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HomeMy WebLinkAbout14-3367S E C I 0 N A S E T I 0 N B Supreme Courtsof-Pennsylvania Cou sof C©mmo '.leas Civil Cover Sheejt b \ 7F CUMBERLAND +: .,, r/ County 20422589 C Y Jer HOH W' UM # For Prothonotary Use Only: r Docket No: The information collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and service ofpleadings or other papers as required by law or rules of court. Commencement of Action: I Plaintiff 13 Complaint ❑ Writ of Summons 0 Petition ^. Tronef r ern.," Ann+tar 1.1ricrlirtinn Progressive Preferred Insurance Company A Declaration of Taking Lead Defendant's Name: THEORDORE W MERRITTS Are money damages requested? El Yes 0 No Dollar Amount Requested: ® within arbitration limits (check one) ❑ outside arbitration limits Is this a Class Action Suit? 0 Yesand No Is this an MDJ Appeal? 0 Yes El No Name of Plaintiff /Appellant's Attorney: Benjamin W. Lawrence,209032 0 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) ❑ Intentional ❑ Malicious Prosecution ❑ Motor Vehicle ❑ Nuisance o Premises Liability o Product Liability (does not include Mass tort) 2- Slander/Libel/Defamation Other: cV bres5c(,-[-;O �l MASS TORT ❑ Asbestos In Tobacco ❑ Toxic Tort - DES ❑ Toxic Tort — Implant ❑ Toxic Waste o Other: PROFESSIONAL LIABILITY ❑ Dental ❑ Legal ❑ Medical ❑ Other Professional: CONTRACT (do not include Judgments) ❑ Buyer Protection ❑ Debt Collection: Credit Card ❑ Debt Collection: Other o Employment Dispute Discrimination ❑ Employment Dispute: Other O Other: REAL PROPERTY ❑ Ejectment El Eminent Domain/Condemnation ❑ Ground Rent o Landlord/Tenant Dispute o Mortgage Foreclosure: Residential ❑ Mortgage Foreclosure: Commercial ❑ Partition ❑ Quiet Title ❑ Other: CIVIL APPEALS Administrative Agencies ❑ Board of Assessment ❑ Board of Elections ❑ Dept. of Transportation ❑ Statutory Appeal: Other ❑ Zoning Board ❑ Other: MISCELLANEOUS ❑ Common Law/Statutory Arbitration ❑ Declaratory Judgment ❑ Mandamus ❑ Non -Domestic Relations Retraining Order ❑ Quo Waranto ❑ Replevin ❑ Other: Updated 1/1/2011 -Et ff��.i �f ,Ui BEFLANO COU, Y'I. PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Progressive Preferred Insurance Company Plaintiff VS. THEORDORE W MERRITTS S. CIVIL DIVISION No PO.% 7 COMPLAINT IN CIVIL ACTION 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 20422589 C Y Jer HOH s Ib3.�spdat ck4q 11iqqa IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ed Y Civil Action No COMPLAINT AND NOTICE TO DEFEND Progressive Preferr Insurance Compan Plaintiff vs. THEORDORE W MERRITTS Defendant You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by an attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249-3166 WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire Pa. Identification No.209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File #20422589 Attorney for Plaintiff(s) PROGRESSIVE PREFERRED INSURANCE COMPANY Court of Common Pleas CUMBERLAND County vs. THEORDORE W MERRITTS 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 920 LANDERBROOK DR, MAYFIELD HTS, OH 44124. 2. Defendant is an adult individual who at all time pertinent hereto resided at 5222 E TRINDLE RD UNIT K, MECHANICSBURG, PA 17050. 3. Plaintiff issued a policy of motor vehicle insurance whereby Plaintiff agreed to insure the motor vehicle involved in this incident ("Insured Vehicle"), owned by Plaintiff's insured. 4. On or about December 31, 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 Simpson Street, Mechanicsburg, 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 Plaintiff Insured's vehicle sustained property damage and/or incurred rental charges in the total amount of $4,399.29. 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 Plaintiff and as a result of the aforesaid payment, Plaintiff became subrogated to the claim of its Insured against Defendant. WHEREFORE, Plaintiff demands Judgment against Defendant in the amount of $4,399.29 plus interest and costs. WE TMAN, WEINBERG & REIS, CO., L.P.A. BenjamiNLawrence, Esquire PA I.D. #9032 325 Chestn t Street Suite 501 Philadelphia, PA 19106 (215) 599-1500 WW R#20422589 EXHIBIT 1 Noakers Auto Body, LLC 819 New Bloomfield Rd., Duncannon, PA 17020 (717) 834-6500 Fax: (717) 834-6506 Damage Assessed By: Harry Purdy #601802 Appraised For: ALLISON GAYER (717) 730-1575 Supplemented By: Brandon Paul #560066 Condition Code: Date of Loss: Deductible: Claim Number: Insured: Owner: Address: Telephone: Description: Body Style: VIN: Mileage: OEM/ALT: Color: Options: Good 12/31/2012 100.00 12-4560420-01 MARLENE EPPLEY MARLENE EPPLEY 425 WILLIAMS GROVE RD, MECHANICSBURG, PA 17055 Home Phone: (717) 766-9251 Mitchell Service: 911753 Date: Estimate ID: Estimate Version: Supplement: Profile ID: Type of Loss: Property Damage Contact Phone: (717) 766-9251 2004 Toyota Highlander Vehicle Production Date: 10/03 4D Ut Drive Train: 3.3L Inj 6 Cyl 4WD JTEEP21AX40009861 License: DBP 2184 PA 1,179454 A Search Code: LANCASTERI GRAY PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW REAR WINDOW DEFOGGER, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN LUGGAGE RACK, ANTI-LOCK BRAKE SYS., TRACTION CONTROL, FOG LIGHTS ALUM/ALLOY WHEELS, LEATHER STEERING WHEEL, POWER ADJUSTABLE EXTERIOR MIRROR 4WD OR AWD, FRONT AIR DAM, TINTED GLASS, THIRD ROW BENCH SEAT THIRD ROW REMOVABLE SEAT, VARIABLE ASSISTED STEERING, AUTOMATIC HEADLIGHTS DAYTIME RUNNING LIGHTS, AM/FM STEREO CASSETTE/CD DRIVER SEAT WITH POWER LUMBAR SUPPORT, ELECTRONIC STABILITY CONTROL INTERIOR AIR FILTER, KEYLESS ENTRY SYSTEM, POWER DISC BRAKES, REAR WINDOW WIPER SECOND ROW SPLIT FOLDING BENCH SEAT Line Entry Labor Line Item Item Number Type Operation Description 1 104947 BDY 51 2 104948 BDY S1 3 100011 BDY S1 4 102627 BDY 5 6 7 8 S1 9 S1 10 51 11 12 S1 13 14 15 S1 16 17 18 BDY 104945 BDY REF 100043 100044 100045 102645 100049 102489 102649 102650 BDY BDY BDY BDY BDY REF BDY BDY BDY REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE OVERHAUL REMOVE/REPLACE REFINISH REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REFINISH REMOVE/REPLACE REMOVE/INSTALL REMOVE/INSTALL Information Labels Inform Label Air Cond Caution Inform Label Coolant Notice Inform Label Load Caution Inform Label Vacuum Routing Front Bumper Frt Bumper Cover Assy Frt Bumper Cover Assy Frt Bumper Cover OEM MATCHED R Frt Bumper Clip L Frt Bumper Clip Frt Ctr Bumper Stay Frt Bumper Impact Absorber L Frt Bumper Cover Support L Frt Bumper Support OEM PRICE MATCH L Frt Bumper Support Bracket R Frt Bumper Fog Lamp Opening Cover L Frt Bumper Fog Lamp Opening Cover ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Software Version: 7.0.483 Part Type/ Part Number .............................................. 88723-50170 11296-27020 11282-74010 17792-20290 52119-48917 52197-52010 52197-52010 52144-48010 "" Non -OEM 52062-48010 52115-48040 Existing Existing 1/14/2013 04:54 PM 12-4560420-01 2 1 (F F) 1/14/2013 04:52:09 PM CPA: All Parts Dollar Labor Amount Units 1.58 1.75 * 2.50 " 2.04 * 2.9 # 202.00 • INC # C 2.6 5.49 * INC 5.49 " INC 16.12 INC 64.62 INC 46.86 " INC C 0.5 5.69 " INC INC r INC r Copyright (C) 1994 - 2012 Mitchell International Page 1 of 6 All Rights Reserved S1 19 102669 BDY REMOVE/REPLACE 20 900500 REF * REMOVE/REPLACE 51 21 100081 BDY REMOVE/REPLACE 22 900500 REF • REFINISH/REPAIR 23 102675 BDY 24 102678 BDY 25 BDY 51 26 27 28 29 51 30 31 32 33 34 35 100118 BDY REF REF 100119 100120 100121 100122 100123 100128 BDY BDY BDY BDY BDY BDY REMOVE/INSTALL REMOVE/REPLACE CHECK/ADJUST REMOVE/REPLACE REFINISH REFINISH REMOVE/REPLACE REMOVE/INSTALL REMOVE/REPLACE REMOVE/INSTALL REMOVE/REPLACE REMOVE/INSTALL 36 102613 BDY REMOVE/INSTALL 37 BDY REMOVE/INSTALL 38 102493 MCH 39 BDY 40 MCH 41 42 43 44 100277 BDY REF REF REMOVE/INSTALL REMOVE/INSTALL REMOVE/REPLACE REMOVE/REPLACE REFINISH REFINISH 45 900500 REF ' REFINISH/REPAIR 46 100280 BDY REMOVE/INSTALL S1 47 900500 BDY " REMOVE/REPLACE S1 48 49 50 51 52 53 S1 54 S1 55 56 S1 57 58 59 60 100285 BDY 100296 BDY 100319 BDY REMOVE/REPLACE REMOVE/INSTALL REMOVE/INSTALL 100322 REF REFINISH 100332 100337 100339 102776 104952 100344 100345 100346 BDY BDY BDY BDY BDY BDY BDY BDY REMOVE/INSTALL REMOVE/REPLACE REMOVE/REPLACE REPAIR REMOVE/REPLACE REMOVE/INSTALL REMOVE/INSTALL REMOVE/INSTALL 61 103097 BDY REMOVE/INSTALL 62 100901 BDY 63 103166 BDY 64 103167 BDY REMOVEIINSTALL REMOVE/INSTALL REMOVE/INSTALL GriIIe Grille MANUAL ENTRIES FLEX ADDITIVE GriIIe Grille Retainer MANUAL ENTRIES BLEND TOW HOOK CVRS Front Lamps R Frt Combination Lamp L Front Combination Lamp Lens & Housing Headlamps Hood Hood Panel Hood Outside Add For Hood Underside OEM MATCH Hood Protector Frt Hood Seal Frt Hood Retainer 11@0.34 Hood Insulator Hood Insulator Retainer 2©1.49 Hood Latch Cooling Radiator Frt Bumper Assy A/C /HeaterNentilation A/C Condenser -M Grille Assy Evacuate & Recharge NC -M Front Fender L Fender Panel L Fender Outside L Add To Edge Fender OEM MATCHED MANUAL ENTRIES BLEND RIGHT FENDER Front Fender R Fender Liner MANUAL ENTRIES L Fender Liner Front Fender L Frt Fender Screw R Fender Mudguard R Fender Antenna Mast Front Inner Structure Radiator Support Complete TIME FOR LT RAD SUPT AND GUSSET Ctr Upr Front Body Tie Bar -S L Front Body Bracket -S L Front Body Baffle Support -S L Front Body Gusset -S L Front Body Extension Front Body Hood Latch Support R Front Body Air Deflector L Front Body Air Deflector Electrical High Note Nom Assy Windshield L W/Shield Moulding R W/Shield Washer Nozzle L W/Shield Washer Nozzle ESTIMATE RECALL NUMBER: 01/0412013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Software Version: 7.0.483 Date: Estimate ID: Estimate Version: Supplement: Profile ID: 53101-48100-E0 Sublet 52161-02020 Existing ** Non -OEM 53301-48090 53393-48020 Existing 90467-08011-83 Existing 90467-A0003 Existing 53802-48070 Existing Existing 53806-48030 90080-15090 Existing Existing 53258-48020 53212-48020 Existing 53288-48010 Existing Existing Existing Existing Existing Existing Existing 1/14/2013 04:54 PM 12-4560420-01 2 1 (F F) 1/14/2013 04:52:09 PM CPA: All Parts 196.66 * INC 8.00 * 0.0* 2.27 * 0.5* 0.4 # 170.00 INC # 0.4 486.16 * 1.3 C 2.6 C 1.3 12.33 * 0.2 r 3.74 2.98 INC r 0.3 r 0.9 # INC # 1.0 # INC 1.4 257.00 * 2.2 # C 1.6 C 0.5 2.0* 0.2 r 136.14 • 0.0' 0.75 * 0.2 0.1 r 1.0* 0.3 r 18.04 * 0.5 30.65 * 1.0 1.0' 15.14 * 0.3 0.1 0.1 0.5 r 0.2 r INC #r INC #r Copyright (C) 1994 - 2012 Mitchell International Page 2 of 6 All Rights Reserved 65 101367 REF 66 101383 BDY 67 101385 BDY 68 101403 BDY BLEND REMOVE/INSTALL REMOVE/INSTALL REMOVE/INSTALL 69 900500 BDY * REMOVE/INSTALL 70 900500 BDY * REPAIR S1 71 72 73 103284 BDY REMOVE/REPLACE 101483 BDY REMOVE/INSTALL ADD'L COST 74 936012 75 900500 BDY " ADD'L LABOR OP 76 900500 BDY * ADD'L LABOR OP 77 900500 BDY * ADD'L LABOR OP 78 REF ADD'L OPR 79 900500 BDY * 80 900500 BDY " 81 900500 BDY * 82 REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE ADD'L COST Front Door L Frt Door Outside L Frt Otr Belt Moulding L Frt Door Mirror L Frt Door Adhesive Moulding MANUAL ENTRIES CLEAN AND RETAPE DOOR MOLDING REMOVE ADHESIVE FROM LF DOOR Front Door L Frt Door Pull Handle DAMAGED DURING R&I L Frt Otr Door Handle Additional Costs & Materials HAZARDOUS WASTE DISPOSAL MANUAL ENTRIES CORROSION PROTECTION WELD THRU PRIMER CAR COVER ADDITIONAL OPERATIONS Clear Coat MANUAL ENTRIES COOLANT R-134 FREON AC OIL Additional Costs & Materials Paint/Materials Date: Estimate ID: Estimate Version: Supplement: Profile ID: Existing Sublet Existing 74811-22010-54 Sublet Sublet Sublet New Non -OEM ** Non -OEM * - 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. 15 JACKSON RD. TOTOWA NJ 07512 (800) 624-4561 (800) 228-6737 12 ** T0273 KEYSTONE AUTOMOTIVE JOHNSTOWN BUMPER MART 320 DOBSON ST. WINDBER PA 15963 (800) 438-2510 (814) 467-5531 64.62 24 ** T02502151 Prior Damage: FRT GLASS PITTED, STONE CHIPS HOOD, SCRATCHES REAR CVR, SCRATCHES AND DINGS ON LT DOORS. SCRATCHES ON RT DOORSRT FNDR DENT RF WHEEL DMG RT FENDER LINER HAS TORN TAB BUT STILL USABLE ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Software Version: 7.0.483 170.00 1/14/2013 04:54 PM 12-4560420-01 2 1 (F F) 1/14/2013 04:52:09 PM CPA: All Parts C 0.9 0.2 # 0.3 # 0.2 r 2.00 * 0.3* 0.2* 19.85 * 0.8 # 3.00 * 15.00 " 0.2* 8.00 * 0.2* 4.00 " 0.2* 2.5 12.00 * 0.0* 15.00 * 0.0* 3.00 * 0.0* 400.00 * Copyright (C) 1994 - 2012 Mitchell International Page 3 of 6 All Rights Reserved Date: Estimate ID: Estimate Version: Supplement: Profile ID: 1/14/2013 04:54 PM 12-4560420-01 2 1 (F F) 1/14/2013 04:52:09 PM CPA: All Parts 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 I. Labor Subtotals Units Rate Body 15.7 46.00 Refinish 16.0 46.00 Mechanical 2.4 50.00 Taxable Labor Labor Tax Labor Summary 34.1 Add" Labor Amount Sublet Amount Totals 0.00 29.00 751.20 T 0.00 0.00 736.00 T 0.00 0.00 120.00 T 1,60720 @ 6.000 % 96.43 1,703.63 II. Part Replacement Summary Amount Taxable Parts 1,743.85 Sales Tax (d1 6.000% 104.63 III. Additional Costs Amount IV. Taxable Costs 403.00 Sales Tax @ 6.000% 24.18 Total Additional Costs 427.18 Paint Material Method: Rates Init Rate = 25.00 ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Software Version: 7.0.483 Total Replacement Parts Amount 1,848.48 Adjustments Insurance Deductible Customer Responsibility Total Labor: Total Replacement Parts: Total Additional Costs: Gross Total: Amount 100.00- 100.00- 1,703.63 1,848.48 427.18 3,979.29 IV. Total Adjustments: 100.00 - Net Total: 3,879.29 Less Original Net Total: 3,567.34 Net Supplement Amount: 311.95 S1: Brandon Paul #560066 311.95 Copyright (C) 1994 - 2012 Mitchell International Page 4 of 6 All Rights Reserved Date: Estimate ID: Estimate Version: Supplement: Profile ID: 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) Insurance Co: PROGRESSIVE INSURANCE Inspection Site: NOAKERS AUTO BODY LLC (Service Center Only) Address: 819 NEW BLOOMFIELD RD Duncannon, PA 17011 1/14/2013 04:54 PM 12-4560420-01 2 1 (F F) 1/14/2013 04:52:09 PM CPA: All Parts 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 OEM parts that have been refurbished. BDY=BODY, BDS=BODY STRUCTURE, REF=REFINISH, GLS=GLASS, FRM=FRAME, MCH=MECHANICAL, ADD'L ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12V MAPP:DEC_12_V Copyright (C) 1994 - 2012 Mitchell International Page 5 of 6 Software Version: 7.0.483 All Rights Reserved Date: 1/14/2013 04:54 PM Estimate ID: 12-4560420-01 Estimate Version: 2 Supplement: 1 (F F) 1/14/2013 04:52:09 PM Profile ID: CPA: All Parts 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: Estimate Started: Estimate Printed: Estimate Committed: Estimate Uploaded: 01/04/2013 12:49:08 PM 01/08/2013 01:28:36 PM Estimate not printed 01/14/2013 04:54:43 PM Estimate not uploaded ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Copyright (C) 1994 - 2012 Mitchell International Page 6 of 6 Software Version: 7.0.483 All Rights Reserved Date: 1/14/2013 04:54 PM Estimate ID: 12-4560420-01 Unrelated Prior Damage Estimate Version: 2 Supplement: 1 (F F) 1/14/201304:52:09 PM Profile ID: CPA: All Parts Noakers Auto Body, LLC 819 New Bloomfield Rd., Duncannon, PA 17020 (717) 834-6500 Fax: (717) 834-6506 Unrelated Prior Damage Damage Assessed By: Harry Purdy #601802 Appraised For: ALLISON GAYER (717) 730-1575 Supplemented By: Brandon Paul #560066 Condition Code: Good Date of Loss: 12/31/2012 Claim Number: 12-4560420-01 Insured: MARLENE EPPLEY Owner: MARLENE EPPLEY Address: 425 WILLIAMS GROVE RD, MECHANICSBURG, PA 17055 Telephone: Home Phone: (717) 766-9251 Mitchell Service: 911753 Type of Loss: Property Damage Contact Phone: (717) 766-9251 Description: 2004 Toyota Highlander Vehicle Production Date: 10/03 Body Style: 4D Ut Drive Train: 3.3L Inj 6 Cyl 4WD VIN: JTEEP21AX40009861 License: DBP 2184 PA Mileage: 1,179,454 OEM/ALT: A Search Code: LANCASTERI Color: GRAY Options: PASSENGER AIRBAG, DRIVER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW REAR WINDOW DEFOGGER, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN LUGGAGE RACK, ANTI-LOCK BRAKE SYS., TRACTION CONTROL, FOG LIGHTS ALUM/ALLOY WHEELS, LEATHER STEERING WHEEL, POWER ADJUSTABLE EXTERIOR MIRROR 4WD OR AWD, FRONT AIR DAM, TINTED GLASS, THIRD ROW BENCH SEAT THIRD ROW REMOVABLE SEAT, VARIABLE ASSISTED STEERING, AUTOMATIC HEADLIGHTS DAYTIME RUNNING LIGHTS, AM/FM STEREO CASSETTE/CD DRIVER SEAT WITH POWER LUMBAR SUPPORT, ELECTRONIC STABILITY CONTROL INTERIOR AIR FILTER, KEYLESS ENTRY SYSTEM, POWER DISC BRAKES, REAR WINDOW WIPER SECOND ROW SPLIT FOLDING BENCH SEAT Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units MANUAL ENTRIES 1 900500 REF " REFINISH/REPAIR RIGHT FENDER Existing 2.5" Additional Costs & Materials 2 ADD'L COST Paint/Materials 62.50 * * - Judgment Item ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Copyright (C) 1994 - 2012 Mitchell International Page 1 of 3 Software Version: 7.0.483 All Rights Reserved Date: 1/14/2013 04:54 PM Estimate ID: 12-4560420-01 Unrelated Prior Damage Estimate Version: 2 Supplement 1 (F F) 1/14/2013 04:52:09 PM Profile ID: CPA: All Parts Prior Damage: ........................................................ FRT GLASS PITTED, STONE CHIPS HOOD, SCRATCHES REAR CVR, SCRATCHES AND DINGS ON LT DOORS, SCRATCHES ON RT DOORSRT FNDR DENT RF WHEEL DMG RT FENDER LINER HAS TORN TAB BUT STILL USABLE 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 Add9 Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Refinish 2.5 46.00 0.00 0.00 115.00 T Labor Summary Taxable Labor Labor Tax Q 6.000 % 115.00 6.90 2.5 121.90 Total Replacement Parts Amount 0.00 ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Copyright (C) 1994 - 2012 Mitchell International Page 2 of 3 Software Version: 7.0.483 All Rights Reserved Date: 1/14/2013 04:54 PM Estimate ID: 12-4560420-01 Unrelated Prior Damage Estimate Version: 2 Supplement: 1 (F F) 1/14/2013 04:52:09 PM Profile ID: CPA: All Parts III. Additional Costs Amount IV. Adjustments Amount ........... Taxable Costs 62.50 Total Adjustments: 0.00 Sales Tax © 6.000% 3.75 Total Additional Costs 66.25 Paint Material Method: Rates [nit Rate = 25.00 Point(s) of Impact 11 Left Front Comer (P) Insurance Co: PROGRESSIVE INSURANCE Inspection Site: NOAKERS AUTO BODY LLC (Service Center Only) Address: 819 NEW BLOOMFIELD RD Duncannon, PA 17011 Event Log File Created: Estimate Started: Estimate Printed: Estimate Committed: Estimate Uploaded: 01/04/2013 12:49:08 PM 01/08/2013 01:28:36 PM Estimate not printed 01/14/2013 04:54:43 PM Estimate not uploaded I. Total Labor: 121.90 II. Total Replacement Parts: 0.00 III. Total Additional Costs: 66.25 Gross Total: 188.15 IV. Total Adjustments: 0.00 Unrelated Damage Net Total: 188.15 ESTIMATE RECALL NUMBER: 01/04/2013 17:30:57 12-4560420-01 Mitchell Data Version: DEC_12_V MAPP:DEC_12_V Copyright (C) 1994 - 2012 Mitchell International Page 3 of 3 Software Version: 7.0.483 All Rights Reserved Claim Payment Detail Claim Payment Detail ( 12-4560420 ) Payment Information Disbursement Number: EFT Trace Number: Paid To: Mailing Address: In Payment Of: Page 1 of 1 766724754 711329180 NOAKERS AUTO BODY LLC 819 NEW BLOOMFIELD RD DUNGANNON, PA 17020 USA Progressive Invoice Number: 8501889 Total Amount: Invoice Number: $3,879.29 8501889 —Vendor Information Name: Type: 1099 Required: No —Reviewed Summary Issuing Rep: Issue Date: Last Updated Rep: TA00001 01-17-13 TA00001 Approved By: Review Date: Reviewed By: --Bank Information Type: Stop Reason: Stop Date: Loss Bank Code: Cleared: CTB 01-18-13 — Exposure Detail: COLL Party Name: Property Description: Payment Type: EPPLEY, MARLENE 04 TOYOT HIGHLANDER FINAL PAYMENT Amount Paid: Deductible Taken: Property Damage: Rental: $3,879.29 $100.00 $3,879.29 $0.00 http://claimspayments/Alpha/ClaimsPaymentsWeb/default.aspx?p... 4/9/2014 Claim Payment Detail Claim Payment Detail ( 12-4560420 ) Payment Information Disbursement Number: EFT Trace Number: Paid To: Mailing Address: In Payment Of: Page 1 of 1 766749163 Total Amount: Invoice Number: ENTERPRISE RENT -A -CAR ENTERPRISE RENT -A -CAR 3950 HARTZDALE DR CAMP HILL, PA 17011-7828 ENTERPRISE RENT -A -CAR RENTAL INVOICE # 57PRD009779 $420.00 —Vendor Information Name: Type: ENTERPRISE RENT... GLASS SHOP 1099 Required: Reviewed Summary Issuing Rep: Issue Date: Last Updated Rep: A091257 01-22-13 A091257 Approved By: Review Date: Reviewed By: —Bank Information Type: Stop Reason: Stop Date: Loss Exposure Detail: RENTAL Party Name: EPPLEY, MARLENE Property Description: 04 TOYOT HIGHLANDER Payment Type: FINAL PAYMENT Bank Code: Cleared: Amount Paid: Deductible Taken: Property Damage: Rental: $420.00 $0.00 $0.00 $420.00 http://claimspayments/Alpha/ClaimsPaymentsWeb/default.aspx?p... 4/9/2014 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 unswo falsification to authorities. Date q o Benjamin W. Lawrence SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff , 01 tio n In bey Jody S Smithrf Chief Deputy (� Richard W Stewart '.,, , ch +� Solicitor t,µ, :, PE.HHSY�-V14I Progressive Speciality Ins Case Number vs. 2014-3367 Theordore W Merritts SHERIFF'S RETURN OF SERVICE 06/11/2014 03:20 PM - Deputy Christopher Sharpe, being duly sworn according to law, served the requested Complaint& Notice by"personally" handing a true copy to a person representing themselves to be the Defendant, to wit:Theordore W Merritts at 5222 E. Trindle Road, Unit K, Hampden Township, Mechanicsburg, PA 17050. CHRISTOP ER SHARPE, DEPUTY SHERIFF COST: $39.30 SO ANSWERS, June 12, 2014 RONNY R ANDERSON, SHERIFF Progressive Preferred Insurance Company Plaintiff vs. THEORDORE W MERRITTS HE t--7LEO-OFh ILL TPROTHON0 2114 SEP 17 Ji //: 1,z 3 UNBERLANO COUNTY PENNSYLVANIA IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION No: 14-3367 CIVIL PRAECIPE FOR DEFAULT JUDGMENT 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 20422589 C Y Jer HOH Judgment Amount $4399.29 Progressive Preferred Insurance Company Plaintiff vs. THEORDORE W MERRITTS TO THE PROTHONTARY: IN THE COURT OF COMMON PLEAS 7,RLAND COUNTY, PENNSYLVANIA CIVIL DIVISION Civil Action No. 14-3367 CIVIL PRAECIPE FOR DEFAULT JUDGMENT Kindly enter Judgment against the Defendant THEORDORE W MERRITTS above named, in the default of an Answer, in the amount of $4399.29 computed as follows: Amount claimed in Complaint $4399.29 Less payments / adjustments made $0.00 Attorney's fees $0.00 TOTAL $4399.29 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, WEINB G & REIS CO., L.P.A. By: Benjamin W'KLawrence,209032 20422589 C Y Jer HOH 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 : THEORDORE W MERRITTS 5222 E TRINDLE RD UNIT K MECHANICSBURG, PA 17050 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION PROGRESSIVE PREFERRED INS. Plaintiff Case No. 14-3367 CIVIL vs. THEORDORE W MERRITTS Defendant TO: IMPORTANT NOTICE THEORDORE W MERRITTS �` 1 5222 E TRINDLE RD UNIT K MECHANICSBURG, PA 17050-3584 Date of Notice: YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE, IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA. 17013 (717) 249-3166 WELTMAN, WEINBERG -. REIS CO., L.P.A. By:. Michael Doug P.A.I.D.# 76''6 WELTMAN, WEINBERG & REIS CO., L.P.A. 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 (215) 599-1500 (215) 599-1505 20422589 Y PHI WELTMAN, WEINBERG & REIS CO., L.P.A. BY: Benjamin W. Lawrence, Esquire —1.D. No. 209032 325 Chestnut Street, Suite 501 Philadelphia, PA 19106 Phone: 215.599.1500 Fax: 215.599.1505 File # 20422589 Attorney for Plaintiff(s) PROGRESSIVE PREFERRED INSURANCE COMPANY CUMBERLAND COUNTY COURT OF COMMON PLEAS vs. THEODORE W. MERRITTS No.: 14-3367 CIVIL NON-MILITARY AFFIDAVIT The undersigned is the duly authorized agent and/or attorney for Plaintiff Progressive Preferred Insurance Company 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, affiant is unable to determine whether or not the defendant, Theodore W. Merritts, is in military service. 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. §4904 relating to unsworn falsification to authorities. By Benjamin'W. Lawrence, Esquire Attorney for Plaintiff(s) WELTMAN, WEINBERG & REIS CO., L.P.A. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION Progressive Preferred Insurance Company Plaintiff vs. THEORDORE W MERRITTS Civil Action No. 14-3367 CIVIL NOTICE OF JUDGMENT OR ORDER TO: ( ) Plaintiff (xx) Defendant ( ) Garnishee You are hereby notified that the f owi�; g Order of Judgment was entered against you on 117 I'L (xx) Assumpsit Judgment in the amount of $4399.29 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 Award Prothonotary THEORDORE W MERRITTS 5222 E TRINDLE RD UNIT K MECHANICSBURG, PA 17050 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