT Splash shield 0.2 29 Repi LKQ RT Gutter 63320SDAAOOZZ 1 Incl. Ind. 0.5 0 Overlap Minor Panel -0.2 4 4 R &I Jlu _u -RT RR 02 32 R &I Mud guard -LT RR 0.2 33 IMEAR SMY Sc FLOOR 101512012. 3,49:44 PM 017631 Page 2 Estimate of Record Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.OL -FI SILVER 34 Repl Rear body panel USA & Mex bit 6610OSDAAOOZZ 1 32112 6.5 1.2 NOTE: REPALCE DUE TO RIGHT SIDE DAMAGED AND NON REPAIRABLE, RIGHT INNER STRUCTURE OF REAR BODY KINKED 35 Overlap Major Adj. Panel -0.4 36 Add for Inside 0.6 37 Deduct for Overlap -1.5 38 a Repl CORROSION PROTECTION 1 0.3 39 # Repl NIB SANDING -DEBIB 1 0.1 40 R &I Rear panel trim Incl. 41 R&I RT Trunk side trim Incl. 42 R &I LT Trunk side trim Ind. 43 R&I Spare cover 0.1 44 Rpr Rear floor pan USA built Federal 2.0 1.5 NOTE: TIME IS TO REPAIR RIGHT REAR CORNER OF FLOOR AFTER PULL AND AFTER QUARTER REMOVED 45 PARTIAL REFINISH DEDUCTION 1 -0.3 46 Repl RT Insulator 74641SDAAOO 1 60.73 NOTE: REPLACE DUE TO BEING TORN AT REAR 47 TRUNK LID 48 R &I R &I trunk lid 0.7 49 Rpr Trunk lid 1.5 2.3 NOTE: TIME IS TO REPAIR RIGHT LOWER CORNER OF TRUNK LID 50 Overlap Major Adj. Panel -0.4 51 K PARTIAL REFINISH ADJSUTMENT 1 -0.2 52 Repl CORROSION PROTECTION 1 0.3 53 Repl NIB SANDING -DEBIB 1 0.2 54 R &I Weatherstrip USA & Mexico built Ind. 55 Repl Emblem "H" factory installed 7570ISDAOOO 1 18.38 0.2 56 Repl Nameplate "Accord" factory 75722SDAAOO 1 17.40 0.2 installed 57 Repl Nameplate "EX" factory 75731S84A20 1 10.98 0.2 58 R &I Trunk lid trim 0.3 59 REAR LAMPS 60 R &I RT Tail lamp 0.3 61 R &I LT Tail lamp 0.3 62 Repl RT Turn & stop lamp 33501SDAA01 1 148.73 Incl. NOTE: RIGHT TAIL LAMP LOCATED AT CHUCKS, BUT NOT COST EEFECTIVE AFTER MARKUP $115.00 + 25% CHUCK'S .AUTO PARTS DOUGLASSVILLE, PA 610 -689 -9545 SPOKE W JAMES, QT #239681 63 REAR BUMPER 64 OJH rear bumper 1.6 65 Repl Bumper cover 04715SDAA90ZZ 1 365.32 Incl. 3.0 NOTE: REPALCE DUE TO RIGHT SIDE MISSING AT TEA.RDOWN 66 Overlap Major Non -Adj. Panel -0.2 67 Deduct for Rear Bumper R&I -1.0 68 Clear Coat 2.5 69 - Repl NIB SANDING -DEBIB 1 0.3 70 Repi RT Side support 71593SDAAOI 1 11.55 0.2 10/512012 3 49:44 PM 017631 Page 3 Estimate of Record Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- .3.OL -FI SILVER 71 Repl Energy absorber 7157OSDAAOO 1 46.52 Incl. NOTE: REPLACE DUE TO ABSORBER SPLIT 72 Repl RT Side support screw 90126SR4000 2 8.60 73 R &I Reinf beam USA & Mex blt Incl. 74 Repl Nameplate "V6" factory 7573IS87AOO 1 12.80 Incl. 75 Repf WASH AND VACUUM INTEROR 1 Incl. Incl_ $29.99 VALUE 76 N Rep) CAR COVER 1 6.00 0.2 77 # Repl HAZARDOUS WASTE REMOVAL 1 100 T 78 Repl SEAM SEALER PER TUBE 1 36.00 -_ 79 Repi TIPS FOR SEAM SEALER PER 1 1.00 PIECE 80 Repl URETHANE KIT FOR WINDOW 1 18.00 81 At Repl RE -TAPE MLDGS 1 5.00 0.4 82 41 Repl ADHESIVE REMOVAL 1 0.1 83 Repl SET -UP PARTIAL 1 1.0 NOTE: SET UP TO PULL RIGHT REAR CORNER OF QUARTER 84 # Repi PULL UNIBODY /FRAME TO 1 2.0 F SPECIFICATIONS 85 # Repi FLEX ADDITIVE FOR BUMPER 1 8.00 REFINISH 86 Repl A/M SPOT WELD DRILL BITS 1 24.00 57 Refn TOUCH -UP BOLTS 0.1 88 QUARTER SLEEVES 1 1.0 89 MASK INTERIOR 1 6.00 0.1 90 LARGE PANEL ADHESIVE 1 25.00 NOTE: PANEL ADHESIVE NEEDED FOR RIGHT QUARTER REPLACEMENT 91 MIXING NOZZLES 1 2.00 92 RESET ELECTRONICS 1 0.2 93 D&R BATTERY 1 0.1 NOTE: DISCONNECT BATTERY FOR WELDING 94 LKQ TRIM TIME 1 3.0 NOTE: TIME IS TO TRIM LKQ QUARTER FROM QUARTER SECTION 95 ACID BRUSH 1 1.00 96 Repl SOUND DEADENING 1 5.00 0.1 SUBTOTALS 1,606.88 45.0 18.8 10/5/2012 3:49:44 PM 017631 Page 4 Estimate of Record Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.0L -FI SILVER ESTIMATE TOTALS Category Basi _ Rate Cost $ Parts 1,603.88 Body Labor 43.0 hrs @ $ 48.00 /hr 2,064.00 Paint Labor 18.8 hrs @ $ 48.00 /hr 902.40 Frame Labor 2.0 hrs @ $ 48.00 /hr 96.00 Paint Supplies 19.0 hrs @ $ 26.00 /hr 494.00 Miscellaneous 3.00 Subtotal 5,163.28 Sales Tax $ 5,163.28 @ 6.0000 309.80 Grand Total 5,473.08 Deductible 250.00 CUSTOMER PAY 250.00 INSURANCE PAY 5,223.08 THIS ESTIMATE IS BASED ON VISUAL DAMAGE ONLY.IF ADDITIONAL DAMAGE IS FOUND ESTIMATE TOTALS ARE SUBJECT TO CHANGE, APPLE COLLISION GIVES A WARRANTY ON WORKMANSHIP & REFINISHING FOR AS LONG AS OWNER RETAINS OWNERSHIP OF REPAIRED VEHICLE 10/512012 3:49:44 PM 017631 Page S Estimate of Record Customer: MOOK, ASHLEY Job Number: Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.0L -1=I SILVER 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 THE PERSON TO CRIMINAL AND CIVIL PENALTIES. IHE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: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 BLVD =BLEND CAPA= CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D &R= DISCONNECT AND RECONNECT FST= ESTIMATE EXT. PRICE =UNIT PRICE MULTIPLIED BY THE QUANTITY INCL = INCLUDED MISC = MISCELLANEOUS NON- ADJ =NON ADJACENT O /H= OVERHAUL OP= OPERATION NO =LINE NUMBER QTY = QUANTITY 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 /_= WIT /_ '= MANUAL LINE ENTRY *=OTHER LIE..MOTORS DATABASE INFORMATION WAS CHANGED]. * *= DATABASE LINE WITH AFTERMARKET N =NOTES ATTACHED TO LINE NAGS = NATIONAL AUTO GLASS SPECIFICATIONS. MQVP= MANUFACTURER'S QUALITY AND VALIDATION PROGRAM.OPT OEM = ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR OTHERWISE PROVIDED WITH SOME UNIQUE PRICING t,R DISCOUNT. THE ATTACHED ESTIMATE REPRESENTS AN APPRAISAL OF THE COST OF REPAIR FOR THE VISIBLE DAMAGE TO THE VEHICLE NOTED AT THE TIME OF INSPECTION NECESSARY TO 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 TO REPAIR THE VEHICLE FOR THE APPRAISED AMOUNT IS AVAILABLE FROM THE INSURANCE COMPANY. IF USED PARTS ARE SPECIFIED, THEY ARE REQUIRED TO BE OF IKE KIND AND QUALITY TO THOSE BEING REPLACED. INCIDENTAL CHARGES SUCH AS TOWING, PROTECTIVE ( ARE, CUSTODY, STORAGE, DEPRECIATION, BATTERY AND TIRE REPLACEMENT ARE NOTED WHEN APPLICABLE. 10 15/2012 3:49:44 PM 017631 Page 6 Estimate of Record Customer: MOOK, ASHLEY Job Number: " Vehicle: 2003 HOND ACCORD EX 4D SED 6- 3.0L -i=i SILVER Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ARG4437, CCC Data Date 10/1/2012, 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 through 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" parts provided by OEM's through OEM vehicle dealerships. Asterisk ( *) or Double Asterisk ( * *) indicates that the parts and /or labor information 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. The symbol (< >) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non - Original Equipment Manufacturer aftermarket parts are described as AM. Used parts are described as LKQ, 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 line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign ( #) items indicate manual entries. Some 2.012 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 CCC ONE estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership, he following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to be repaired or replaced: SYMBOLS FOLLOWING PART PRICE: r-,i=MOTOR Mechanical component. s =MOTOR Structural component. T= Miscellaneous Taxed charge category. X= Miscellaneous Non -Taxed charge category. SYMBOLS FOLLOWING LABOR: )= Diagnostic labor category. E =Electrical labor category. F =Frame labor category. G =Glass labor category. %1- Mechanical labor category. S= Structural labor category. (numbers) 1 through 4 =User Defined Labor Categories. OTHER SYMBOLS AND ABBREVIATIONS: Adj.= Adjacent. Algn.= Align. ALU= Aluminum. A/M= Aftermarket part. Bind= Blend. BOR =Boron steel. (;APA= Certified Automotive Parts Association. D &R= Disconnect and Reconnect. HSS =High Strength Steel. HYD= Hydroformed Steel. Incl.= Included. LKQ =Like Kind and Quality. LT =Left. MAG= Magnesium. Non -Adj. =Non Adjacent. NSF =NSF International Certified Part. O /H= Overhaul. Qty = Quantity. Refn= Refinish. Repl == Replace. R &I= Remove and Install. R &R= Remove and Replace. Rpr= Repair. RT= Right. SAS = Sandwiched Steel. Sect= Section. Subl= Sublet. UHS =Ultra High Strength Steel. N= Note(s) associated with the estimate line. ;CC ONE Estimating - A product of CCC Information Services Inc. The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR= Bureau of Automotive Repair. EPA= Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR= Paintless Dent Repair. VIN = Vehicle Identification Number. 10/5/2012 3:49:44 PM 017631 Page 7 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. f B amin W. Lawrence Date SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson c: ' .:m w Sheriff �Qt�rttr of � Jody S Smith 2 Chief Deputy r-"� � �.`�� cn Richard W Stewart Solicitor State Farm Mutual Auto Insurance Case Number vs. 2013-1547 Erick Roy Snyder SHERIFF'S RETURN OF SERVICE 03/28/2013 06:22 PM- Deputy Shawn Gutshall, being duly sworn according to law, served the requested Complaint& Notice by handing a true copy to a person representing themselves to be Larry Snyder, father of defendant, who accepted as"Adult Person in Charge"for Erick Roy Snyder at 15 Peacock Drive, Carlisle, PA 17015. TSHALL, DEPUTY SHERIFF COST: $34.46 SO ANSWERS, April 01, 2013 R-ONISW RANDERSON, SHERIFF ici:^ou-t-,;'ul' Sher,!!.?vie gso?i M On t"- h4 C On . a CO IN THE COURT OF COMMON PLEASE - + - CUMBERLAND COUNTY, PENNSYLVANIA mac-: =ti CIVIL DIVISION 4` 4 #e' STATE FARM MUTUAL AUTO INS Plaintiff No: 13-1547 VS. PRAECIPE FOR DEFAULT JUDGMENT ERICK SNYDER 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 20037372 C Y Jer DKM Judgment Amount $5487 . 73 AJ , aglo6. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff VS . Civil Action No. 13-1547 ERICK SNYDER PRAECIPE FOR DEFAULT JUDGMENT TO THE PROTHONTARY: Kindly enter Judgment against the Defendant ERICK SNYDER above named, in the default of an Answer, in the amount of $5487 . 73 computed as follows: Amount claimed in Complaint $5487 . 73 Less payments / adjustments made $0 . 00 Attorney' s fees $0 . 00 TOTAL $5487 . 73 I hereby certify that appropriate Notices of Default, as attached have been mailed in accordance with PA R.C.P. 237 . 1 on the dates indicated on the Notices. WELTMAN, WEINBERG & REIS CO. , L.P.A. By:_ 4L,-- Benjami W. Lawrence, 209032 20037372 C Y Jer DKM Plaintiff ' s address is : c/o WELTMAN, WEINBERG & REIS CO. , L.P.A. , 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106-2614 And that the last known address of the Defendant is ERICK SNYDER 15 PEACOCK DR CARLISLE, PA 17015 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff vs . Civil Action No. 13-1547 ERICK SNYDER NOTICE OF JUDGMENT OR ORDER TO: ( ) Plaintiff (xx) Defendant ( ) Garnishee You are hereby notified that the following order of Judgment was entered against you on (xx) Assumpsit Judgment in the amount of $5487 . 73 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 (xx) Default ( ) Verdict ( ) Arbitrat ' n Award ,) Prothonotary By: r a� PROTHONO Y" 'OR­DEPUTY ERICK SNYDER 15 PEACOCK DR CARLISLE, PA 17015 Plaintiff ' s address is : c/o WELTMAN, WEINBERG & REIS CO. , L.P.A. , 325 CHESTNUT STREET SUITE 501 PHILADELPHIA, PA 19106-2614 215-599-1500 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff Case No. 13-1547 Vs. ERICK SNYDER Defendant IMPORTANT NOTICE TO: ERICK SNYDER 15 PEACOCK DR CARLISLE, PA 17015 MAY.0 12013 Date of Notice: 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 DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU 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. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA. 17013 (717)249-3166 WELTMAN,WEIN RG & REIS CO., L.P.A. By: ' Michael 0 herty P.A.I.D.# 046 WELTMAN,WEINBERG&REIS CO., L.P.A. 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 (215)599-1500 (215)599-1505 20037372 Y PHI IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff VS . Civil Action No. 13-1547 NON-MILITARY AFFIDAVIT ERICK SNYDER The undersigned is the duly authorized agent and/or attorney for the Plaintiff in the within matter and states as follows: Affiant states that the within Affidavit is made pursuant to and in accordance with the Servicemembers ' Civil Relief Act (SCRA) , 50 U.S.C. App. 521. Affiant further states that based upon investigation it is the affiant ' s belief that the Defendant, ERICK SNYDER is not in military service. Affiant further states that this belief is supported by the attached certificate from the Defense Manpower Data Center (DMDC) , which states that the DMDC does not possess any information indicating that the below individual is in the military service: ERICK SNYDER 15 PEACOCK DR CARLISLE, PA 17015 Affiant further states that the averments contained herein are true and correct to the best of Affiant ' s knowledge, information and belief and that these averments are made subject to the penalties of 18 Pa C.S .A. Section 4904 relating to unsworn falsification to authorities . AFFIAN Department of Defense Manpower Data Center Results as of:May-22-20,3,,:55:,8 SCRA 3.0 Pursuant to Servrcemembers Civil.Relief Act t�.rr Last Name: SNYDER First Name: ERIC Middle Name: Active Duty Status As Of: May-22-2013 On Act ve Duty On Active Duty Status Date Active Duty Start Date Active Duty End Date Status Service Component NA NA No NA This response reflects the individuals'active duty status based on the Active'Duty Status Date Left Active Duty Within 387 Days of Active Duty Status Date Active Duty Start Date Active Duty End Date Status Service Component NA NA No NA This response reflects where the individual left active duty status within 387 days preceding the Active Duty Status Date The Member or His/Her Unit Was Notified of a Future Call-Up to Active Duty on Active Duty Status Date Order Notification Stag Date Order Notification End Date Status Service Component NA NA - No NA This response reflects whether the individual or his/her unit has received early notification to report for active duty Upon searching the data banks of the Department of Defense Manpower Data Center,based on the information that you provided,the above is the status of the individual on the active duty status date as to all branches of the Uniformed Services(Army,Navy,Marine Corps,Air Force,NOAH,Public Health,and Coast Guard). This status includes information on a Servicemember or his/her unit receiving notification of future orders to report for Active Duty. HOWEVER,WITHOUT A SOCIAL SECURITY NUMBER,THE DEPARTMENT OF DEFENSE MANPOWER DATA CENTER CANNOT AUTHORITATIVELY ASSERT THAT THIS IS THE SAME INDIVIDUAL THAT YOUR QUERY REFERS TO.NAME AND DATE OF BIRTH ALONE DO NOT UNIQUELY IDENTIFY AN INDIVIDUAL. AajA_ **411(101414 Mary M.Snavely-Dixon,Director Department of Defense-Manpower Data Center 4800 Mark Center Drive,Suite 04E25 Arlington,VA 22350 The Defense Manpower Data Center(DMDC)is an organization of the Department of Defense(DoD)that maintains the Defense Enrollment and Eligibility Reporting System(DEERS)database which is the official source of data on eligibility for military medical care and other eligibility systems. The DoD strongly supports the enforcement of the Servicemembers Civil Relief Act(50 USC App.§501 at seq,as amended)(SCRA)(formerly known as the Soldiers'and Sailors'Civil Relief Act of 1940). DMDC has issued hundreds of thousands of"does not possess any information indicating that the individual is currently on active duty"responses,and has experienced only a small error rate. In the event the individual referenced above,or any family member,friend,or representative asserts in any manner that the individual was on active duty for the active duty status date,or is otherwise entitled to the protections of the SCRA,you are strongly encouraged to obtain further verification of the person's status by contacting that person's Service via the "defenselink.mil"URL:http://www.defenselink.mil/faq/pis/PC09SLDR.html. If you have evidence the person was on active duty for the active duty status date and you fail to obtain this additional Service verification,punitive provisions of the SCRA may be invoked against you. See 50 USC App.§521(c). This response reflects the following information: (1)The individual's Active Duty status on the Active Duty Status Date(2)Whether the individual left Active Duty status within 367 days preceding the Active Duty Status Date(3)Whether the individual or his/her unit received early notification to report for active duty on the Active Duty Status Date. More information on "Active Duty Status" Active duty status as reported in this certificate is defined in accordance with 10 USC§101(d)(1). Prior to 2010 only some of the active duty periods less than 30 consecutive days in length were available. In the case of a member of the National Guard,this includes service under a call to active service authorized by the President or the Secretary of Defense under 32 USC§502(f)for purposes of responding to a national emergency declared by the President and supported by Federal funds. All Active Guard Reserve(AGR)members must be assigned against an authorized mobilization position in the unit they support. This includes Navy Training and Administration of the Reserves(TARs),Marine Corps Active Reserve(ARs)and Coast Guard Reserve Program Administrator(RPAs). Active Duty status also applies to a Uniformed Service member who is an active duty commissioned officer of the U.S. Public Health Service or the National Oceanic and Atmospheric Administration(NOAH Commissioned Corps). Coverage Under the SCRA is Broader in Some Cases Coverage under the SCRA is broader in some cases and includes some categories of persons on active duty for purposes of the SCRA who would not be reported as on Active Duty under this certificate. SCRA protections are for Title 10 and Title 14 active duty records for all the Uniformed Services periods. Title 32 periods of Active Duty are not covered by SCRA,as defined in accordance with 10 USC§101(d)(1). Many times orders are amended to extend the period of active duty,which would extend SCRA protections.Persons seeking to rely on this website certification should check to make sure the orders on which SCRA protections are based have not been amended to extend the inclusive dates of service. Furthermore, some protections of the SCRA may extend to persons who have received orders to report for active duty or to be inducted,but who have not actually begun active duty or actually reported for induction. The Last Date on Active Duty entry is important because a number of protections of the SCRA extend beyond the last dates of active duty. Those who could rely on this certificate are urged to seek qualified legal counsel to ensure that all rights guaranteed to Service members under the SCRA are protected WARNING: This certificate was provided based on a last name,SSN/date of birth,and active duty status date provided by the requester. Providing erroneous information will cause an erroneous certificate to be provided. Certificate ID: 2217Q4CFTOC3F90 WELTMAN,WEINBERG &REIS CO.,L.P.A. BY: Benjamin W. Lawrence, Esquire Attorney for Plaintiff(s) c:a I.D. No. 209032 � � 't 325 Chestnut Street, Suite 501 w Philadelphia, PA 19106 Phone: 215.599.1500 ' _ Fax: 215.599.1505 -<> File#20037372 r- c, CD STATE FARM MUTUAL AUTO INS CO =' CUMERBLAND County Court of Common Pleas vs. ERICK SNYDER NO. 13-1547 PRAECIPE FOR CERTIFICATION OF MOTOR VEHICLE JUDGMENT TO THE PROTHONOTARY: Kindly issue a Certification of Motor Vehicle Judgment against the Defendant(s), ERICK SNYDER, above named in the amount of$5,487.73. WELTMAN, WEINBERG & REIS CO., L.P.A. By Benjamin W. Lawrence, Esquire Attorney for Plaintiff i WELTMAN,WEINBERG &REIS CO.,L.P.A. r' BY: Benjamin W Lawrence, Esquire Attorney for Plaintiff(s) , I.D. No. 209032 ' W 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 , Phone: 215.599.1500 "x" Fax: 215.599.1505 , ' File #20037372 LV Al fir C)�y I STATE FARM MUTUAL AUTOMOBILE 7t► h' ': INSURANCE COMPANY CUMBERLAND County Court of Common Pleas vs. NO. 13 1547 ERICK SNYDER PRAECIPE TO ENTER INTO SETTLEMENT AGREEMENT 1. On or around May 28, 2013 a judgment was entered against Defendant in favor of Plaintiff in the amount of$5487.73 related to a motor vehicle accident. 2. At the time of this accident, Defendant did not maintain a valid policy of insurance under the Pennsylvania Motor Vehicle Financial Responsibility Law. 3. Based on this judgment, Plaintiff requested that PennDOT revoked Defendant's Pennsylvania driving privileges. 4. Defendant has subsequently entered into a monthly payment arrangement to satisfy this judgment, wherein Defendant will make an immediate payment of $350.00, and thereafter make payments of$350.00 per month, due on the 20th of each month, beginning December , until judgment is paid in full. 5. As a result of Defendant's entry into this payment plan, Plaintiff does not object to Defendant, Erick Snyder, license being reinstated. 6. Plaintiff reserves the right to seek revocation of Defendant's driving privileges, if Defendant fails to fulfill the terms of the monthly payment arrangement. WELTMAN, WEINBERG & REIS CO., L.P.A. By /r Benjamin -Lawrence, Esquire Attorney for Plaintiff WELTMAN,WEINBERG &REIS CO.,L.P.A. BY: Benjamin W Lawrence, Esquire Attorney for Plaintiff(s) I.D. No. 209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File#20037372 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY CUMBERLAND County Court of Common Pleas vs. ERICK SNYDER No.: 13 1547 CERTIFICATE OF SERVICE TO THE PROTHONOTARY: On November 25, 2013 Plaintiff served Stipulation upon Defendant, Erick Snyder at 15 Peacock Dr Carlisle, Pa 17015 by first class, United States mail, postage-prepaid. WELTMAN, WEINBERG & REIS:.CO.,L.P.A. B Y Benjamin W Lawrence, Esquire Attorney for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff vs. ERICK SNYDER Defendant(s) MEMBERS 1ST FCU Garnishee(s) Civil Action No. 13-1547 Is PoaCocti. � r. � 11°15 �o J S CGYi, s -e, I (7t t Bert. -1 I? --t Cf.„0Y V S\e , I /-11)/& PRAECIPE FOR WRIT OF EXECUTION TO THE PROTHONOTARY: Kindly issue a Writ of Execution in the above matter... 1. directed to the Sheriff of CUMBERLAND County: 2. against ERICK SNYDER , Defendant 3. against MEMBERS 1ST FCU, , , Garnishee 4. Judgment Amount Less Payments/credits received Interest Costs SUBTOTAL: Costs (to be added by Prothonotary): 3(4. Cj co cF Sc t It It (� S.7S sl pd a $5,487.73 22 $1,400.00 '• � �r. 9J $325.10 $4,412.83 WELTMAN, WEINBERG & REIS CO., L.P.A. By: James P. Vale ko, Esquire PA I.D. #7959 WELTMAN, WEINBERG & REIS CO., L.P.A. 436 7th Avenue, Suite 2500 Pittsburgh, PA 15219 (412) 434-7955 tt 33114�asou. atkiMua ‘-2__k#OgCoD hWR No. 20017372 t f v- i'sskod IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION STATE FARM MUTUAL AUTO INS Plaintiff vs. ERICK SNYDER Defendant(s) MEMBERS 1ST FCU Garnishee(s) No. 13-1547 PRAECIPE FOR WRIT OF EXECUTION (BANK ATTACHMENT ONLY) FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: James P. Valecko, Esquire PA I.D. #79596 WELTMAN, WEINBERG & REIS CO., L.P.A. 436 7th Avenue, Suite 2500 Pittsburgh, PA 15219 (412) 434-7955 WWR No. 20037372 THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PA DAVID D. BUELL, PROTHONOTARY One Courthouse Square • Suite100 • Carlisle, PA • 17013 (717)240-6195 www.cepa.net STATE FARM MUTUAL AUTO INS. Vs. ERICK SNYDER WRIT OF EXECUTION (Pa R.C.P. 3252) NO 13-1547 Civil Term CIVIL ACTION - LAW TO THE SHERIFF OF CUMBERLAND COUNTY: To satisfy the judgment, interest and costs against ERICK SNYDER, 15 PEACOCK DRIVE, CARLISLE, PA 17015 Defendant (s) (1) you are directed to levy upon the property of the defendant (s) and to sell the defendant (s) interest therein; (2.) you are also directed to attach the property of the defendant (s) not levied upon in the possession of MEMBERS 1ST FCUGARNISHEE(S), as garnishee, 1711 SPRING ROAD, CARLISLE, PA 17013 (Specifically describe property) and to notify the garnishee that (a) an attachment has been issued; (b) except as provided in paragraph (c), the garnishee is enjoined from paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant (s) or otherwise disposing thereof; (c) the attachment shall not include (i) the first $10,000 of each account of the defendant (s) with a bank or other financial institution containing any funds which are deposited electronically on a recurring basis and are identified as being funds that upon deposit are exempt from execution, levy or attachment under Pennsylvania or federal law. (ii) each account of the defendant (s) with a bank or other financial institution in which funds on deposit exceed $10,000.00 at any time if all funds are deposited electronically on a recurring basis and are identified as being funds that upon deposit are exempt from execution, levy or attachment under Pennsylvania or federal law. (iii) any funds in an account of the defendant (s) with a bank or other financial institution that total $300 or less. If multiple accounts are attached, a total of $300 in all accounts shall not be subject to levy and attachment as determined by the executing officer. The funds shall be set aside pursuant to the defendant (s) general exemption provided in 42 Pa.C.S. § 8123. (3) if property of the defendant (s) not levied upon and subject to attachment is found in the possession 1 of anyone other, than a named garnishee, you are directed to notify such other person that he or she has been added as a garnishee and is enjoined as above stated. Amount Due $4,087.73 Plaintiff Paid Interest $325.10 Law Library $.50 Attorney's Comm. % Due Prothonotary $2.25 Attorney Paid $189.46 Other Costs Date: 7/17/14 David D. Buell, Prothonotary REQUESTING PARTY: Name : JAMES P. VALECKO, ESQUIRE Address: WELTMAN, WEINBERG & REIS CO., L.P.A. 436 7TH AVENUE, SUITE 2500 PITTSBURGH, PA 15219 Attorney for: PLAINTIFF Telephone: 412-434-7955 Supreme Court. ID No. PLAINTIFF MAJOR EXEMPTIONS UNDER PENNSYLVANIA AND FEDERAL LAW 1. $300 statutory exemption 2. Bibles, school books, sewing machines, uniforms and equipment 3. Most wages and unemployment compensation 4. Social Security benefits 5. Certain retirement funds and accounts 6. Certain veteran and armed forces benefits 7. Certain insurance proceeds 8. Such other exemptions as may be provided by law E "ee,24.64Z-- Deputy 2 Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor SHERIFF'S OFFICE OF CUMBERLAND COUNTY vox et �f�hL�r40.1y4 OFFICE OF THE SHERIFF State Farm Mutual Auto Insurance vs. Case Number Erick Roy Snyder 2013-1547 SHERIFF'S RETURN OF SERVICE 07/30/2014 01:30 PM - William Cline, Deputy, who being duly sworn according to law, attached as herein commanded all goods, chattels, rights, debts, credits, and monies of the Defendant, in the hands, possession, or control of the within named garnishee, Members 1st Federal Credit Union, 1166 Walnut Bottom Road, Carlisle, PA 17015, Cumberland County, by handing to Meg Beaston, Member Services Rep., personally three copies of interrogatories together with three true and attested copies of the Writ of Execution and made the contents there of known to her. The writ of execution and notice to defendant was mailed on August 1, 2014 too f k Snyder at 15 Peacock Drive, Carlisle, PA 17015. August 01, 2014 (c) CountySuito Sheriff, Toleosoft, Inc. 1 )1 ILLIA 'CLINE, DEPUTY SO ANSWERS, RONNY R ANDERSON, SHERIFF WELTMAN, WEINBERG & REIS CO., L.P.A. BY: James P Valecko, Esquire Attorney for Plaintiff(s) I.D. No. 79596 436 Seventh Avenue, Suite 2500 Pittsburgh, PA 15219 Phone: 412.434.7955 Fax: 412.434.7959 File # 20037372 fi O TN, ©ISL UF THE P . 2014 AUGt 1 f f't1 2: CUMBERLAND PENNSYLVANIA STATE FARM MUTUAL AUTO INS Cumberland County Court of Common Pleas vs. ERICK SNYDER and MEMBERS 1ST FCU Garnishee(s) PRAECIPE TO DISCONTINUE ATTACHMENT EXECUTION NO. 13-1547 TO THE PROTHONOTARY: Kindly mark the above matter discontinued and ended as to Garnishee(s), MEMBERS 1ST FCU, only. WELTMAN, WEINBERG & REIS CO., L.P.A. By James P Val cko, Esquire Attorney for Plaintiff sG so -pa a+ J CLit inia0,►uq �# 3a5 iso