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Home My WebLink About13-3414 20041693 C Y Jer DKM Supreme Court of PennsvI�ania WWR Court;bf Common Fleas 0 Cover Sheet For Prothonotan' Uw On4-: C UMBERLANa Cpririh- Docket No: " l �q l The igforniation collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and ser ice ofpleadings or other papers as required by low or rules of court. Commencement of Action: S II Complaint ❑ Writ of Summons ❑ Petition E' ❑ Transfer from Another Jurisdiction ❑ Declaration of Takin C Lead Plaintiffs Name: Lead Defendant's Name: T PROGRESSIVE SPECIALY INSJZP fJCb Co. DANIELLE N FRALISH I O Are money damages requested? ® Yes ❑ No Dollar Amount Requested: ® within arbitration limits N (check one) ❑ outside arbitration limits A Is this a Class Action Suit? ❑ Yes 13 No Is this an MDJ Appeal? 13 Yes EU No , Name of Plaintiff /Appellant's Attorney: Benjamin W. Lawrence,209032 ❑ Check here if you have no attorney (are a Self- Represented [Pro Se] Litigant) Nature of the Case Place an "X" to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim, check the one that you consider most important. TORT (do not include Mass Tort) CONTRACT (do not include Judgments) CIVIL APPEALS ❑ Intentional ❑ Buyer Protection Administrative Agencies ❑ Malicious Prosecution ❑ Debt Collection: Credit Card ❑ Board of Assessment ❑ Motor Vehicle ❑ Debt Collection: Other ❑ Board of Elections ❑ Nuisance ❑ Dept. of Transportation S ❑ Premises Liability [I Statutory Appeal: Other E I] Product Liability (does not include E] Employment Dispute Mass tort) Discrimination C ❑ Slander /Libel/Defamation ❑ Employment Dispute: Other ❑ Zoning Board er: ❑ Other: O 11 Other: N MASS TORT ❑ Asbestos $ ❑ Tobacco REAL PROPERTY MISCELLANEOUS • Toxic Tort - DES ❑ Ejectment ❑ Common Law /Statutory Arbitration • Toxic Tort — Implant ❑ Eminent Domain/Condemnation ❑ Declaratory Judgment ❑ Toxic Waste ❑ Ground Rent ❑ Mandamus ❑ Other: ❑ Landlord/Tenant Dispute ❑ Non - Domestic Relations ❑ Mortgage Foreclosure: Residential Retraining Order ❑ Mortgage Foreclosure: Commercial ❑ Quo Waranto ❑ Partition ❑ Replevin PROFESSIONAL LIABILITY ❑ Quiet Title ❑ Other: ❑ Dental ❑ Other: ❑ Legal ❑ Medical ❑ Other Professional: Updated 1/1/2011 lil'JN It�i\ "'tV8ERL ND CRINTY PE N NSYLWG1 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE SPECIALY INSU1' - b' Plaintiff No l /v VS. COMPLAINT IN CIVIL ACTION DANIELLE N FRALISH 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 20041693 C Y Jer DKM C � aw� V-4 ag IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE SPECIALY INWR f- CO. Plaintiff VS. Civil Action No DANIELLE N FRALISH 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 #20041693 } PROGRESSIVE SPECIALTY } INSURANCE COMPANY } Court of Common Pleas } Cumberland County } } vs. } } DANIELLE N FRALISH } NO. CIVIL ACTION — COMPLAINT 1. Plaintiff is a business organization licensed and authorized to conduct business in the State of OHIO with a place of business located at 5920 LANDERBROOK DRIVE, MAYFIELD HEIGHTS, OH 44124. 2. Defendant is an adult individual who at all time pertinent hereto resided at 435 W LOUTHER STREET, CARLISLE, PA. 3. PROGRESSIVE issued a policy of motor vehicle insurance whereby PROGRESSIVE agreed to insure the motor vehicle involved in this incident ( "Insured Vehicle "), owned by Plaintiff's insured. 4. On or about January 10, 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 Sate Highway 641 and Newville Road, West Pennsboro, 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 PROGRESSIVE Insured's vehicle sustained property damage and /or incurred rental charges in the total amount of $4330.91. 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 PROGRESSIVE and as a result of the aforesaid payment, PROGRESSIVE became subrogated to the claim of its Insured against Defendant. WHEREFORE, Plaintiff demands Judgment against Defendant in the amount of $4330.91 plus interest and costs. WELT N, WEINBERG & REIS, CO., L.P.A. BENJAM N W. WRENCE, Esquire PA 1. D. # 0903 325 Chest ut Str et Suite 501 Philadelphia, 19106 (215) 599 -1500 WWR #20041693 EXHIBIT 1 Date: 1/1212012 09:19 AM Estimate ID: 12- 1101302 -01 Estimate Version: 0 Committed Profile ID: CPA: All Parts PROGRESSIVE 3950 Hartzdale Dr, Camp Hill, PA 17011 (717) 648 -0885 Email: DHanori@progressive.com Damage Assessed by: Lic#429068 David Hanor Claim Rep: Dave Sotosky (814) 947 -4776 For supplements please call Dave Hanor @ 717 - 646 -0885 or email to DHanorl @progressive.com * Product Type: Auto * Date of Loss: 1I10I2012 * Deductible: 500.00 * Claim Number: 124101302 -01 Insured: XIAO JIANG Claimant: XIAO JIANG Address: 84 LONESOME RAOD, NEWVILLE, PA 17241 Telephone: Home Phone: (717) 360 -1137 Owner: XIAO JIANG Address: 84 LONESOME RAOD, NEWVILLE, PA 17241 Telephone: Home Phone: (717) 360.1137 Mitchell Service: 910445 Description: 2007 Ford Mustang GT Deluxe Vehicle Production Date: 1107 Body Style: 2D Cpe Drive Train: 4.6L Inj 8 Cyl 5M RWD VIN: 1ZVFT82H875299847 License: HDT -2429 PA Mileage: 60,719 OEM /ALT: A Search Code: LANCASTER? Color: RED Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW POWER STEERING, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN ANTI -LOCK BRAKE SYS., TRACTION CONTROL, ALUM /ALLOY WHEELS, AUXILIARY INPUT POWER ADJUSTABLE EXTERIOR MIRROR, FRONT AIR DAM, TINTED GLASS, ANTI -THEFT SYSTEM AMIFM STEREO CO, FRONT BUCKET SEATS, FRONT SEATS WITH POWER LUMBAR SUPPORT KEYLESS ENTRY SYSTEM, POWER DISC BRAKES, REAR SPOILER STEERING WHEEL MOUNTED CONTROLS Line Entry Labor Line Item Part Type / Dollar Labor Item Number Type Operation Description Part Number Amount Units Front Bumper 1 001607 BDY OVERHAUL Frt Bumper Cover Assy 2.1 # 2 000018 BDY REMOVEIREPLACE Frt Bumper Cover ** Non -OEM CAPA 356.00 INC # 3 REF REFINISH Frt Bumper Cover C 2.8 4 000002 BDY REMOVEIREPLACE Frt Bumper Rivet 4@1.27 * W715030 S437 5.08 INC 5 000005 BDY REMOVE/REPLACE L Frt Bumper Bracket ** Non -OEM 15.38 INC 6 000007 BDY REMOVE/REPLACE L Frt Bumper Clip * W705589 S 1.70 INC 7 000009 BDY REMOVE/REPLACE L Frt Bumper Reinforcement 5113Z 17C861 AB 10.20 INC 8 000019 BDY REMOVEIREPLACE Frt Bumper Grille ** Non -OEM CAPA 43.00 INC 9 missing at inspection Front Lamps 10 002169 BDY REMOVEIREPLACE L H/Lamp Assembly ** Non -OEM 137.00 INC # 11 BDY REMOVEIINSTALL Frt Bumper Cover INC # 12 BDY CHECK/ADJUST Headlamps OA 13 002461 BDY REMOVE/REPLACE L ParklSignal/Marker Lamp Assembly ** Non -OEM 45.00 INC # Hood 14 001616 REF BLEND Hood Outside C 1.2 15 001621 BDY REMOVE/INSTALL R Hood Washer Nozzle 0.2 # 16 001622 BDY REMOVEIINSTALL L Hood Washer Nozzle 0.2 # Front Fender ESTIMATE RECALL NUMBER: 011121201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC 11 V0109 MAPP:DEC 11 — V0108 Copyright (C) 1994 - 2011 Mitchell International Page 1 of 5 Software Version: 7.0.437 All Rights Reserved i a,�-, C\3 Date: 111212012 09:19 AM Estimate ID: 12- 1101302 -01 Estimate Version: 0 Committed Profile ID: CPA: All Parts 17 000210 BDY REMOVEIREPLACE L Fender Panel ** Non-OEM CAPA 297.00 1.5 # 18 REF REFINISH L Fender Outside C 2.0 19 REF REFINISH L Add To Edge Fender C 0.5 20 000218 BDY REMOVE/REPLACE L Fender Front Liner ** Non -OEM 19.00 INC # 21 000225 BDY REMOVEIREPLACE L Fender Adhesive Nameplate 5113Z 16098 AA 21.73 0.1 Front Inner Structure 22 000235 BDY REPAIR Front Body Radiator Support Existing 3.5* # 23 spot refinish 24 REF REFINISHIREPAIR Front Body Radiator Support 0.3* 25 000236 BDY REMOVE/INSTALL Upr Front Body Shield Existing INC r 26 000242 BDY REMOVE/REPLACE Front Body Under Cover 5R3Z 17626 BA 61.82 0.3 27 000246 BDY REPAIR L Upr Front Body Apron Panel S Existing 1.0 *# 28 spot refinish 29 REF REFINISHIREPAIR L Upr Front Body Apron Panel S 0.3* 30 003243 BDY REPAIR L Front Body Apron Assy S Existing 1.0* 31 REF REFINISHIREPAIR L Front Body Apron Assy S 0.3* Wheel 32 001830 BDY REMOVEIREPLACE Alloy Wheel Remanufactured 189.00 * 0.3 33 LKQ250, Tom, 1-800-334-9811, quote 7893200 34 002556 BDY REMOVE/REPLACE Wheel Tire Pressure Sensor 6F2Z 1A193 D 52.22 35 left front installation kit Front Suspension 36 001847 MCH REMOVEIREPLACE L Frt Susp Strut Assy -M 9R3Z 18124 B 93.42 1.6 # Rocker/Pillars/Floor 37 001661 BDY REMOVEIINSTALL L Rocker Moulding 0.5 38 000778 BDY REMOVEIREPLACE L Rocker Moulding Clip 7 @1.95 * W710528 S300 13.65 39 000782 BDY REMOVEIREPLACE L Rocker Moulding Clip 8 @1.63 * W710532 S300 13.04 Front Door 40 001676 REF REFINISH L Frt Add For Jambs C 0.3* 41 001678 BDY REMOVEIINSTALL L Frt Door Assembly 1.0 42 000976 BDY REPAIR L Frt Door Shell Existing 1.0* # 43 REF REFINISH L Frt Door Outside C 1.8 44 001564 BDY REPAIR L Frt Door Repair Panel Existing 3.5 *# 45 001680 BDY REMOVEIINSTALL L Frt Rear View Mirror 0.3 # 46 000988 BDY REMOVE/INSTALL L Frt Otr Door Belt Moulding Existing 0.3 r 47 001684 BDY REMOVEIINSTALL L Frt Door Trim Panel INC 48 001688 BDY REMOVE/INSTALL L Frt Otr Door Handle 0.8 # 49 936001 ADD'L COST TOWING 130.00 * 50 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * ADDITIONAL OPERATIONS 51 REF ADD'L OPR Clear Coat 2.4 Additional Costs & Materials 52 ADD'L COST Paint/Materials 297.50 * MANUAL ENTRIES 53 900500 FRM * ALIGN TIE DOWN AND MEASURE Existing 1.0* 54 900500 FRM * REPAIR PULL/ALIGN FRONT UNIBODY Existing 1.0* 55 900500 BDY * ADD'L LABOR OP CAR COVER Sublet 4.00 * 0.2* 56 900500 BDY * ADD'L LABOR OP CORROSION PROTECTION Sublet 15.00 * 0.2* 57 900500 BDY * ADD'L LABOR OP WELD THRU PRIMER Sublet 8.00 * 0.2* 58 900500 REF * REMOVE/REPLACE FLEX ADDITIVE Sublet 8.00 * 0.0* 59 900500 BDY * REMOVE/REPLACE 4 WHEEL ALIGNMENT Sublet 74.95 * 0.0* 60 900500 MCH* REMOVE/REPLACE MOUNT & BALANCE Sublet 14.00 * 0.0* * - Judgment Item # - Labor Note Applies ** Non -OEM CAPA - Non - Original Equipment Manufacturer Replacement Part, CAPA Certified '* Non -OEM - Non - Original Equipment Manufacturer Replacement Part C - Included in Clear Coat Calc r - CEG R &R Time Used For This Labor Operation ESTIMATE RECALL NUMBER: 01/12/2012 09:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0109 MAPP:DEC_11_V0108 Copyright (C) 1994 - 2011 Mitchell International Page 2 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/1212012 09:19 AM Estimate ID: 12- 1101302 -01 Estimate Version: 0 Committed Profile ID: CPA: All Parts EMPIRE AUTO PARTS, INC. KEYSTONE AUTOMOTIVE KEYSTONE AUTOMOTIVE PP 141 LANZA AVE. JOHNSTOWN BUMPER MART 3221 ESPRESSO WAY GARFIELD 320 DOBSON ST. YORK NJ 07026 WINDBER PA 17404 (800)624.4561 (800) 228 -6737 PA 15963 (717) 843 -8927 (800) 524 -4349 (800) 438 -2510 (814) 467 -5531 5 " F0035 15.38 2 " F01000575C 356.00 17 " F01240246PP 297.00 8 " F01036114PP 43.00 10 * F02502231 137.00 13 •` F02520180 45.00 20 •* F01250129 19.00 ALL MANUFACTURERS REQUIREMENTS REGARDING SEATBELT AND SUPPLEMENTAL RESTRAINT SYSTEM REPLACEMENT MUST BE ADHERED TO. IF ADDITIONAL PARTS OR OPERATIONS ARE NECESSARY TO PROPERLY ACCOMPLISH THIS, PLEASE CONTACT THE ESTIMATING CLAIMS REPRESENTATIVE. THIS IS A DAMAGE ASSESSMENT ONLY - NOT AN AUTHORIZATION TO REPAIR -BASED ON DAMAGE VISIBLE OR CERTAIN AT THE TIME IT WAS WRITTEN. IF FRAME OR UNIBODY REPAIR IS INCLUDED ON THIS ESTIMATE, THE AMOUNT SHOWN INCLUDES TIME OR ALLOWANCE FOR MEASURING BEFORE, DURING AND AFTER THOSE REPAIRS. YOU ARE UNDER NO REQUIREMENT TO 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. TO ENSURE PROPER AND PROMPT PAYMENT FOR ADDITIONAL DAMAGE DISCOVERED DURING THE COURSE OF REPAIRS, CONTACT PROGRESSIVE FOR SUPPLEMENT HANDLING PROCEDURES. Estimate Totals Add'I Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 18.6 46.00 0.00 27.00 882.60 T Taxable Parts 1,471.19 Refinish 11.9 46.00 0.00 0.00 547.40 T Sales Tax @ 6.000% 88.27 Frame 2.0 48.00 0.00 0.00 96.00 T Mechanical 1.6 50.00 0.00 0.00 80.00 T Total Replacement Parts Amount 1,559.46 Taxable Labor 1,606.00 Labor Tax @ 6.000% 96.36 Labor Summary 34.1 1,702.36 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 300.50 Insurance Deductible 500.00 - Sales Tax @ 6.000% 18.03 Customer Responsibility 500,00- Non-Taxable Costs 130.00 Total Additional Costs 448.53 Paint Material Method: Rates Init Rate = 25.00 ESTIMATE RECALL NUMBER: 01112/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0109 MAPP:DEC_11_V0108 Copyright (C) 1994 -2011 Mitchell International Page 3 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1112/2012 09:19 AM Estimate ID: 124101302 -01 Estimate Version: 0 Committed Profile ID: CPA: All Parts 1. Total Labor: 1,702.36 11. Total Replacement Parts: 1,559.48 Ill. Total Additional Costs: 448.53 Gross Total: 3,710.35 IV. Total Adjustments: 500.00 - Net Total: 3,210.35 THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR VEHICLE. THE AFTERMARKET CRASH PARTS USED IN THE PREPARATION OF THIS ESTIMATE ARE WARRANTED BY THE MANUFACTURER OR DISTRIBUTOR OF SUCH PARTS, RATHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. Point(s) of Impact 11 Left Front Corner (P) Inspection Date: 1/1212012 PROGRESSIVE HONORS THE PREVAILING LABOR MARKET RATE IN YOUR AREA FOR YOUR PROPERTY. IF YOU CHOOSE A SHOP THAT CHARGES IN EXCESS OF PREVAILING LABOR MARKET RATES OR ADDITIONAL COSTS ABOVE THE APPRAISED AMOUNT, YOU WILL BE RESPONSIBLE FOR THE DIFFERENCE. LIFETIME GUARANTEE FOR SHEET METAL AND PLASTIC BODY PARTS The replacement parts written on the estimate are intended to return your vehicle to its pre -loss condition with proper installation. After repair, if any sheet metal or plastic body part included in the estimate fails to return your vehicle to its pre -loss condition (assuming proper installation), in terms of form, fit, finish, durability or functionality, Progressive will arrange and pay for the replacement of the part, to the extent not covered by a manufacturer's or other warranty. This service will be performed at no cost to you (including associated repair and rental car costs). To obtain service under this Guarantee, call Progressive at 1- 800 - 274 -4641. This Guarantee applies as long as you own or lease the vehicle. This Guarantee is not transferable and terminates if you sell or otherwise transfer your vehicle. THIS GUARANTEE DOES NOT COVER NORMAL WEAR AND TEAR OR DAMAGE CAUSED BY IMPROPER MAINTENANCE, NEGLECT, ABUSE OR SUBSEQUENT ACCIDENT. THIS GUARANTEE IS LIMITED TO ARRANGING FOR THE SELECTION OF REPAIR PARTS THAT WILL RETURN YOUR VEHICLE TO ITS PRE -LOSS CONDITION. ACCORDINGLY, PROGRESSIVE WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE INSTALLATION OR USE OF THESE PARTS. Part Type Terms and Abbreviations NEW and OEM or part number displayed - These refer to a new, original equipment manufacturer part. NON -OEM and A/M and Qual REPL - These refer to an after - market part, which is a new, non - original equipment manufacturer part. USED /RECYCLED and LKQ - These refer to a used OEM part. REMANUFACTURED and RECOND. and RECORE - These refer to used /recycled ESTIMATE RECALL NUMBER: 01/12/2012 09:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0109 MAPP:DEC_11_V0108 Copyright (C) 1994 -2011 Mitchell International Page 4 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1112)2012 09:19 AM Estimate ID: 12- 1101302 -01 Estimate Version: 0 Committed Profile ID: CPA: All Parts OEM parts that have been refurbished. BDY =BODY, BDS =BODY STRUCTURE, REF= REFINISH, GLS= GLASS, FRM =FRAME, MCH= MECHANICAL, ADD'L COST = ADDITIONAL COST, ADD'L OPR= ADDITIONAL OPERATION, FRT= FRONT, RR I_—LEFT, R= RIGHT,UPR= UPPER,LWR= LOWER, OTR=OUTER, INR= INNER, ASSY ASSEMBLY, SUSP= SUSPENSION, EXT= EXTENSION, BRK= BRACKET, INST= INSTRUMENT, ATG= ASSEMBLY TIME GUIDE. IF THIS APPRAISAL HAS BEEN PREPARED BASED UPON 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. REPAIR SHOP'S AUTHORIZED REPRESENTATIVE'S SIGNATURE INDICATING AGREEMENT ON COST TO RETURN THE VEHICLE TO PRE —LOSS CONDITION INCLUDING TOW /STORAGE CHARGES: SHOP SIGNATURE: EST. COMPLETION DATE: ANY PERSON WHO KNOWINGLY AND WITH THE 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. APPRAISER SIGNATURE Event Log Pile Created: 0111212012 07:37:24 AM Estimate Started: 01/12/2012 08:03:48 AM Estimate Printed: 01/12/2012 08:49:10 AM Estimate Committed: 01/12/2012 09:19:03 AM Estimate Uploaded: 01112/2012 09:19:22 AM ESTIMATE RECALL NUMBER: 01/12/2012 09:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0109 MAPP:DEC_11_V0108 Copyright (C) 1994 -2011 Mitchell International Page 5 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/181201211:04 AM Estimate ID: 12- 1101302 -01 Estimate Version: 1 Supplement: 1 (F F) 1/18/2012 09:13 :58 AM Profile ID: CPA: All Parts PROGRESSIVE 3950 Hartzdale Dr, Camp Hill, PA 17011 (717) 648 -0885 Email: DHanorl@progressive.com Damage Assessed by: Lic#429068 David Hanor Claim Rep: Dave Sotosky (814) 947 -4776 Supplemented By: Lic#429068 David Hanor For supplements please call Dave Hanor @ 717 - 648 -0885 or email to DHanorl @progressive.com * Product Type: Auto * Date of Loss: 111012012 * Deductible: 500.00 * Claim Number: 124101302 -01 Insured: XIAO JIANG Claimant: XIAO JIANG Address: 84 LONESOME RAOD, NEWVILLE, PA 17241 Telephone: Home Phone: (717) 360 -1137 Owner: XIAO JIANG Address: 84 LONESOME RAOD, NEWVILLE, PA 17241 Telephone: Home Phone: (717) 360.1137 Mitchell Service: 910445 Description: 2007 Ford Mustang GT Deluxe Vehicle Production Date: 1107 Body Style: 2D Cpe Drive Train: 4.6L Inj 8 Cyl 5M RWD VIN: 1ZVFT82H875299847 License: HDT -2429 PA Mileage: 60,719 OEM /ALT: A Search Code: LANCASTER? Color: RED Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW POWER STEERING, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN ANTI -LOCK BRAKE SYS., TRACTION CONTROL, ALUMJALLOY WHEELS, AUXILIARY INPUT POWER ADJUSTABLE EXTERIOR MIRROR, FRONT AIR DAM, TINTED GLASS, ANTI -THEFT SYSTEM AM /FM STEREO CD, FRONT BUCKET SEATS, FRONT SEATS WITH POWER LUMBAR SUPPORT KEYLESS ENTRY SYSTEM, POWER DISC BRAKES. REAR SPOILER STEERING WHEEL MOUNTED CONTROLS Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units Front Bumper 1 001607 BDY OVERHAUL Frt Bumper Cover Assy 2.1 # 2 000018 BDY REMOVE/REPLACE Fit Bumper Cover ** Non -OEM 356.00 INC # 3 REF REFINISH Fit Bumper Cover C 2.8 4 000002 BDY REMOVE/REPLACE Frt Bumper Rivet 4@1.27 ' W715030 S437 5.08 INC 5 000005 BDY REMOVE/REPLACE L Frt Bumper Bracket ** Non -OEM 15.38 INC 6 000007 BDY REMOVEIREPLACE L Frt Bumper Clip * W705589 S 1.70 INC 7 000009 BDY REMOVEIREPLACE L Frt Bumper Reinforcement 5113Z 17C861 AB 10.20 INC 8 000019 BDY REMOVEIREPLACE Frt Bumper Grille ** Non -OEM 43.00 INC 9 missing at inspection Front Lamps 10 002169 BDY REMOVEIREPLACE L H/Lamp Assembly ** Non -OEM 137.00 INC # 11 BDY REMOVEIINSTALL Frt Bumper Cover INC # 12 BDY CHECK/ADJUST Headlamps 0.4 S1 13 002461 BDY REMOVEIREPLACE L Park/Signal/Marker Lamp Assembly ** Non-OEM 47.00 INC # Hood 14 001616 REF BLEND Hood Outside C 1.2 15 001621 BDY REMOVE/INSTALL R Hood Washer Nozzle 0.2 # 16 001622 BDY REMOVEIINSTALL L Hood Washer Nozzle 0.2 # ESTIMATE RECALL NUMBER: 01112/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC_11_VO113 MAPP:DEC_11_V0115 Copyright (C) 1994 -2011 Mitchell International Page 1 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/18/201211:04 AM Estimate ID: 12- 1101302 -01 Estimate Version: 1 Supplement: 1 (F F) 1/18/2012 09:13:58 AM Profile ID: CPA: All Parts Front Fender 17 000210 BDY REMOVE/REPLACE L Fender Panel ** Non-OEM 297.00 1.5 # 18 REF REFINISH L Fender Outside C 2.0 19 REF REFINISH L Add To Edge Fender C 0.5 20 000218 BDY REMOVE/REPLACE L Fender Front Liner ** Non -OEM 19.00 INC # 21 000225 BDY REMOVEIREPLACE L Fender Adhesive Nameplate 5113Z 16098 AA 21.73 0.1 Front Inner Structure 22 000235 BDY REPAIR Front Body Radiator Support Existing 3.5 *# 23 spot refinish 24 REF REFINISH /REPAIR Front Body Radiator Support 0.3* 25 000236 BDY REMOVEtINSTALL Upr Front Body Shield Existing INC r 26 000242 BDY REMOVE/REPLACE Front Body Under Cover 5113Z 17626 BA 61.82 0.3 27 000246 BDY REPAIR L Upr Front Body Apron Panel S Existing 1.0* # 28 spot refinish 29 REF REFINISH /REPAIR L Upr Front Body Apron Panel S 0.3* 30 003243 BDY REPAIR L Front Body Apron Assy S Existing 1.0* 31 REF REFINISH /REPAIR L Front Body Apron Assy S 0.3* Wheel 32 001830 BDY REMOVE/REPLACE Alloy Wheel Remanufactured 189.00 * 0.3 33 LK0250, Tom, 1-800-334-9811, quote 7893200 34 002556 BOY REMOVEIREPLACE Wheel Tire Pressure Sensor 6F2Z 1A193 D 52.22 35 left front installation kit Front Suspension 36 001847 MCH REMOVEIREPLACE L Frt Susp Strut Assy -M 9R3Z 18124 B 93.42 1.6 # Rocker /Pillars/Floor 37 001661 BDY REMOVEIINSTALL L Rocker Moulding 0.5 38 000778 BDY REMOVE/REPLACE L Rocker Moulding Clip 7 @1.95 * W710528 S300 13.65 39 000782 BDY REMOVEIREPLACE L Rocker Moulding Clip 8 @1.63 * W710532 S300 13.04 Front Door 40 001676 REF REFINISH L Frt Add For Jambs C 0.3* 41 001678 BDY REMOVEIINSTALL L Frt Door Assembly 1.0 42 000976 BDY REPAIR L Frt Door Shell Existing 1.0*# 43 REF REFINISH L Frt Door Outside C 1.8 44 001564 BDY REPAIR L Frt Door Repair Panel Existing 3.5* # 45 001680 BDY REMOVEIINSTALL L Frt Rear View Mirror 0.3 # 46 000988 BDY REMOVEIINSTALL L Frt Otr Door Belt Moulding Existing 0.3 r 47 001684 BDY REMOVEIINSTALL L Frt Door Trim Panel INC 48 001688 BDY REMOVEIINSTALL L Frt Otr Door Handle 0.8 # 49 936001 ADD'L COST TOWING 130.00 * 50 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * ADDITIONAL OPERATIONS 51 REF ADD'L OPR Clear Coat 2A Additional Costs & Materials 52 ADD'L COST Paint/Materials 297•50 * MANUAL ENTRIES 53 900500 FRM * ALIGN TIE DOWN AND MEASURE Existing 1.0* 54 900500 FRM * REPAIR PULUALIGN FRONT UNIBODY Existing 1.0* 55 900500 BDY * ADD'L LABOR OP CAR COVER Sublet 4.00 * 0.2* 56 900500 BDY * ADWL LABOR OP CORROSION PROTECTION Sublet 15.00 * 0.2* 57 900500 BDY * ADD'L LABOR OP WELD THRU PRIMER Sublet 8.00 * 0.2* 58 900500 REF * REMOVEIREPLACE FLEX ADDITIVE Sublet 8.00 * 0.0* 59 900500 BDY * REMOVE/REPLACE 4 WHEEL ALIGNMENT Sublet 74.95 * 0.0* 60 900500 MCH* REMOVEIREPLACE MOUNT & BALANCE Sublet 14.00 * 0.0* S1 61 900500 BDY * REMOVEIREPLACE LEFT FRONT TIRE ** Non -OEM 209.59 * 0.0* 62 BETTERMENT /DEPRECIATION BASED ON 63 AMOUNT OF TREAD WORN 64 CURRENT TREAD DEPTH: 0132 65 TREAD DEPTH NEW: 10132 66 Deimler's Tire Service, 717 - 582 -2009 67 Pirelli, 235651117 S1 68 BETTERMENT - P LEFT FRONT TIRE 0 /*80.00 167.67 S1 69 900500 BDY * REMOVE/REPLACE TIRE TAX & DISPOSAL Sublet 3.00 * 0.0* ESTIMATE RECALL NUMBER: 01112/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC MAPP:DEC_11_V0115 Copyright (C) 1994 - 2011 Mitchell International Page 2 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/1812012 11:04 AM Estimate ID: 12- 1101302 -01 Estimate Version: 1 Supplement: 1 (F F) 1/1812012 09:13:58 AM Profile ID: CPA: All Parts * - Judgment Item # - Labor Note Applies ** Non -OEM - Non - Original Equipment Manufacturer Replacement Part C - Included in Clear Coat Calc r - CEG R&R Time Used For This Labor Operation EMPIRE AUTO PARTS, INC. KEYSTONE AUTOMOTIVE KEYSTONE AUTOMOTIVE PP 141 LAN2A AVE. JOHNSTOWN BUMPER MART 3221 ESPRESSO WAY GARFIELD 320 DOBSON ST. YORK NJ 07026 WINDBER PA 17404 (800) 624-4561 (800) 228 -6737 PA 15963 (717) 843 -8927 (800) 524 -4349 (800)438.2510 (814) 467 -5531 5 ** F0035 15.38 2 *` F01000575C 356.00 17 - F01240246PP 297.00 8 *` F01036114PP 43.00 10 *" F02502231 137.00 20 ** F01250129 19.00 ALL MANUFACTURERS REQUIREMENTS REGARDING SEATBELT AND SUPPLEMENTAL RESTRAINT SYSTEM REPLACEMENT MUST BE ADHERED TO. IF ADDITIONAL PARTS OR OPERATIONS ARE NECESSARY TO PROPERLY ACCOMPLISH THIS, PLEASE CONTACT THE ESTIMATING CLAIMS REPRESENTATIVE. THIS IS A DAMAGE ASSESSMENT ONLY - NOT AN AUTHORIZATION TO REPAIR -BASED ON DAMAGE VISIBLE OR CERTAIN AT THE TIME IT WAS WRITTEN. IF FRAME OR UNIBODY REPAIR IS INCLUDED ON THIS ESTIMATE, THE AMOUNT SHOWN INCLUDES TIME OR ALLOWANCE FOR MEASURING BEFORE, DURING AND AFTER THOSE REPAIRS. YOU ARE UNDER NO REQUIREMENT TO 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. TO ENSURE PROPER AND PROMPT PAYMENT FOR ADDITIONAL DAMAGE DISCOVERED DURING THE COURSE OF REPAIRS, CONTACT PROGRESSIVE FOR SUPPLEMENT HANDLING PROCEDURES. Estimate Totals Addy Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 18.6 46.00 0.00 27.00 882.60 T Taxable Parts 1,682.78 Refinish 11.9 46.00 0.00 0.00 547.40 T Sales Tax @ 6.000% 100.97 Frame 2.0 48.00 0.00 0.00 96.00 T Mechanical 1.6 50.00 0.00 0.00 80.00 T Non - Taxable Parts 3.00 Taxable Labor 1,606.00 Total Replacement Parts Amount 1,786.75 Labor Tax @ 6.000% 96.36 Labor Summary 34.1 1,702.36 ESTIMATE RECALL NUMBER: 011121201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0113 MAPP:DEC_11 - V0115 Copyright (C) 1994 -2011 Mitchell International Page 3 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1118/201211:04 AM Estimate ID: 12- 1101302 -01 Estimate Version: 1 Supplement: 1 IF F) 1/18/2012 09:13:58 AM Profile ID: CPA: All Parts III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 300.50 Betterment 167.67 - Sales Tax @ 6.000°/0 18.03 Insurance Deductible 500.00 - Non Taxable Costs 130.00 Customer Responsibility 667.67 - Total Additional Costs 448.53 Paint Material Method: Rates [nit Rate = 25.00 I. Total Labor: 1,702.36 I]. Total Replacement Parts: 1,786.75 III. Total Additional Costs: 448.53 Gross Total: 3,937.64 IV. Total Adjustments: 667.67 - Net Total: 3,269.97 Less Original Net Total: 3,210.35 Net Supplement Amount: 59.62 S1: Lic#429068 David Hanor 59.62 THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR VEHICLE. THE AFTERMARKET CRASH PARTS USED IN THE PREPARATION OF THIS ESTIMATE ARE WARRANTED BY THE MANUFACTURER OR DISTRIBUTOR OF SUCH PARTS, RATHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. Point(s) of Impact 11 Left Front Comer (P) Inspection Date: 1/12/2012 PROGRESSIVE HONORS THE PREVAILING LABOR MARKET RATE IN YOUR AREA FOR YOUR PROPERTY. IF YOU CHOOSE A SHOP THAT CHARGES IN EXCESS OF PREVAILING LABOR MARKET RATES OR ADDITIONAL COSTS ABOVE THE APPRAISED AMOUNT, YOU WILL BE RESPONSIBLE FOR THE DIFFERENCE. LIFETIME GUARANTEE FOR SHEET METAL AND PLASTIC BODY PARTS The replacement parts written on the estimate are intended to return your vehicle to its pre -loss condition with proper installation. After repair, if any sheet metal or plastic body part included in the estimate fails to return your vehicle to its pre -loss condition (assuming proper installation), in terms of form, fit, finish, durability or functionality, Progressive will arrange and pay for the replacement of the part, to the extent not covered by a manufacturer's or other warranty. This service will be performed at no cost to you (including associated repair and rental car costs). To obtain service under this Guarantee, call Progressive at 1- 800 - 274 -4641. This Guarantee applies as long as you own or lease the vehicle. This Guarantee is not transferable and terminates if you sell or otherwise transfer your vehicle. THIS GUARANTEE DOES NOT COVER NORMAL WEAR AND TEAR OR DAMAGE CAUSED BY IMPROPER MAINTENANCE, NEGLECT, ABUSE OR SUBSEQUENT ACCIDENT. THIS GUARANTEE IS LIMITED TO ARRANGING FOR THE SELECTION OF REPAIR PARTS ESTIMATE RECALL NUMBER: 01/12/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0113 MAPP:DEC_11_V0115 Copyright (C) 1994 -2011 Mitchell International Page 4 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/181201211:04 AM Estimate ID: 12- 1101302 -01 Estimate Version: 1 Supplement: 1 (F F) 1/1812012 09:13:58 AM Profile ID: CPA: All Parts THAT WILL RETURN YOUR VEHICLE TO ITS PRE —LOSS CONDITION. ACCORDINGLY, PROGRESSIVE WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE INSTALLATION OR USE OF THESE PARTS. Part Type Terms and Abbreviations NEW and OEM or part number displayed - These refer to a new, original equipment manufacturer part. NON -OEM and A/M and Qual REPL - These refer to an after - market part, which is a new, non - original equipment manufacturer part. USED /RECYCLED and LKQ - These refer to a used OEM part. REMANUFACTURED and RECOND. and RECORE - These refer to used /recycled OEM parts that have been refurbished. BDY =BODY, BDS =BODY STRUCTURE, REF= REFINISH, GLS= GLASS, FRM =FRAME, MCH= MECHANICAL, ADD'L COST = ADDITIONAL COST, ADD'L OPR= ADDITIONAL OPERATION, FRT= FRONT, RR =REAR, L =LEFT, R=RIGHT,UPR=UPPER,LWR= LOWER, OTR=OUTER, INR= INNER, ASSY= ASSEMBLY, SUSP= SUSPENSION, EXT= EXTENSION, BRK= BRACKET, INST= INSTRUMENT, ATG= ASSEMBLY TIME GUIDE. IF THIS APPRAISAL HAS BEEN PREPARED BASED UPON 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. REPAIR SHOP'S AUTHORIZED REPRESENTATIVE'S SIGNATURE INDICATING AGREEMENT ON COST TO RETURN THE VEHICLE TO PRE -LOSS CONDITION INCLUDING TOW /STORAGE CHARGES: SHOP SIGNATURE: EST. COMPLETION DATE: ANY PERSON WHO KNOWINGLY AND WITH THE 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. APPRAISER SIGNATURE Event Log File Created: 01112/2012 07:37:24 AM Estimate Started: 01/17/2012 01:52:18 PM Estimate Printed: 01/18/2012 09:14:18 AM Estimate Committed: 0111812012 11:04:32 AM Estimate Uploaded: 01118/2012 11:04:39 AM ESTIMATE RECALL NUMBER: 01112/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0113 MAPPMEC_11_V0115 Copyright (C) 1994 -2011 Mitchell International Page 5 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/1812012 11:04 AM Estimate ID: 12- 1101302 -01 Estimate Version: 1 Supplement: 1 (F F) 1/18/2012 09:13:58 AM Profile ID: CPA: All Parts PROGRESSIVE 3950 Hartzdale Dr, Camp Hill, PA 17011 (717) 648 -0885 Email: DHancrl@progressive.com Supplement Delta Report Comparison of Estimate 12- 1101302 -01 Supplement 0 and Supplement 1 Damage Assessed by: Lic#429068 David Hanor Supplemented By: Lic#429066 David Hanor Insured: XIAO JIANG Owner: XIAO JIANG Vehicle Description: 2007 Ford Mustang GT Deluxe * Date of Loss: 1/10/2012 Line Labor Line Item Dollar Labor CEG Item Type Operation Description Part Type Amount Units Unit Changed Entries 13 BDY REMOVEIREPLACE L Park/Signal/Marker Lamp Assembly * *Qual Rep[ Part 45.00 INC 0.2T S1 13 BDY REMOVEIREPLACE L ParklSignal/Marker Lamp Assembly * *Qual Repi Part 47.00 *< INC 0.2T Added Entries S1 61 BDY REMOVE/REPLACE LEFT FRONT TIRE * *Qual Rep[ Part 209.59 * 0.0* T 62 BETTERMENT /DEPRECIATION BASED ON 0.0 63 AMOUNT OF TREAD WORN 0.0 64 CURRENT TREAD DEPTH: 0132 0.0 65 TREAD DEPTH NEW: 10132 0.0 66 Deimler's Tire Service, 717 - 582 -2009 0.0 67 Pirelli, 235/551117 0.0 S1 68 BETTERMENT - P LEFT FRONT TIRE 0 /680.00 167.67 0.0 S1 69 BDY REMOVE/REPLACE TIRE TAX S DISPOSAL Sublet 3.00 * 0.0* Global Changes No Deductible, Customer Responsibility, Labor Rate, or Part Adjustment changes were made. Amount Original Estimate: 3,210.35 Supplement 1 59.62 Orig Total Tax 202.66 Supp 1 Total Tax 215.36 Net Supplement Amount 59.61 Net Total 3,269.97 Program Calc Versions Data Versions Supp 0 7.0.437 DEC 11_V0109 Supp 1 7.0.437 DEC7_11_V0113 ESTIMATE RECALL NUMBER: 11121201209:19:03 12- 1101302 -01 Software Version: 7.OA37 Copyright (C) 1994 - 2011 Mitchell International Page 1 of 1 All Rights Reserved Date: 1/1912012 12:18 PM Estimate ID: 12- 1101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/19/201211:07 :25 AM Profile ID: CPA: All Parts PROGRESSIVE 3950 Hartzdale Dr, Camp Hill, PA 17011 (717) 648 -0885 Email: DHanori@progressive.com Damage Assessed by: Lic#429068 David Hanor Claim Rep: Dave Sotosky (814) 947 -4776 Supplemented By: Lic#429068 David Hanor For supplements please call Dave Hanor @ 717 - 648 -0885 or email to DHanorl @progressive.com * Product Type: Auto * Date of Loss: 1/10/2012 * Deductible: 500.00 * Claim Number: 12- 1101302.01 Insured: XIAO JIANG Claimant: XIAO JIANG Address: 84 LONESOME RAOD, NEWVILLE, PA 17241 Telephone: Home Phone: (717) 360 -1137 Owner: XIAO JIANG Address: 84 LONESOME RAOD, NEWVILLE, PA 17241 Telephone: Home Phone: (717) 360 -1137 Mitchell Service: 910445 Description: 2007 Ford Mustang GT Deluxe Vehicle Production Date: 1107 Body Style: 2D Cpe Drive Train: 4.61- Inj 8 Cyl 5M RWD YIN: 1ZVFT82H875299847 License: HDT -2429 PA Mileage: 60,719 OEM /ALT: A Search Code: LANCASTERI Color: RED Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW POWER STEERING, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN ANTI -LOCK BRAKE SYS., TRACTION CONTROL, ALUM /ALLOY WHEELS, AUXILIARY INPUT POWER ADJUSTABLE EXTERIOR MIRROR, FRONT AIR DAM, TINTED GLASS, ANTI -THEFT SYSTEM AM /FM STEREO CD, FRONT BUCKET SEATS, FRONT SEATS WITH POWER LUMBAR SUPPORT KEYLESS ENTRY SYSTEM, POWER DISC BRAKES, REAR SPOILER STEERING WHEEL MOUNTED CONTROLS Line Entry Labor Line Item Part Type / Dollar Labor Item Number Type Operation Description Part Number Amount Units Front Bumoer 1 001607 BDY OVERHAUL Frt Bumper Cover Assy 2.1 # 2 000018 BDY REMOVE/REPLACE Frt Bumper Cover ** Non -OEM 356.00 INC # 3 REF REFINISH Frt Bumper Cover C 2.8 4 000002 BDY REMOVE/REPLACE Frt Bumper Rivet 4@1.27 * W715030 S437 5.08 INC 5 000005 BDY REMOVEIREPLACE L Frt Bumper Bracket ** Non -OEM 15.38 INC 6 000007 BDY REMOVEIREPLACE L Frt Bumper Clip * W705589 S 1.70 INC 7 000009 BDY REMOVEIREPLACE L Frt Bumper Reinforcement 5113Z 170861 AB 10.20 INC 8 000019 BDY REMOVEIREPLACE Frt Bumper Grille ** Non -OEM 43.00 INC 9 missing at inspection Front Lamas 10 002169 BDY REMOVEIREPLACE L H/Lamp Assembly ** Non -OEM 137.00 INC # 11 BDY REMOVEIINSTALL Frt Bumper Cover INC # 12 BDY CHECK/ADJUST Headlamps 0.4 S1 13 002461 BDY REMOVEIREPLACE L Park/Signal/Marker Lamp Assembly ** Non-OEM 47.00 * INC # Hood, 14 001616 REF BLEND Hood Outside C 1.2 15 001621 BDY REMOVEIINSTALL R Hood Washer Nozzle 0.2 # 16 001622 BDY REMOVEIINSTALL L Hood Washer Nozzle 0.2 # ESTIMATE RECALL NUMBER: 01112/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0116 MAPP:DEC_11_V0115 Copyright (C) 1994 -2011 Mitchell International Page 1 of 5 Software Version: 7.0.437 All Rights Reserved Date: 111912012 12:18 PM Estimate ID: 124101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/191201211:07:25 AM Profile ID: CPA: All Parts Front Fender 17 000210 BOY REMOVE/REPLACE L Fender Panel ** Non-OEM 297.00 1.5 # 18 REF REFINISH L Fender Outside C 2.0 19 REF REFINISH L Add To Edge Fender C 0.5 S2 20 000218 BOY REMOVEIREPLACE L Fender Front Liner 5113Z 16103 BA 33.60 INC # 21 000225 BOY REMOVE/REPLACE L Fender Adhesive Nameplate 5R3Z 16098 AA 21.73 0.1 Front Inner Structure 22 000235 BOY REPAIR Front Body Radiator Support Existing 3.5 *# 23 spot refinish 24 REF REFINISHIREPAIR Front Body Radiator Support 0.3* 25 000236 BOY REMOVE/INSTALL Upr Front Body Shield Existing INC r 26 000242 BOY REMOVE/REPLACE Front Body Under Cover 5R3Z 17626 BA 61.82 0.3 27 000246 BOY REPAIR L Upr Front Body Apron Panel S Existing 1.0*# 28 spot refinish 29 REF REFINISH /REPAIR L Upr Front Body Apron Panel S 0.3* 30 003243 BOY REPAIR L Front Body Apron Assy S Existing 1.0* 31 REF REFINISHIREPAIR L Front Body Apron Assy S 0.3* Wheel 32 001830 BOY REMOVEIREPLACE Alloy Wheel Remanufactured 189.00 * 0.3 33 LK0250, Tom, 1-800-334-9811, quote 7893200 34 002556 BOY REMOVE/REPLACE Wheel Tire Pressure Sensor 6F2Z 1A193 D 52.22 35 left front installation kit Front Suspension 36 001847 MCH REMOVE/REPLACE L Frt Susp Strut Assy -M 9R3Z 18124 B 93.42 1.6 # S2 37 000382 MCH REMOVEIREPLACE L Lwr Frt Susp Control Arm Assy -M 9R3Z 3079 B 276.48 1.8 # Rocker /Pillars/Floor 38 001661 BOY REMOVE/INSTALL L Rocker Moulding 0.5 39 000778 BOY REMOVEIREPLACE L Rocker Moulding Clip 7 @1.95 * W710528 5300 13.65 40 000782 BOY REMOVEIREPLACE L Rocker Moulding Clip 8 @1.63 * W710532 S300 13.04 Front Door 41 001676 REF REFINISH L Frt Add For Jambs C 0.3* 42 001678 BOY REMOVEIINSTALL L Frt Door Assembly 1.0 43 000976 BOY REPAIR L Frt Door Shell Existing 1.0 *# 44 REF REFINISH L Frt Door Outside C 1.8 45 001564 BOY REPAIR L Frt Door Repair Panel Existing 3.5 *# 46 001680 BOY REMOVEIINSTALL L Frt Rear View Mirror 0.3 # 47 000988 BOY REMOVEIINSTALL L Frt Otr Door Belt Moulding Existing 0.3 r 48 001684 BOY REMOVEIINSTALL L Frt Door Trim Panel INC 49 001688 BOY REMOVE/INSTALL L Frt Otr Door Handle 0.8 # 50 936001 ADD'L COST TOWING 130.00 * 51 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * ADDITIONAL OPERATIONS 52 REF ADD'L OPR Clear Coat 2.4 Additional Costs & Materials 53 ADD'L COST Paint/Materials 297.50 * MANUAL ENTRIES 54 900500 FRM * ALIGN TIE DOWN AND MEASURE Existing 1.0* 55 900500 FRM * REPAIR PULL/ALIGN FRONT UNIBODY Existing 1.0* 56 900500 BDY * ADD'L LABOR OP CAR COVER Sublet 4.00 * 0.2* 57 900500 BOY * ADD'L LABOR OP CORROSION PROTECTION Sublet 15.00 * 0.2* 58 900500 BOY * ADD'L LABOR OF WELD THRU PRIMER Sublet 8.00 * 0.2* 59 900500 REF * REMOVEIREPLACE FLEX ADDITIVE Sublet 8.00 * 0.0* 60 900500 BOY * REMOVEIREPLACE 4 WHEEL ALIGNMENT Sublet 74.95 * 0.0* 61 900500 MCH* REMOVEIREPLACE MOUNT & BALANCE Sublet 14.00 * 00 S1 62 900500 BOY * REMOVEIREPLACE LEFT FRONT TIRE ** Non-OEM 209.59 * 0.0* 63 BETTERMENT /DEPRECIATION BASED ON 64 AMOUNT OF TREAD WORN 65 CURRENT TREAD DEPTH: 0/32 66 TREAD DEPTH NEW: 10132 67 Deimler's Tire Service, 717 - 582.2009 68 Pirelli, 235155817 S1 69 BETTERMENT - P LEFT FRONT TIRE 1 1680.00 167.67 S1 70 900500 BOY * REMOVE/REPLACE TIRE TAX & DISPOSAL Sublet 100 * 0.0* ESTIMATE RECALL NUMBER: 01112/201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0116 MAPP:DEC_11_V0115 Copyright (C) 1994 -2011 Mitchell International Page 2 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/19/201212:18 PM Estimate ID: 12- 1101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/19/201211:07:25 AM Profile ID: CPA: All Parts * - Judgment Item # - Labor Note Applies ** Non -OEM - Non - Original Equipment Manufacturer Replacement Part C - Included In Clear Coat Calc r - CEG R&R Time Used For This Labor Operation EMPIRE AUTO PARTS, INC. KEYSTONE AUTOMOTIVE KEYSTONE AUTOMOTIVE PP 141 LANZA AVE. JOHNSTOWN BUMPER MART 3221 ESPRESSO WAY GARFIELD 320 DOBSON ST. YORK NJ 07026 WINDBER PA 17404 (800) 624 -4561 (800) 228 -6737 PA 15963 (717) 843 -8927 (800) 524 -4349 (800) 438 -2510 (814) 467 -5531 5 ** F0035 15.38 2 ** F01000575C 356.00 17 "` F01240246PP 297.00 8 *• F01036114PP 43.00 10 ** F02502231 137.00 ALL MANUFACTURERS REQUIREMENTS REGARDING SEATBELT AND SUPPLEMENTAL RESTRAINT SYSTEM REPLACEMENT MUST BE ADHERED TO. IF ADDITIONAL PARTS OR OPERATIONS ARE NECESSARY TO PROPERLY ACCOMPLISH THIS, PLEASE CONTACT THE ESTIMATING CLAIMS REPRESENTATIVE. THIS IS A DAMAGE ASSESSMENT ONLY - NOT AN AUTHORIZATION TO REPAIR -BASED ON DAMAGE VISIBLE OR CERTAIN AT THE TIME IT WAS WRITTEN. IF FRAME OR UNIBODY REPAIR IS INCLUDED ON THIS ESTIMATE, THE AMOUNT SHOWN INCLUDES TIME OR ALLOWANCE FOR MEASURING BEFORE, DURING AND AFTER THOSE REPAIRS. YOU ARE UNDER NO REQUIREMENT TO 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. TO ENSURE PROPER AND PROMPT PAYMENT FOR ADDITIONAL DAMAGE DISCOVERED DURING THE COURSE OF REPAIRS, CONTACT PROGRESSIVE FOR SUPPLEMENT HANDLING PROCEDURES. Estimate Totals Add'i Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 18.6 46.00 0.00 27.00 882.60 T Taxable Parts 1,973.86 Refinish 11.9 46.00 0.00 0.00 547.40 T Sales Tax @ 6.000% 118.43 Frame 2.0 48.00 0.00 0.00 96.00 T Mechanical 3.4 50.00 0.00 0.00 170.00 T Non - Taxable Parts 3.00 Taxable Labor 1,696.00 Total Replacement Parts Amount 2.095.29 Labor Tax @ 6.000% 101.76 Labor Summary 35.9 1,797.76 ESTIMATE RECALL NUMBER: 01/12/2012 09:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0116 MAPP:DEC 11 - V0115 Copyright (C) 1994 - 2011 Mitchell International Page 3 of 5 Software Version: 7.0.437 All Rights Reserved Date: 019/201212:18 PM Estimate ID: 12- 1101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/19/201211:07:25 AM Profile ID: CPA: All Parts 111. Additional Costs Amount 1V. Adjustments Amount Taxable Costs 300.50 Betterment 167.67 - Sales Tax @ 6.000 16.03 Insurance Deductible 500.00 - Non- Taxable Costs 130.00 Customer Responsibility 667.67 - Total Additional Costs 448.53 Paint Material Method: Rates Init Rate = 25.00 1. Total Labor: 1.797.76 11, Total Replacement Parts: 2,095.29 111. Total Additional Costs: 448.53 Gross Total: 4,341.58 IV. Total Adjustments: 667.67 - Net Total: 3,673.91 Less Original Net Total: 3,210.35 Net Supplement Amount: 463.56 S1: Lic#429068 David Hanor 59.62 S2: Lic#429068 David Hanor 403.94 THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR VEHICLE. THE AFTERMARKET CRASH PARTS USED IN THE PREPARATION OF THIS ESTIMATE ARE WARRANTED BY THE MANUFACTURER OR DISTRIBUTOR OF SUCH PARTS, RATHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. Point(s) of Impact 11 Left Front Corner (P) Inspection Date: 1 /1 212 01 2 PROGRESSIVE HONORS THE PREVAILING LABOR MARKET RATE IN YOUR AREA FOR YOUR PROPERTY. IF YOU CHOOSE A SHOP THAT CHARGES IN EXCESS OF PREVAILING LABOR MARKET RATES OR ADDITIONAL COSTS ABOVE THE APPRAISED AMOUNT, YOU WILL BE RESPONSIBLE FOR THE DIFFERENCE. LIFETIME GUARANTEE FOR SHEET METAL AND PLASTIC BODY PARTS The replacement parts written on the estimate are intended to return your vehicle to its pre -loss condition with proper installation. After repair, if any sheet metal or plastic body part included in the estimate fails to return your vehicle to its pre -loss condition (assuming proper installation), in terms of form, fit, finish, durability or functionality, Progressive will arrange and pay for the replacement of the part, to the extent not covered by a manufacturer's or other warranty. This service will be performed at no cost to you (including associated repair and rental car costs). To obtain service under this Guarantee, call Progressive at 1- 800 - 274 -4641. This Guarantee applies as long as you own or lease the vehicle. This Guarantee is not transferable and terminates if you sell or otherwise transfer your vehicle. THIS GUARANTEE DOES NOT COVER NORMAL WEAR AND TEAR OR DAMAGE CAUSED BY IMPROPER MAINTENANCE, NEGLECT, ABUSE OR SUBSEQUENT ACCIDENT. THIS ESTIMATE RECALL NUMBER: 01112/201209:19:03 12-1101302 -01 Mitchell Data Version: OEM: DEC _11_V0116 MAPP:DEC_11_V0115 Copyright (C) 1994 - 2011 Mitchell International Page 4 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/19/201212:16 PM Estimate ID: 12- 1101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/191201211:07:25 AM Profile ID: CPA: Ail Parts GUARANTEE IS LIMITED TO ARRANGING FOR THE SELECTION OF REPAIR PARTS THAT WILL RETURN YOUR VEHICLE TO ITS PRE —LOSS CONDITION. ACCORDINGLY, PROGRESSIVE WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE INSTALLATION OR USE OF THESE PARTS. Part Type Terms and Abbreviations NEW and OEM or part number displayed - These refer to a new, original equipment manufacturer part. NON -OEM and A/M and Qual REPL - These refer to an after - market part, which is a new, non - original equipment manufacturer part. USED /RECYCLED and LKQ - These refer to a used OEM part. REMANUFACTURED and RECOND. and RECORE - These refer to used /recycled OEM parts that have been refurbished. BDY =BODY, BDS =BODY STRUCTURE, REF= REFINISH, GLS= GLASS, FRM =FRAME, MCH= MECHANICAL, ADD'L COST = ADDITIONAL COST, ADD'L OPR= ADDITIONAL OPERATION, FRT= FRONT, RR-REAR, L =LEFT, R=RIGHT,UPR=UPPER,LWR= LOWER, OTR=OUTER, INR= INNER, ASSY= ASSEMBLY, SUSP= SUSPENSION, EXT= EXTENSION, BRK= BRACKET, INST= INSTRUMENT, ATG= ASSEMBLY TIME GUIDE. IF THIS APPRAISAL HAS BEEN PREPARED BASED UPON 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. REPAIR SHOP'S AUTHORIZED REPRESENTATIVE'S SIGNATURE INDICATING AGREEMENT ON COST TO RETURN THE VEHICLE TO PRE -LOSS CONDITION INCLUDING TOW /STORAGE CHARGES: SHOP SIGNATURE: EST. COMPLETION DATE: ANY PERSON WHO KNOWINGLY AND WITH THE 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. APPRAISER SIGNATURE Event Log File Created: 01112/2012 07:37:24 AM Estimate Started: 01!19!2012 11:07:06 AM Estimate Printed: 01/19!201211:49:44 AM Estimate Committed: 01/19/201212:14:41 PM Estimate Uploaded: 01119/201212:17:56 PM ESTIMATE RECALL NUMBER: 011121201209:19:03 12- 1101302 -01 Mitchell Data Version: OEM: DEC _11_V0116 MAPP:DEC_11 — V0115 Copyright (C) 1994 -2011 Mitchell International Page 5 of 5 Software Version: 7.0.437 All Rights Reserved Date: 1/19/201212:18 PM Estimate ID: 12- 1101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/19/201211:07:25 AM Profile ID: CPA: All Parts PROGRESSIVE 3950 Hartzdale Dr, Camp Hill, PA 17011 (717) 648 -0885 Email: DHancri@progressive.com Supplement Delta Report Comparison of Estimate 12- 1101302 -01 Supplement 0 and Supplement 2 Damage Assessed by: Lic#429068 David Hanor Supplemented By: Lic#429068 David Hanor Insured: XIAO JIANG Owner: XIAO JIANG Vehicle Description: 2007 Ford Mustang GT Deluxe * Date of Loss: 111012012 Line Labor Line Rem Dollar Labor CEG Item Type Operation Description Part Type Amount Units Unit Added Entries 1 BDY OVERHAUL Frt Bumper Cover Assy 2.1 2.1 2 BDY REMOVEIREPLACE Frt Bumper Cover * *Qua/ Repi Part 356.00 INC 2.1T 3 REF REFINISH Frt Bumper Cover C 2.8 2.8 4 BDY REMOVEIREPLACE Frt Bumper Rivet New 5.08 INC T 5 BDY REMOVEIREPLACE L Frt Bumper Bracket * *Qual Repi Part 15.38 INC T 6 BDY REMOVE/REPLACE L Frt Bumper Clip New 1.70 INC T 7 BDY REMOVEIREPLACE L Frt Bumper Reinforcement New 10.20 INC T 8 BDY REMOVEIREPLACE Frt Bumper Grille * *Qual Repl Part 43.00 INC 0.2T 9 missing at inspection 0.0 10 BDY REMOVE/REPLACE L H/Lamp Assembly * *Qual Repi Part 137.00 INC 0.3T 11 BDY REMOVEIINSTALL Frt Bumper Cover INC 1.1 12 BDY CHECKIADJUST Headlamps 0.4 0.4 S1 13 BDY REMOVE/REPLACE L Park/Signal/Marker Lamp Assembly * *Qua/ Repi Part 47.00 * INC 0.2T 14 REF BLEND Hood Outside C 1.2 2.9 15 BDY REMOVE/INSTALL R Hood Washer Nozzle 0.2 0.2 16 BDY REMOVEIINSTALL L Hood Washer Nozzle 0.2 0.2 17 BDY REMOVE/REPLACE L Fender Panel * *Qual Repi Part 297.00 1.5 2.6T 18 REF REFINISH L Fender Outside C 2.0 2.0 19 REF REFINISH L Add To Edge Fender C 0.5 0.5 S2 20 BDY REMOVE/REPLACE L Fender Front Liner New 33.60 INC 0.3T 21 BDY REMOVE/REPLACE L Fender Adhesive Nameplate New 21.73 0.1 0.2T 22 BDY REPAIR Front Body Radiator Support Existing 3.5* 7.5 23 spot refinish 0.0 24 REF REFINISH /REPAIR Front Body Radiator Support 0.3* 1.5 25 BDY REMOVEIINSTALL Upr Front Body Shield Existing INC 0.3 26 BDY REMOVE/REPLACE Front Body Under Cover New 61.82 0.3 0.3T 27 BDY REPAIR L Upr Front Body Apron Panel S Existing 1.0* 2.5 28 spot refinish 0.0 29 REF REFINISHIREPAIR L Upr Front Body Apron Panel S 0.3* 0.5 30 BDY REPAIR L Front Body Apron Assy S Existing 11* 5.0 31 REF REFINISH/REPAIR L Front Body Apron Assy -S 0.3* 0.5 32 BDY REMOVEIREPLACE Alloy Wheel Remanufactured 189.00 * 0.3 0.3T 33 LKQ250, Tom, 1- 800 - 334 -9811, quote 7893200 0.0 34 BDY REMOVE/REPLACE Wheel Tire Pressure Sensor New 52.22 0.0 T 35 left front installation kit 0.0 36 MCH REMOVEIREPLACE L Frt Susp Strut Assy -M New 93.42 1.6 1.6T S2 37 MCH REMOVEIREPLACE L Lwr Frt Susp Control Arm Assy -M New 276.48 1.8 1.8T 38 BDY REMOVE/INSTALL L Rocker Moulding 0.5 0.5 39 BDY REMOVEIREPLACE L Rocker Moulding Clip New 13.65 0.0 T 40 BDY REMOVEIREPLACE L Rocker Moulding Clip New 13.04 010 T 41 REF REFINISH L Frt Add For Jambs C 0.3* 0.5 42 BDY REMOVEIINSTALL L Frt Door Assembly 1.0 1.0 ESTIMATE RECALL NUMBER: 1/12/201209:19:03 12- 1101302 -01 Software Version: 7.0.437 Copyright (C) 1994 - 2011 Mitchell International Page 1 of 2 All Rights Reserved Date: 1/19!201212:18 PM Estimate ID: 12- 1101302 -01 Estimate Version: 2 Supplement: 2 (F F) 1/19/201211:07:25 AM Profile ID: CPA: All Parts 43 BDY REPAIR L Frt Door Shell Existing 1.0* 4.7 44 REF REFINISH L Frt Door Outside C 1.8 2.2 45 BDY REPAIR L Frt Door Repair Panel Existing 3.5* 6.6 46 BDY REMOVE/INSTALL L Frt Rear View Mirror 0.3 0.7 47 BDY REMOVE/INSTALL L Frt Otr Door Belt Moulding Existing 0.3 0.3 48 BDY REMOVE/INSTALL L Frt Door Trim Panel INC 0.4 49 BDY REMOVEIINSTALL L Frt Otr Door Handle 0.8 0.8 50 ADD'L COST TOWING 130.00 * 0.0 51 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * 0.0 T 52 REF ADD'L OPR Clear Coat 2.4 53 ADD'L COST Paint/Materials 297.50 * 0.0 T 54 FRM ALIGN TIE DOWN AND MEASURE Existing 1.0* 55 FRM REPAIR PULLIALIGN FRONT UNIBODY Existing 10 56 BDY ADD'L LABOR OP CAR COVER Sublet 4.00 * 0.2* T 57 BDY ADD'L LABOR OP CORROSION PROTECTION Sublet 15.00 * 0.2* T 58 BDY ADD'L LABOR OP WELD THRU PRIMER Sublet 8.00 * 0.2* T 59 REF REMOVE/REPLACE FLEX ADDITIVE Sublet 8.00 * 0.0* T 60 BDY REMOVE/REPLACE 4 WHEEL ALIGNMENT Sublet 74.95 * 0.0* T 61 MCH REMOVE/REPLACE MOUNT & BALANCE Sublet 14.00 * 0.0* T S1 62 BDY REMOVEIREPLACE LEFT FRONT TIRE * *Qual Repl Part 209.59 * 0.0* T 63 BETTERMENT /DEPRECIATION BASED ON 0.0 64 AMOUNT OF TREAD WORN 0.0 65 CURRENT TREAD DEPTH: 0/32 0.0 66 TREAD DEPTH NEW: 10132 0.0 67 Deimler's Tire Service, 717. 582 -2009 0.0 68 Pirelli, 235155R17 0.0 S1 69 BETTERMENT - P LEFT FRONT TIRE 5 /680.00 167.67 0.0 S1 70 BDY REMOVEIREPLACE TIRE TAX 8: DISPOSAL Sublet 3.00 * 0.0* Global Changes Deductible From: To: 0.00 500.00 Labor Rates From: To: Adjustments From: To: Body 0.00 46.00 Refinish 0.00 46.00 Glass 0.00 46.00 Mechanical 0.00 50.00 Frame 0.00 48.00 Body -S 0.00 46.00 Estimate profile calculation settings (other than labor rates and adjustments) have changed. Amount Original Estimate: 3,210.35 Supplement 1 59.62 Supplement 2 403.94 Supp 2 Total Tax 238.22 Net Supplement Amount 463.56 Net Total 3,673.91 Program Calc Versions Data Versions Supp 0 Prior to 5.0 - 400 Series Supp 2 7.0.437 DEC_11_V0116 ESTIMATE RECALL NUMBER: 11121201209:19:03 12. 1101302 -01 Software Version: 7.0.437 Copyright (C) 1994 - 2011 Mitchell International Page 2 of 2 All Rights Reserved Claim Payment Detail Page 1 of 1 Claim Payment Detail { 12- 1101302 } Print1' E Payment Information Disbursement Number: 472926970 Total Amount: $157.00 I EFT Trace Number: Invoice Number: Paid To: JASON BELTZ, ONLY Mailing Address: 64 LONESOME RAOD j NEWVILLE, PA 17241 USA j In Payment Of: REIMBURSEMENT OF TOW BILL ` F Vendor Information Name: 1099 Required: Type: I ................. _ ______..,,,.,,,,,.,.,.., ._..._.__._,.,............__.__ ____.__._._..............,................................... .. .......... ..,,,,,,,.,. ................ ......_._ ............................ ______.__.m.. ___._...____..... [- Reviewed Summary - -- i Issuing Rep: DAS0042 Approved By: Issue Date: 01 -17 -12 Review Date: Last Updated Rep: DAS0042 Reviewed By: x , ....................... .......................__........_._.,_............. _ .... ____. ....._.___.........._... ....... _ _ _ _ - __.....,,.............,,...,. _, ._._......_.._....__.._.._..__..._... .._..._........,.,__.........._ __..__...__ ....._____.......__........__ _: -Bank Information 3 Type: Loss Bank Code: AS2 Stop Reason: Cleared: 01 -26 -12 i Stop Date: ,,, _ „. ............................ ..... _,._ ,, .,, ,..,,,,,,,.,.,...._.._._..... ..__ ................ _.__..__ -._.._ _,..,,.,, ,,..,,,,,.,,,- ,,.,,,,...- „_ - .. -_ ................ „ ,,, ..................... ....._..._.,_. .......................................... ._—_____ --- - ..........,, _- ._....__. ....................... ? F Exposure Detail: COLL Party Name: JIANG, XIAO Q Amount Paid: $157.00 Property Description: 07 FORD MUSTANG Deductible Taken: $0.00 Payment Type: PARTIAL PAYMENT Property Damage: $0.00 Rental: $0.00 http: / /claimspayments /Alpha /ClaimsPaymentsWeb /default. aspx ?page= ClaimPaymentDetail ... 5/1/2013 Claim Payment Detail Page 1 of 1 Claim Payment Detail 12- 1101302 Print 0 Payment Information Disbursement Number: 765632048 Total Amount: $3,67191 ` F EFT Trace Number: 711096820 Invoice Number: 5443677 Paid To: EDS AUTO BODY - LANDISBURG Mailing Address: 400 E WATER ST 400 E. WATER ST. LANDISBURG, PA 17040 USA In Payment Of: Progressive Invoice Number: 5443677 Vendor Information Name: 1099 Required: Type: r- -Reviewed Summary Issuing Rep: DJH0019 Approved By: Issue Date: 01 -20 -12 Review Date: Last Updated Rep: DJH0019 Reviewed By: ' [ --Bank Information Type: Loss Bank Code: CTB I Stop Reason: Cleared: 01 -23 -12 J Stop Date: Exposure Detail: COLL ... ... . ...._ .._ ......................... ............................ �.............. ...... _-- .__.....--------------- ................ ..... ........ .... ....... ..... _ ...... � Party Name: JIANG, XIAO Q Amount Paid: $3,673.91 Property Description: 07 FORD MUSTANG Deductible Taken: $500.00 1 Payment Type: FINAL PAYMENT Property Damage: $0.00 Rental: $0.00 http: / /claimspayments/ Alpha /ClaimsPaymentsWeb /default.aspx ?page= ClaimPaymentDetail... 5/1/2013 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. BENJA N . LAWRENCE Date SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson * _ �. Sheriff u THF IG,! H 6 �<tYt�9 uirarar( r Jody S Smith Chief Deputy '" y 2013 JUL 26 AM 10, 31 Richard W Stewart CUMBERLAND COUNTY Solicitor 011RCE CC-."y,l,°m�?I PENN 5 Y LVA H I A Progressive Speciality Ins vs. Case Number Danielle Fralish 2013-3414 SHERIFF'S RETURN OF SERVICE 07/19/2013 Ronny R Anderson, Sheriff, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Danielle Fralish, but was unable to locate the Defendant in his bailiwick. The Sheriff therefore returns the within requested Complaint& Notice as"Not Found"at 435 W. Louther Street, Carlisle Borough, Carlisle, PA 17013. To this date the Carlisle Postmaster has been unable to provide a forwarding address and the Complaint has expired. SHERIFF COST: $40.24 SO ANSWERS, July 19, 2013 RON W R ANDERSON, SHERIFF (c)CountySuite Sheriff,Teleosoft,Inc. 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 �r,w Phone: 215.599.1500 ri Fax: 215.599.1505 File # 20041693 {c — zca ._- -rt: PROGRESSIVE SPECIALTY INSURANCE 3' COMPANY --c -i CUMBERLAND County Court of Common Pleas vs. DANIELLE N FRALISH NO. 13 3414 CIVIL PRAECIPE TO REINSTATE TO THE PROTHONOTARY: Kindly reinstate the Complaint in Civil Action in the above-captioned matter. WELTMAN, WEINBERG & REIS CO., L.P.A. By Benjamin W. Lawrence, Esquire Attorney for Plaintiff • 11.75ctk, Si� c�. Rosy 72ZqLSLL SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff t} f, ��yx v of Cumber Jody S Smith "ti'I3 4 Chief Deputy .� Q� �1�. y' Solicitor W Stewart f CE OE THE SHE EE f '�I '1 L ri r`i J l d 4; ' ' PE'P�NS �'LVrk N le, E Progressive Speciality Ins vs. Case Number Danielle Fralish 2013-3414 SHERIFF'S RETURN OF SERVICE 10/08/2013 Sheriff Ronny R Anderson, being duly sworn according to law, states he search and inquiry for the within named Defendant to wit: Danielle Fralish, but wa efendant in the Sheriffs bailiwick.The Sheriff therefore deputizes the Sheriff of Dauphin, ennsy is to serve the within Complaint&Notice according to law. 10/10/2013 10:30 AM -The requested Complaint&Notice served by the Sheriff of Dauphin Count u on Service attache to an m . SHERIFF COST: $37.00 SO ANSWERS, te-7:11 _, 1( October 15, 2013 RONNY ANDERSON, SHERIFF i i C:n t,Sui!e Sheriff:Te eosof, nc. ilia of fibs watic, Shelley Ruhl 1/% Jack Duignan Real Estate Deputy �`1/ � .� Chief Deputy Matthew L. Owens ��•...A Michael W. Rinehart Solicitor Assistant Chief Deputy Dauphin County 101 Market Street Harrisburg,Pennsylvania 17101-2079 ph:(717)780-6590 fax (717)255-2889 Jack Lotwick Sheriff Commonwealth of Pennsylvania PROGRESSIVE SPECIALTY INSURANCE CO. VS County of Dauphin DANIELLE FRALISH Sheriffs Return No. 2013-T-2729 OTHER COUNTY NO. 2013-3414 And now: OCTOBER 10, 2013 at 10:30:00 AM served the within REINSTATED COMPLAINT & NOTICE upon DANIELLE FRALISH by personally handing to DANIELLE FRALISH 1 true attested copy of the original REINSTATED COMPLAINT &NOTICE and making known to him/her the contents thereof at 405 S. 13TH STREET HARRISBURG PA 17104 Sworn and subscribed to So Answers, before me this 11TH day of October, 2013 Q�✓�"�� Sheriff of D phin Count Pa. B 1 Y COMMONWEALTH OF PENNSYLVANIA Dep heriff NOTARIAL SEAL Deputy: JEFF TEETER Karen M.Hoffman,Notary Public City of Harrisburg,Dauphin County Sheriffs Costs: $41.25 10/9/2013 My Commission Expires August 17,2014 1 4. YL.91 VAI I A. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE SPECIALY INS Plaintiff No: 13-3414 CIVIL VS . PRAECIPE FOR DEFAULT JUDGMENT DANIELLE N FRALISH 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 20041693 C Y Jer TWI Judgment Amount $4330 . 91 I(,,25o P D A7TY et 61-W 16 o �u� IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE SPECIALY INS Plaintiff VS. Civil Action No. 13-3414 CIVIL DANIELLE N FRALISH PRAECIPE FOR DEFAULT JUDGMENT TO THE PROTHONTARY: Kindly enter Judgment against the Defendant DANIELLE N FRALISH above named, in the default of an Answer, in the amount of $4330 . 91 computed as follows : Amount claimed in Complaint $4330 . 91 Less payments / adjustments made $0 . 00 Attorney' s fees $0 . 00 TOTAL $4330 . 91 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, WEIN ERG & REIS CO. , L.P.A. By: Benjamin W Lawrence, 209032 20041693 C Y Jer TWI 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 DANIELLE N FRALISH 405 S 13TH ST HARRISBURG, PA 17104 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE SPECIALY INS Plaintiff VS . Civil Action No. 13-3414 CIVIL DANIELLE N FRALISH NOTICE OF JUDGMENT OR ORDER TO: ( ) Plaintiff (xx) Defendant ( ) Garnishee You are hereby notified that thq f L/3 1 wing Order of Judgment was entered against you on • (1, (xx) Assumpsit Judgment in the amount of $4330 . 91 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 ( ) Arbitration Awar Prothonotary By: PROTHONOTARY `.^" r„-,,.UT-Y) DANIELLE N FRALISH 405 S 13TH ST HARRISBURG, PA 17104 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 PROGRESSIVE SPECIALY INS Plaintiff Case No. 13.3414 CIVIL vs. DANIELLE N FRALISH Defendant IMPORTANT NOTICE TO: DANIELLE N FRALISH 405 S 13TH ST a a of a ice' FA 17104 v j HARRISBURG, N 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,,.WEINBERG&REIS CO., L P.A. By: Michael Do� a ty rAN6,046 WEINBERG & REIS CO., L.P.A. 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 (215)599-1600 (215)599-1505 20041653 Y PHI IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE SPECIALY INS Plaintiff VS . Civil Action No. 13-3414 CIVIL NON-MILITARY AFFIDAVIT DANIELLE N FRALISH 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, DANIELLE N FRALISH 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: DANIELLE N FRALISH 405 S 13TH ST HARRISBURG, PA 17104 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 . AFFI T Department of Defense Manpower Data Center Results as of:Dec-10-2013 06:32:08 SCRA 3.0 Statw Rtport Pm- t to Sery cemembas Civil Relief Act Last Name: FRALISH First Name: DANIELLE Middle Name: N Active Duty Status As Of: Dec-10-2013 On Active 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 367 Days of Active Duty Status Date Active Duty Start Date Active Duty End Date Status Service Component NA I NA No NA This response reflects where the individual left active duty status within 367 days preceding the Active Duty Status Date The Member or HWHer Unit Was Notified of a Future Call-Up to Active Duty on Active Duty Status Date Order Notification Start 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,NOAA,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. iA 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(NOAA 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: M641 E831 LOCEE50 WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire I.D. No. 209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File # 20041693 Attorney for Plaintiff(s) PROGRESSIVE INSURANCE COMPANY vs. DANIELLE N FRALISH CUMBERLAND County Court of Common Pleas NO. 13 3414 CIVIL PRAECIPE FOR CERTIFICATION OF MOTOR VEHICLE JUDGMENT TO THE PROTHONOTARY: Kindly issue a Certification of Motor Vehicle Judgment against the Defendant(s), DANIELLE N FRALISH, above named in the amount of $4330.91. WELTMAN, WEINBERG & REIS CO., L.P.A. By Benamin W. Lawrence, Esquire Attorney for Plaintiff 0-1"4 a CU( iv/&z/ 2633se