Loading...
HomeMy WebLinkAbout13-6200 Y Supreme Court of Pennsylvania `i;WR # 20070910 C Y Jer TWI Court of Common Pleas Civil Cover Sheet For Pmthonotaq Use Orrtr: C UMBERLAND Countv Docket No: s The rtrfor motion collected on this ,form is used solely for courr administration purposes. This Jbrrrr does not supplemenr or replace thefiling and ser,•ice of pleadings or other papers cis required bi - /ail or rules of court. Commencement of Action: S 13 Complaint ❑ Writ of Summons ❑ Petition E ❑ Transfer from Another Jurisdiction Declaration of Takin C Lead Plaintiff's Name: Lead Defendant's Name: T STATE FARM MUTUAL AUTO INS TONYA ZUBER I 0 Are money damages requested? El Yes ❑ No Dollar Amount Requested: ® within arbitration limits N (check one) ❑ outside arbitration limits A Is. this a Class Action Suit? ❑ Yes IR No Is this an NMJ Appeal? 13 Yes 53 No Name of Plaintiff /Appellant's Attorney: Benjamin W. Lawrence,209032 ❑ Check here if you have no attorney (are a Self- Represented [Pro Sel 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 ❑ Statutory Appeal: Other E [3 Product Liability (does not include E3 Employment Dispute Mass tort) Discrimination C ❑ Slander/Libel /Defamation ❑ Employment Dispute: Other ❑ Zoning Board T Other: ❑ Other: I �c.� rz, �a�hzn - 0 ❑ Other: N MASS TORT ❑ Asbestos B ❑ 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 Ff ..E0 -0 -FF ;E OF TH 2 +a 13 0 1 21 Pr? 2. 30 CUMBERLAND COUN PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION State Farm Mutual Automobile Insurance Company - - -- - -- -- Plaintiff No: �J� W010d C ot VS. COMPLAINT IN CIVIL ACTION TONYA ZUBER 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 20070910 C Y Jer TWI OJ j da j L# // alc�l -3 �* a 9-11 Us IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION State Farm Mutual Automobile Insurance Company Plaintiff VS. Civil Action No TONYA ZUBER 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 # 20070910 } STATE FARM MUTUAL AUTOMOBILE } INSURANCE COMPANY } Court of Common Pleas } Cumberland County } } vs. } } TONYA R. ZUBER } 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 61702. 2. Defendant, Tonya R. Zuber, is an adult individual who at all time pertinent hereto resided 23 N. East Street, Apartment 3, Carlisle, Pennsylvania 17013. 3. State Farm issued a policy of motor vehicle insurance whereby State Farm agreed to insure the motor vehicle involved in this incident ( "Insured Vehicle "), owned by Plaintiff's insured. 4. On or about October 27, 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 East Pomfret Street and South East Street, Carlisle, Pennsylvania. 5. The negligence and /or carelessness of the Defendant consisted of the following: a. Failing to have her motor vehicle under such control as the situation warranted; b. Operating her 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 $10,378.22. 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 $10,378.22 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A. i Benjamin awrence, Esquire PA I. D. # 209032 325 Chestnut Street Suite 501 Philadelphia, PA 19106 (215) 599 -1500 WWR #20070910 VERIFICATION I, Benjamin W. Lawrence, Esquire, attorney for the Plaintiff(s) do hereby swear and affirm that the averments in the attached Complaint are true and correct to the best of my knowledge, information and /or belief. These averments are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsification to authorities. Benjamin W. Lawrence Date EXHIBIT 1 Date: 114/2013 10:33 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 3 Supplement: 2 (F F) 1/ 412013 10:33:36 AM FINAL Profile ID: State Farm Ins Fine Line Auto Body 1746 West Trindle Rd., Carlisle, PA 17015 (71T) 241 -2225 Email: finelineautobody @comcast.net Damage Assessed By: R Bankey LIC#474537 Appraised For: Team CP Unit C3 ACC PA NJ (888) 713 -4694 Supplemented By: Thomas Rodkey LIC #566089 Type of Loss: Collision (Spec) Date of Loss: 10/27/2012 Accident Date: 10127/2012 Deductible: 500.00 Claim Number: 38 -1R58 -24601 Insured: JOHN HOEFLING Owner: JOHN HOEFLING Address: 1457 COCKLEYS MEADOW DR, BOILING SPRGS, PA 17007 -9687 Telephone: Home Phone: (717) 258-66394 Mitchell Service: 910698 Description: 2010 Toyota Camry Vehicle Production Date: 1109 Body Style: 4D Sed Drive Train: 2.5L Inj 4 Cyl 6A FWD VIN: JTNBF3EK2A3000015 License: JCL 2708 PA Mileage: 48,049 OEM /ALT: A Search Code: B843750 Color: WHITE Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW REAR WINDOW DEFOGGER, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN TELESCOPIC STEERING COLUMN, ANTI -LOCK BRAKE SYS., TRACTION CONTROL, FOG LIGHTS AUXILIARY INPUT, FRONT AIR DAM, TINTED GLASS, VARIABLE ASSISTED STEERING SIDE AIRBAGS, ANTI -THEFT SYSTEM, AUTOMATIC HEADLIGHTS, SIDE HEAD CURTAIN AIRBAGS DAYTIME RUNNING LIGHTS, AM /FM STEREO CD /MP3 PLAYER, ELECTRONIC STABILITY CONTROL FRONT BUCKET SEATS, INTERIOR AIR FILTER, KEYLESS ENTRY SYSTEM, POWER DISC BRAKES REAR WINDOW DIVERSITY ANTENNA, STEERING WHEEL AUDIO CONTROLS Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units S1 1 001758 REF REFINISH L Frt Access Hole Cover C 0.3 2 AUTO BDY OVERHAUL Frt Bumper Assy 2.7 S1 3 004750 BDY REMOVE /REPLACE Frt Bumper Cover Qual Recycled Part INC* INC r 4 AUTO REF REFINISH Frt Bumper Cover C 2.8 S2 5 005014 BDY REMOVE/REPLACE L Frt Bumper Opening Cover 52129 -33902 4.34 INC S1 6 000062 BDY REMOVE/REPLACE Frt Bumper Reinforcement Bar (HSS) Qual Recycled Part INC* 0.3 #r 7 AUTO BDY REMOVE /INSTALL Frt Bumper Assy INC S2 8 004000 REF REFINISH Grille C 1.0 S1 9 004539 BDY REMOVE /REPLACE Grille Qual Recycled Part INC* INC #r S1 10 004873 BDY REMOVE/REPLACE R Front Combination Lamp Assembly Qual Recycled Part INC* INC #r 11 AUTO BDY CHECK /ADJUST Headlamps 0.4 S1 12 004874 BDY REMOVE /REPLACE L Front Combination Lamp Assembly Qual Recycled Part INC* INC #r 13 002012 REF BLEND Hood Outside C 1.2* 14 000195 BDY REPAIR Hood Panel Existing 0.3* 15 RPR HOOD STRIKER S1 16 000337 MCH REMOVE /REPLACE Air Cond Condenser Assy -M Qual Recycled Part INC* 0.9 #r $1 17 AUTO MCH REMOVE /REPLACE Evacuate & Recharge A/C -M 1.4 S1 18 000437 BDY REMOVE /REPLACE R Fender Panel Qual Recycled Part INC* 1.8 #r 19 AUTO REF REFINISH R Fender Outside C 2.1 ESTIMATE RECALL NUMBER: 11/051201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: NOV _12_V MAPP:NOV_12_V Copyright (C) 1994 - 2012 Mitchell International Page 1 of 5 Software Version: 7.0.482 All Rights Reserved Date: 1/ 412013 10:33 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 3 Supplement: 2 (F F) 11 4/2013 10:33:36 AM FINAL Profile ID: State Farm Ins 20 AUTO REF REFINISH R Add To Edge Fender C 0.5 S1 21 000438 BDY REMOVE /REPLACE L Fender Panel Qual Recycled Part INC* 1.8 #r S1 22 AUTO REF REFINISH L Fender Outside C 1.9 S1 23 AUTO REF REFINISH L Add To Edge Fender C 0.5 S1 24 000452 BDY REMOVE/REPLACE L Fender Liner Qual Recycled Part INC* INC r S1 25 800044 BDY REMOVE /REPLACE Replace Front Inner Structure Assy -S Qua[ Recycled Part INC* 24.6 S1 26 AUTO REF REFINISH Front Inner Structure Assy 3.0 S2 27 000551 MCH REMOVEIREPLACE Sub -Frame -M Qual Recycled Part 250.00 * INC *# 28 STOYSTOWN 800 - 358 -8770 OT286190 S1 29 Line Markup 0 /625.00 62.50 S1 30 000589 MCH REMOVE/INSTALL L Junction Block -M Existing 0.2* S1 31 000168 MCH REMOVE /INSTALL Wiring Harness -M Existing 1.0* S2 32 004556 MCH REMOVE/INSTALL Engine & Trans Assy -M INC* S1 33 931104 MCH ADD'L LABOR OP Front End Alignment Sublet 49.95 * 0.0* S1 34 004430 BDY REMOVE /REPLACE L Engine Under Cover 51442 -06100 98.06 0.3 # S1 35 004749 BDY REMOVE /INSTALL Air Cleaner Assy 0.5 36 004438 BDY REMOVE /REPLACE Air Cleaner Inlet 17750 -36010 118.38 0.3 S1 37 001198 BDY REMOVE /INSTALL Battery Existing 0.2 r S1 38 001319 BDY REMOVE /INSTALL W /Shield Washer Reservoir Existing 0.5 #r S1 39 002306 REF BLEND R Hinge Pillar C 0.4 40 005025 REF BLEND R Roof Rail C 0.5 S1 41 002547 BDY REMOVEIINSTALL R Rocker Moulding INC S1 42 002548 BDY REMOVE /INSTALL L Rocker Moulding INC S2 43 001695 BDY REMOVE /REPLACE L Cowl /Dash Trim Panel 62102- 33180 -81 33.49 * 0.0* 44 DAMAGED WHEN REMOVED DURING REPAIRS 45 002186 BDY REPAIR R Frt Door Repair Panel Existing 0.3* # 46 RPR FRT EDGE 47 REF REFINISH /REPAIR R Frt Door Repair Panel C 2.0* 48 MODIFIED REFINISH WITH FULL CLEAR COAT 49 002578 BDY REMOVE /INSTALL R Frt Otr Belt Moulding 0.9 # 50 002580 BDY REMOVE /INSTALL R Frt Rear View Mirror INC # 51 005087 BDY REMOVE /INSTALL R Frt Otr Door Handle 03 52 936001 ADD'L COST Towing 270.00 * 53 LEBO'S GARAGE 717 - 241 -8260 54 936014 ADD'L COST Flex Additive 6.00 * 55 933006 FRM ADD'L OPR Frame /Rack Set Up 2.0* 56 933035 FRM ADD'L OPR Unibody Pull 1.0* 57 AUTO REF ADD'L OPR Clear Coat 3.2 S1 58 933019 BDY ADD'L OPR Taped Stripe 12.00 * 0.2* 59 .1 PER PANEL/ AVERAGE $6.00 STRIPE PER PANEL 60 AUTO ADD'L COST PaintlMaterials 504.40 * 61 AUTO ADD'L COST Hazardous Waste Disposal 3.00 * S1 62 900500 BDY * ADD'L LABOR OP MASK FOR OVERSRAY Sublet 2.50 * 0.3* S1 63 900500 BDY * REMOVE /REPLACE FRONT CLIP Qual Recycled Part 3,000.00 * 0.0* 64 STOYSTOWN 800 - 358 -8770 QT286190 S1 65 Line Markup 9 /625.00 750.00 S2 66 900500 BDY * REMOVE /REPLACE SUB -FRAME REPLACEMENT / ENGINEITRANS R &I Sublet 834.00 * 0.0* 67 SUBLET TO CARLISLE AUTOCARE CENTER 243 -4573 68 INCL FLUID, BRAKE BLEED, SUSP TRANSFER, EXHAUST RI S2 69 900500 BDY * REMOVE /REPLACE TOW TO CARLISLE AUTOCARE CENTER FOR ENGIN Sublet 55.00 * 0,0* S2 70 900500 BDY * REMOVE /REPLACE TOW FROM CARLISLE AUTOCARE CENTER TO SHO Sublet 55.00 * 0.0* S2 71 900500 BDY * REMOVE /REPLACE TOW FROM SHOP TO CARLISLE AUTOCARE FOR EN Sublet 55.00 * 0.0* 82 72 900500 BDY * REPAIR TRIM LKQ INNER STRUCTURE FOR FIT Existing 2.0* ESTIMATE RECALL NUMBER: 11/051201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: NOV 12 V MAPP:NOV_12_V Copyright (C) 1994 - 2012 Mitchell International Page 2 of 5 Software Version: 7.0.482 All Rights Reserved Date: 1/ 4/2013 10:33 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 3 Supplement: 2 (F F) 11 41201310:33:36 AM FINAL Profile ID: State Farm Ins * - Judgment Item # - Labor Note Applies C - Included in Clear Coat Calc r - CEG R &R Time Used For This Labor Operation Remarks NO RECYCLED AVAILABLE UltraMate Abbreviations: Labor Type: BDY =Body BDS =Body Structure REF= Refinish GLS =Glass FRM =Frame MCH= Mechanical Operation: Add'1 Cost = Additional Cost Add'1 Opr= Additional Operation Line Item Description: Frt =Front RR =Rear L =Left R =Right Upr =Upper Lwr =Lower Otr =Outer Inr =Inner Assy = Assembly Susp= Suspension Ext= Extension Brkt= Bracket Inst = Instrument ATG= Assembly Time Guide PartType /PartNumber: Qual Repl Part = Quality Replacement Part Qual Recycled Part = Qualty Recycled Part Estimate Totals Add'I Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals 11. Part Replacement Summary Amount �..._.- ._..._._ _. .... - __._...._ ------ . Body 37.7 46.00 12.00 2.50 1,748.70 T Taxable Parts 4,338.27 Refinish 19.4 46.00 0.00 0.00 892.40 T Parts Adjustments 812.50 Frame 3.0 46.00 0.00 0.00 138.00 T Sales Tax @ 6.000% 309.05 Mechanical 3.5 46.00 0.00 49.95 210.95 T Non - Taxable Parts 165.00 Taxable Labor 2,990.05 Labor Tax @ 6.000% 179.40 Total Replacement Parts Amount 5,624,82 Labor Summary 63.6 3,169.45 Ill. Additional Costs Amount IV. Adjustments Amount Taxable Costs 513.40 Insurance Deductible 500.00 - Sales Tax @ 6.000% 30,80 Customer Responsibility 500.00 - Non- Taxable Costs 270.00 Totai Additional Costs 814.20 Paint Material Method: Rates Init Rate = 26.00 , Init Max Hours = 99.9, Addl Rate = 0.00 ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: NOV MAPP:NOV_12_V Copyright (C) 1994 - 2012 Mitchell International Page 3 of 5 Software Version: 7.0.482 All Rights Reserved Date: 1/ 4/2013 10:33 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 3 Supplement: 2 (F F) 11412013 10:33:36 AM FINAL Profile ID: State Farm Ins I. Total Labor: 3,169.45 11. Total Replacement Parts: 5,624.82 Ill. Total Additional Costs: 814.20 Gross Total: 9,608.47 IV. Total Adjustments: 500.00 - Net Total: 9,108.47 Less Original Net Total: 3,683.36 Net Supplement Amount: 5,425.11 S1: Jake Raudabaugh 4,648.04 S2: Thomas Rodkey LIC #566089 777.07 Point(s) of Impact 12 Front Center (P) Insurance Co: State Farm Inspection Site: FINE LINE AUTO BODY Address: 1746 W TRINDLE RD CARLISLE, PA 17015 -9757 (717) 241.2225 Body Shop: FINE LINE AUTO BODY LLC Address: 1746 W TRINDLE RD CARLISLE, PA 17015 -9757 ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1858 -24601 Mitchell Data Version: OEM: NOV 12 V MAPP:NOV_12_V Copyright (C) 1994 - 2012 Mitchell International Page 4 of 5 Software Version: 7.0.482 All Rights Reserved Date: 11412013 10:33 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 3 Supplement: 2 (F F) 1/ 412013 10:33:36 AM FINAL Profile ID: State Farm Ins You may have your vehicle repaired at the repair shop of your choice. Costs above the appraised amount may be the responsibility of the vehi cle owner. There is no requirement to use any specified repair shop. Information regarding re pair facilities, which will be able to repair the vehicle for the appraised amount, is available from the insurer. However, there is no requirement to use any specified repair shop. This appraisal may have been prepared based on the use of aftermarket crash parts. If the use of an aftermarket crash part v oids the existing warranty on the part being replaced or any other part, the aftermarket crash part shal 1 have a warranty equal to or better than the remainder of the existing warranty. An Aftermarket crash part is a nonoriginal equipment manufacturer (non -OEM) replacement part, either new or used, for any o f the nonmechanical parts that generally constitute the exterior of the motor vehicle, including inne r and outer panels. Aftermarket crash parts are identified in this estimate as " * *Qual Repl Part" Appraiser Signature: Date: ANY PERSON WHO KNOWLINGLY 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 FAC T MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON T O CRIMINAL AND CIVIL PENALTIES. THANK YOU Cycle Time Information_ Drop Off Date and Time: 10/29/2012 Time: 08:00 Repair Dates: Promise Date: 12/21/2012 Start Date: 11119/2012 Vehicle Pick Up Date and Time: 12119/2012 Time: 16:00 Completion Date: 12/19/2012 Is Vehicle Driveable (YIN) ?: N ESTIMATE RECALL NUMBER: 11/05/2012 09:28:59 38 -1 R58 -24601 Mitchell Data Version: OEM: NOV 12_V MAPP:NOV_12_V Copyright (C) 1994 - 2012 Mitchell International Page 5 of 5 Software Version: 7.0.482 All Rights Reserved Date: 12/ 312012 12:03 PM Estimate ID: 38 -1R58 -24601 Estimate Version: 2 Supplement: 1 (F F) 11130/2012 05:18:38 PM Profile ID: State Farm Ins Fine Line Auto Body 1746 West Trindle Rd., Carlisle, PA 17015 (717) 241 -2225 Email: finelineautobody @comcast.net Tax ID: 043706373 Damage Assessed By: R Bankey LIC#474537 Appraised For: Team CP Unit C3 ACC PA NJ (888) 713 -4694 Supplemented By: Jake Raudabaugh Type of Loss: Collision (Spec) Date of Loss: 10/27/2012 Accident Date: 10/27/2012 Deductible: 500.00 Claim Number: 38 -1R58 -24601 Insured: JOHN HOEFLING Owner: JOHN HOEFLING Address: 1457 COCKLEYS MEADOW DR, BOILING SPRGS, PA 17007 -9687 Telephone: Home Phone: (717) 258-6394 Mitchell Service: 910698 Description: 2010 Toyota Camry Vehicle Production Date: 1109 Body Style: 4D Sed Drive Train: 2,5L Inj 4 Cyl 6A FWD VIN: JTNBF3EK2A3000015 License: JCL 2708 PA Mileage: 48,049 OEM /ALT: A Search Code: B843750 Color: WHITE Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW REAR WINDOW DEFOGGER, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN TELESCOPIC STEERING COLUMN, ANTI -LOCK BRAKE SYS., TRACTION CONTROL, FOG LIGHTS AUXILIARY INPUT, FRONT AIR DAM, TINTED GLASS, VARIABLE ASSISTED STEERING SIDE AIRBAGS, ANTI -THEFT SYSTEM, AUTOMATIC HEADLIGHTS, SIDE HEAD CURTAIN AIRBAGS DAYTIME RUNNING LIGHTS, AMJFM STEREO CDIMP3 PLAYER, ELECTRONIC STABILITY CONTROL FRONT BUCKET SEATS, INTERIOR AIR FILTER, KEYLESS ENTRY SYSTEM, POWER DISC BRAKES REAR WINDOW DIVERSITY ANTENNA, STEERING WHEEL AUDIO CONTROLS Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units Information Labels S1 1 000018 BDY REMOVE /REPLACE Inform Label Caution Plate 16793 -46010 1.18 Front Bumper S1 2 001758 REF REFINISH L Frt Access Hole Cover C 03 3 BDY OVERHAUL Frt Bumper Assy 2.7 Si 4 004750 BDY REMOVEIREPLACE Frt Bumper Cover Qual Recycled Part INC* INC r 5 REF REFINISH Frt Bumper Cover C 2.8 S1 6 000062 BDY REMOVE/REPLACE Frt Bumper Reinforcement Bar (HSS) Qual Recycled Part INC* 0.3 #r 7 BDY REMOVE /INSTALL Frt Bumper Assy INC Grille S1 8 004539 BDY REMOVEIREPLACE Grille Qual Recycled Part INC* INC #r Front Lamps S1 9 004873 BDY REMOVE /REPLACE R Front Combination Lamp Assembly Qual Recycled Part INC* INC #r 10 BDY CHECK/ADJUST Headlamps 0.4 S1 11 004874 BDY REMOVEIREPLACE L Front Combination Lamp Assembly Qual Recycled Part INC* INC #r Hood 12 002012 REF BLEND Hood Outside C 1.2* 13 000195 BDY REPAIR Hood Panel Existing 0.3* 14 RPR HOOD STRIKER ESTIMATE RECALL NUMBER: 11/05/2012 09:28:59 38 -1 R58 -24601 Mitchell Data Version: OEM: SEP_12_V MAPP:SEP_12_V Copyright (C) 1994 - 2012 Mitchell International Page 1 of 5 Software Version: 7.0.481 All Rights Reserved Date: 1213/2012 12:03 PM Estimate ID: 38 -1R58 -24601 Estimate Version: 2 Supplement: 1 (F F) 11130/2012 05:18:38 PM Profile ID: State Farm Ins A/C /Heater/Ventilation S1 15 000337 MCH REMOVE /REPLACE Air Cond Condenser Assy -M Qual Recycled Part INC* 0.9 #r $1 16 MCH REMOVEIREPLACE Evacuate & Recharge A/C -M 1.4 Front Fender S1 17 000437 BDY REMOVE /REPLACE R Fender Panel Qual Recycled Part INC* 1.8 #r 18 REF REFINISH R Fender Outside C 2.1 19 REF REFINISH R Add To Edge Fender C 0.5 S1 20 000438 BDY REMOVEIREPLACE L Fender Panel Qual Recycled Part INC* 1.8 #r S1 21 REF REFINISH L Fender Outside C 1.9 S1 22 REF REFINISH L Add To Edge Fender C 0.5 S1 23 000445 BDY REMOVE/REPLACE R Fender Protector 53825 -06020 42.61 S1 24 000446 BDY REMOVE/REPLACE L Fender Protector 53826 -06020 42.61 S1 25 000452 BDY REMOVE/REPLACE L Fender Liner Qua[ Recycled Part INC* INC r Front Inner Structure S1 26 800044 BDY REMOVE /REPLACE Replace Front Inner Structure Assy -S Qual Recycled Part INC* 24.6 S1 27 REF REFINISH Front Inner Structure Assy 3.0 S1 28 000551 MCH REMOVE /REPLACE Sub -Frame -M Qual Recycled Part 250.00 * 8.7 #r 29 STOYSTOWN 800 -358 -8770 OT286190 S1 30 Line Markup 0 /625.00 62.50 S1 31 000589 MCH REMOVE /INSTALL L Junction Block -M Existing 0.2* S1 32 000168 MCH REMOVE /INSTALL Wiring Harness M Existing 1.0* Engine/Trans S1 33 004556 MCH REMOVE/INSTALL Engine & Trans Assy •M INC Body Components S1 34 931104 MCH ADD'L LABOR OP Front End Alignment Sublet 49.95 * 0.0* Engine Under Cover S1 35 004430 BDY REMOVEIREPLACE L Engine Under Cover 51442 -06100 98.06 INC # Air Cleaner S1 36 004749 BDY REMOVE/INSTALL Air Cleaner Assy 0.5 37 004438 BDY REMOVEIREPLACE Air Cleaner Inlet 17750 -36010 118.38 0.3 Electrical S1 38 001198 BDY REMOVEIINSTALL Battery Existing 0.2 r Windshield S1 39 001319 BDY REMOVE /INSTALL W /Shield Washer Reservoir Existing 0.5 #r Rocker /Pillars /Floor S1 40 002306 REF BLEND R Hinge Pillar C 0.4 41 005025 REF BLEND R Roof Rail C 0.5 S1 42 002547 BDY REMOVE/INSTALL R Rocker Moulding INC S1 43 002548 BDY REMOVE /INSTALL L Rocker Moulding INC Front Door 44 002186 BDY REPAIR R Frt Door Repair Panel Existing 0.3* # 45 RPR FRT EDGE 46 REF REFINISH /REPAIR R Frt Door Repair Panel C 2.0* 47 MODIFIED REFINISH WITH FULL CLEAR COAT 48 002578 BDY REMOVEIINSTALL R Frt Otr Belt Moulding 0.9 # 49 002580 BDY REMOVE /INSTALL R Frt Rear View Mirror INC # 50 005087 BDY REMOVE /INSTALL R Frt Otr Door Handle 0.3 Additional Costs & Materials 51 936001 AOD'L COST Towing 270.00 52 LEBO'S GARAGE 717 - 241 -8260 53 936014 ADD'L COST Flex Additive 6.00 Additional Operations 54 933006 FRM ADD'L OPR Frame /Rack Set Up 2.0* 55 933035 FRM ADD'L OPR Unibody Pull 1.0* 56 REF ADD'L OPR Clear Coat 3.0 S1 57 933019 BDY ADD'L OPR Taped Stripe 12.00 * 0.2* 58 .1 PER PANELI AVERAGE $6.00 STRIPE PER PANEL Additional Costs & Materials 59 ADD'L COST Paint/Materials 473.20 * 60 ADD'L COST Hazardous Waste Disposal 3.00 * MANUAL ENTRIES S1 61 900500 BDY * ADD'L LABOR OP MASK FOR OVERSRAY Sublet 2.50 * 0.3* ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -lR58 -24601 Mitchell Data Version: OEM: SEP_12 V MAPP:SEP_12_V Copyright (C) 1994 - 2012 Mitchell International Page 2 of 5 Software Version: 7.0.481 All Rights Reserved Date: 12/ 312012 12:03 PM Estimate ID: 38 -1R58 -24601 Estimate Version: 2 Supplement: 1 (F F) 11130/2012 05:18:38 PM Profile ID: State Farm Ins S1 62 900500 BDY • REMOVE/REPLACE FRONT CLIP Qua[ Recycled Part 3,000.00 ' 0.0` 63 STOYSTOWN 800- 358 -8770 QT286190 S1 64 Line Markup 1 /625.00 750.00 * - Judgment Item # - Labor Note Applies C - Included in Clear Coat Calc r - CEG R &R Time Used For This Labor Operation Remarks NO RECYCLED AVAILABLE UltraMate Abbreviations: Labor Type: BDY =Body BDS =Body Structure REF= Refinish GLS =Glass FRM =Frame MCH= Mechanical Operation: Add'1 Cost = Additional Cost Add'1 Opr= Additional Operation Line Item Description: Frt =Front RR =Rear L =Left R =Right Upr =Upper Lwr =Lower Otr =Outer Inr =Inner Assy = Assembly Susp= Suspension Ext= Extension Brkt = Bracket Inst= Instrument ATG= Assembly Time Guide PartType /PartNumber: Qual Repl Part = Quality Replacement Part Qual Recycled Part = Qualty Recycled Part Estimate Totals Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 35.4 46.00 12.00 2.50 1,642.90 T Taxable Parts 3,552.84 Refinish 18.2 46.00 0.00 0.00 837.20 T Parts Adjustments 812.50 Frame 3.0 46.00 0.00 0.00 138.00 T Sales Tax @ 6.000% 261.92 Mechanical 12.2 46.00 0.00 49.95 611.15 T Total Replacement Parts Amount 4,627.26 Taxable Labor 3,229.25 Labor Tax @ 6.000 % 193.76 Labor Summary 68.8 3,423.01 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 48220 Insurance Deductible 500.00 - Sates Tax @ 6.000% 28.93 Customer Responsibility 500.00 - Non- Taxable Costs 270.00 Total Additional Costs 781.13 Paint Material Method: Rates Init Rate = 26.00 , Init Max Hours = 99.9, Addl Rate = 0.00 ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: SEP_12V MAPP:SEP_12__V Copyright (C) 1994 - 2012 Mitchell International Page 3 of 5 Software Version: 7.0.481 All Rights Reserved Date: 1213/2012 12:03 PM Estimate ID: 38 -1R58 -24601 Estimate Version: 2 Supplement: 1 (F F) 11/30/2012 05:18:38 PM Profile ID: State Farm Ins I. Total Labor: 3,423.01 II. Total Replacement Parts: 4,627.26 III. Total Additional Costs: 781.13 Gross Total: 8,831.40 IV. Total Adjustments: 500.00 - Net Total: 8,331.40 Less Original Net Total: 3,683.36 Net Supplement Amount: 4,648.04 S1: Jake Raudabaugh 4,648.04 Point(s) of Impact 12 Front Center (P) Insurance Co: State Farm Inspection Site: FINE LINE AUTO BODY Address: 1746 W TRINDLE RD CARLISLE, PA 17015 -9757 (717) 241 -2225 Body Shop: FINE LINE AUTO BODY LLC Address: 1746 W TRINDLE RD CARLISLE, PA 17015 -9757 ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: SEP_12_V MAPP:SEP_12_V Copyright (C) 1994 - 2012 Mitchell International Page 4 of 5 Software Version: 7.0.481 All Rights Reserved Date: 12/ 3/2012 12:03 PM Estimate ID: 38 -1R58 -24601 Estimate Version: 2 Supplement: 1 (F F) 1113012012 05:18:38 PM Profile ID: State Farm Ins You may have your vehicle repaired at the repair shop of your choice. Costs above the appraised amount may be the responsibility of the vehi cle owner. There is no requirement to use any specified repair shop. Information regarding re pair facilities, which will be able to repair the vehicle for the appraised amount, is available from the insurer. However, there is no requirement to use any specified repair shop. This appraisal may have been prepared based on the use of aftermarket crash parts. If the use of an aftermarket crash part v aids the existing warranty on the part being replaced or any other part, the aftermarket crash part shal 1 have a warranty equal to or better than the remainder of the existing warranty. An Aftermarket crash part is a nonoriginal equipment manufacturer (non -OEM) replacement part, either new or used, for any o f the nonmechanical parts that generally constitute the exterior of the motor vehicle, including inne r and outer panels. Aftermarket crash parts are identified in this estimate as " * *Qual Repl Part" Appraiser Signature: Date: ANY PERSON WHO RNOWLINGLY 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 FAC T MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON T O CRIMINAL AND CIVIL PENALTIES. THANK YOU Cycle Time Information Drop Off Date and Time: 10/29/2012 Repair Dates: Promise Date: 12/21/2012 Start Date: 11/19/2012 Is Vehicle Driveable (YIN)?: N ESTIMATE RECALL NUMBER: 11/05/201209:28 38 -1858 -24601 Mitchell Data Version: OEM: SEP_12_V MAPP:SEP_12_V Copyright (C) 1994 - 2012 Mitchell International Page 5 of 5 Software Version: 7.0.481 All Rights Reserved Date: 11/5/2012 09:28 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 0 Committed Profile ID: State Farm Ins Fine Line Auto Body 1746 West Trindle Rd., Carlisle, PA 17015 (717) 241 -2225 Email: finelineautobody @comcast.net Tax ID: 043706373 Damage Assessed By: R Bankey LIC#474537 Appraised For: Team CP Unit C3 ACC PA NJ (888) 713 -4694 Type of Loss: Collision (Spec) Date of Loss: 10127/2012 Accident Date: 10127/2012 Deductible: 500,00 Claim Number: 38 -1R58 -24601 Insured: JOHN HOEFLING Owner: JOHN HOEFLING Address: 1457 COCKLEYS MEADOW DR, BOILING SPRGS, PA 17007 -9687 Telephone: Home Phone: (717) 258.6394 Mitchell Service: 910698 Description: 2010 Toyota Camry Vehicle Production Date: 1109 Body Style: 4D Sod Drive Train: 2.5L Inj 4 Cyl 6A FWD VIN: JTNBF3EK2A3000015 License: JCL 2708 PA Mileage: 48,049 OEM /ALT: A Search Code: 8843750 Color: WHITE Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW REAR WINDOW DEFOGGER, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN TELESCOPIC STEERING COLUMN, ANTI -LOCK BRAKE SYS., TRACTION CONTROL, FOG LIGHTS AUXILIARY INPUT, FRONT AIR DAM, TINTED GLASS, VARIABLE ASSISTED STEERING SIDE AIRBAGS, ANTI -THEFT SYSTEM, AUTOMATIC HEADLIGHTS, SIDE HEAD CURTAIN AIRBAGS DAYTIME RUNNING LIGHTS, AM /FM STEREO CD /MP3 PLAYER, ELECTRONIC STABILITY CONTROL FRONT BUCKET SEATS, INTERIOR AIR FILTER, KEYLESS ENTRY SYSTEM, POWER DISC BRAKES REAR WINDOW DIVERSITY ANTENNA, STEERING WHEEL AUDIO CONTROLS Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units Front Bumper 1 BDY OVERHAUL Frt Bumper Assy 2.7 2 004750 BDY REMOVE /REPLACE Frt Bumper Cover Remanufactured 245,00 INC 3 REF REFINISH Frt Bumper Cover C 2.8 4 000062 BDY REMOVE/REPLACE Frt Bumper Reinforcement Bar (HSS) 52021 -33140 170,75 0.3 # 5 BDY REMOVE /INSTALL Frt Bumper Assy INC Grille 6 004539 BDY REMOVE /REPLACE Grille 53101- 06070 -AO 215.78 INC # Front Lamps 7 004873 BDY REMOVE /REPLACE R Front Combination Lamp Assembly 81110 -06500 354.43 INC # 8 BDY CHECK/ADJUST Headlamps 0.4 9 004874 BDY REMOVE /REPLACE L Front Combination Lamp Assembly 81150 -06500 354.43 0.3 # Hood 10 002012 REF BLEND Hood Outside C 112' 11 000195 BDY REPAIR Hood Panel Existing 0.3• 12 RPR HOOD STRIKER Front Fender 13 000437 BDY REMOVE/REPLACE R Fender Panel 53801 -06110 229.26 1.8 # 14 REF REFINISH R Fender Outside C 2.1 15 REF REFINISH R Add To Edge Fender C 0.5 ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1858 -24601 Mitchell Data Version: OEM: SEP_12_V MAPP:SEP_12_V Copyright (C) 1994 - 2012 Mitchell International Page 1 of 4 Software Version: 7.0.481 All Rights Reserved Date: 1115/2012 09:29 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 0 Committed Profile ID: State Farm Ins 16 000452 BDY REMOVE/REPLACE L Fender Liner 53876 -06060 85.22 0.4 Front Inner StructUre 17 004017 BOY REMOVEAREPLACE Front Body Upper Tie Bar 53216 -06080 97.95 0.5 18 REF REFINISH Upper Tie Bar 0.5 19 004029 BOY REMOVE /REPLACE L Upr Front Body Support 53214 -33030 30.40 0.5 20 REF REFINISH L Upr Radiator Support 0.3 21 003580 BOY REMOVE/INSTALL R Front Body Radiator Side Support S Existing 1.5 r 22 003581 BOY REMOVE/REPLACE L Front Body Radiator Side Support -S 51466 -33050 40.91 1.5 23 REF REFINISH L Radiator Side Panel 0.3 24 000540 BOY REMOVE/REPLACE L Front Body Sidemember EXT -S 57108 -33032 57.64 1.5 Air Cleaner 25 004438 BOY REMOVEIREPLACE Air Cleaner Inlet 17750 -36010 118.38 0.3 Rocker/Fill rs/Floor 26 005025 REF BLEND R Roof Rail C 0.5 Front Door 27 002186 BOY REPAIR R Frt Door Repair Panel Existing 0.3 *# 28 RPR FRT EDGE 29 REF REFINISH /REPAIR R Frt Door Repair Panel C 2.0* 30 MODIFIED REFINISH WITH FULL CLEAR COAT 31 002578 BOY REMOVEIINSTALL R Frt Otr Belt Moulding 0.9 # 32 002580 BOY REMOVE /INSTALL R Frt Rear View Mirror INC # 33 005087 BOY REMOVEANSTALL R Frt Ott Door Handle 0.3 Additional Costs & Materials 34 936001 ADD'L COST Towing 270.00 * 35 LEBO'S GARAGE 717 - 241 -8260 36 936014 ADD'L COST Flex Additive 6.00 * Additional Operations 37 933006 FRM ADD'L OPR Frame /Rack Set Up 2,0* 38 933035 FRM ADD'L OPR Unibody Pull 1.0* 39 REF AOD'L OPR Clear Coat 2.4 Additional Costs & Materials 40 ADD'L COST Paint/Materials 327.60 * 41 ADD'L COST Hazardous Waste Disposal 3.00 * MANUAL ENTRIES 42 900500 BOY * ADD'L LABOR OP MASK FOR OVERSRAY Sublet 2.50 * 0.3* * - Judgment Item # - Labor Note Applies ** QUAL REPL PART - Quality Replacement Parts C - Included in Clear Coat Calc r - CEG R &R Time Used For This Labor Operation KEYSTONE AUTOMOTIVE JOHNSTOWN BUMPER MART 320 DOBSON ST. WINDBER PA 15963 (800) 438 -2510 (814) 467 -5531 2 - T01000356R 245.00 Remarks NO RECYCLED AVAILABLE ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1858 -24601 Mitchell Data Version: OEM: SEP_12V MAPP:SEP_12__V Copyright (C) 1994 - 2012 Mitchell International Page 2 of 4 Software Version: 7.0.481 All Rights Reserved Date: 111 51201 2 09:29 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 0 Committed Profile ID: State Farm Ins UltraMate Abbreviations: Labor Type: BDY =Body BDS =Body Structure REF= Refinish GLS =Glass FRM =Frame MCH= Mechanical Operation: Add'1 Cost = Additional Cost Add'1 Opr= Additional Operation Line Item Description: Frt =Front RR =Rear L =Left R =Right Upr =Upper Lwr =Lower Otr =Outer Inr =Inner Assy = Assembly Susp= Suspension Ext= Extension Brkt= Bracket Inst = Instrument ATG= Assembly Time Guide PartType /PartNumber: Qual Repl Part = Quality Replacement Part Qual Recycled Part = Qualty Recycled Part Estimate Totals Add'I Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals 11. Part Replacement Summary Amount Body 13.8 46.00 0.00 2.50 637.30 T Taxable Parts 2,000.35 Refinish 12.6 46.00 0.00 0.00 579.60 T Sales Tax @ 6.000% 120.02 Frame 3.0 46.00 0.00 0.00 138.00 T Taxable Labor 1.354.90 Total Replacement Parts Amount 2,120.37 Labor Tax @ 6.000% 81.29 Labor Summary 29.4 1,436.19 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 336.60 Insurance Deductible 500.00- Sales Tax @ 6.000% 20.20 Non- Taxable Costs 270.00 Customer Responsibility 500.00 - Total Additional Costs 626.80 Paint Material Method: Rates Init Rate = 26.00 , Init Max Hours = 99.9, Addl Rate = 0.00 I. Total Labor: 1,436.19 II. Total Replacement Parts: 2,120.37 III. Total Additional Costs: 626.80 Gross Total: 4,183.36 IV. Total Adjustments: 500.00 - Net Total: 3,683.36 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 12 Front Center (P) ESTIMATE RECALL NUMBER: 11/051201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: SEP_12_V MAPP:SEP 12_V Copyright (C) 1994 - 2012 Mitchell International Page 3 of 4 Software Version: 7.0.481 All Rights Reserved Date: 11/5/2012 09:29 AM Estimate ID: 38 -1R58 -24601 Estimate Version: 0 Committed Profile ID: State Farm Ins Insurance Cc: State Farm Inspection Site: FINE LINE AUTO BODY Address: 1746 W TRINDLE RD CARLISLE, PA 17015 -9757 (717) 241 -2225 Body Shop: FINE LINE AUTO BODY LLC Address: 1746 W TRINDLE RD CARLISLE, PA 17015 -9757 You may have your Vehicle repaired at the repair shop of your choice. Costs above the appraised amount may be the responsibility of the vehi cle owner. There is no requirement to use any specified repair shop. Information regarding re pair facilities, which will be able to repair the vehicle for the appraised amount, is available from the insurer. However, there is no requirement to use any specified repair shop. This appraisal may have been prepared based on the use of aftermarket crash parts. If the use of an aftermarket crash part v oids the existing warranty on the part being replaced or any other part, the aftermarket crash part shal I have a warranty equal to or better than the remainder of the existing warranty. An Aftermarket crash part is a nonoriginal equipment manufacturer (non -OEM) replacement part, either new or used, for any o f the nonmechanical parts that generally constitute the exterior of the motor vehicle, including inne r and outer panels. Aftermarket crash parts are identified in this estimate as * *Qual Repl Part" Appraiser Signature: Date: ANY PERSON WHO RNOWLINGLY 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 FAC T MATERIAL THERETO COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON T O CRIMINAL AND CIVIL PENALTIES. - THANX YOU Cycle Time Information Drop Off Date and Time: 10/2912012 Repair Dates: Promise Date: 11/28/2012 Start Date: 11/19/2012 Is Vehicle Driveable (Y /N) ?: N ESTIMATE RECALL NUMBER: 11/05/201209:28:59 38 -1R58 -24601 Mitchell Data Version: OEM: SEP_12_V MAPP:SEP_12_V Copyright (C) 1994 - 2012 Mitchell International Page 4 of 4 Software Version: 7.0.481 All Rights Reserved STATE FARM RBZOOOHK State Farm Mutual Automobile Insurance Company Auto Claim File Print - Full �asu�ANte Route To: Valerie Kaiser BASIC CLAIM INFORMATION Claim Number: 38 -1 R58 -246 Date of Loss: 10 -27 -2012 Policy Number: 2029- 960 -38 Named Insured: HOEFLING, JOHN REPORTING INFORMATION Recorded By Name: Novella Campbell (U658) Phone: (904) 443 -5620 User Type: CRC Reporting Agent Name: A ent Code: Phone: Reporting Method System- ELR Workflow: Regular FACTS OF LOSS Date of Loss: 10 -27 -2012 Time of Loss: 05:15 PM Date Reported: 10 -28 -2012 DateMme Recorded: 10 -28 -2012 - 01:36 PM CDT Facts of Loss: Final - V1 was going down the street and V2 ran the stop sign and hit V1. Claim Group Claim Group: Negotiation Pending Location of Loss Location Description Intersection of Pomfret and East St Street(s): Intersection of Pomfret and East St City: Carlisle County: State /Prov: Pennsylvania I L Zip /Postal: Country: United States CLAIM DETAILS Product Line: Auto Fatality Exists: No Liability: Yes Policy Type: Private Passenger Record Only: No AMR/ISO: Yes Claim File Type: Regular SIU: No Theft Recovery: No Confidential: Standard Split Claim: No Hit and Run: No Status Information Claim Status: Open 10-30 -2012 Maintain Date: Subrogation Status: Open 10 -30 -2012 Suit/ADR Status: Last Sent to ISO: 01 -15 -2013 Contacted: No Misc Stat: Date: 02 -15 -2013 page 1 This report includes only ECS Claims. FOR INTERNAL STATE FARM USE ONLY Contains CONFIDENTIAL information which may not be disclosed without express written authorization. SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith k �t.� : � T �u��,. s`� Chief Deputy ; 25 PM 4: 03 Richard W Stewart Solicitor CUMBERLAND OWN- PENNSYLVANIA State Farm Mutual Auto Insurance Case Number vs. Tonya Zuber 2013-6200 SHERIFF'S RETURN OF SERVICE 11/21/2013 Ronny R Anderson, Sheriff, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Tonya Zuber, but was unable to locate the Defendant in his bailiwick. The Sheriff therefore returns the within requested Complaint& Notice as"Not Found"at 32 E. North Street,Apt. 3, Carlisle Borough, Carlisle, PA 17013. Defendant's were unable to make contact with anyone at the address provided to effectuate service and per the Carlisle Postmaster the defendant is not known at the address given. SHERIFF COST: $39.78 SO ANSWERS, November 21, 2013 RON Y R ANDERSON, SHERIFF tci Uau^tpSu:e Sheriff Te'eosof+..'.,.. 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 # 20070910 Attorney for Plaintiff(s) r rn may.. c r ©_-, Z 1 _ STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY CUMBERLAND County Court of Common Pleas vs. TONYA ZUBER NO. 13 6200 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 2#� 3o7aqc, Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor SHERIFF'S OFFICE OF CUMBERLAND COUNTY OFFICE OF THE SHERIFF . THE F f 3THOFil t1zti JUL -9 AM 9: (-t CUMBERLAND COUNTY PENNSYLVANIA State Farm Mutual Auto Insurance vs. Tonya Zuber Case Number 2013-6200 SHERIFF'S RETURN OF SERVICE 06/30/2014 Ronny R Anderson, Sheriff, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Tonya Zuber, but was unable to locate the Defendant in his bailiwick. The Sheriff therefore returns the within requested Complaint & Notice as "Not Found" at 32 North East Street, Carlisle Borough, Carlisle, PA 17013. Per neighbor no one is residing at this address and per the Carlisle Postmaster the defendant is not known at the address provided. SHERIFF COST: $39.78 SO ANSWERS, June 30, 2014 RONNY R ANDERSON, SHERIFF (c) CountySuite Sheriff, Teleasoft, Inc. 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 # 20070910 STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY vs. TONYA ZUBER TO THE PROTHONOTARY: Attorney for Plaintiff(s) Cumberland County Court of Common Pleas NO. 13 6200 CIVIL PRAECIPE TO REINSTATE 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 orkil-k/i4aci CL -41 /rPag4;�„ Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor SHERIFF'S OFFICE OF CUMBERLAND COUNTY 01. Cifiiib OFF.ICf OF rk Stt.RIF-F -7 2: 1;1 C'UM ER AND PENNSYL`',-'AMA State Farm Mutual Auto Insurance vs. Tonya Zuber Case Number 2013-6200 SHERIFF'S RETURN OF SERVICE 12/29/2014 Ronny R Anderson, Sheriff, being duly sworn according to law, states he made diligent search and inquiry for the within named Defendant to wit: Tonya Zuber, but was unable to locate the Defendant in his bailiwick. The Sheriff therefore returns the within requested Complaint & Notice as "Not Found" at 129 Hanover Street, Apt. C, Carlisle Borough, Carlisle, PA 17013. Four attempts at service were made, a business card was left at the residence and the current tenant called and informed this office that the defendant does not live at this address and he does not know her or her whereabouts. SHERIFF COST: $46.56 SO ANSWERS, December 30, 2014 (c) CountySuito Sheritf, Teieosoft, Inc. RONIN R ANDERSON, SHERIFF