The URL can be used to link to this page

Home My WebLink About15-0224 20473094 C Y Jer JIH Supreme Court—,of Pennsylvania W R# Couif Com on Pleas - rP F Wt � or rotho�wt •UO anse n4r: vil Cover/Sheethly- CUMBERLAND] s, ,, COUn11, Docket No: 01o/5- 00do iv117Grm The hiforniation collected on this form is used solely fol- court admini'sti'otion pinposes. This forin does not supplement or replace the filing and service ofpleadings or other papers as required by law or rules of court. Commencement of Action: S a Complaint ❑ Writ of Summons ❑ Petition E Transfer from Another Jurisdiction Declaration of Taking C Lead Defendant's Name: Progressive Advanced 1Insurance Company STEDMAN MCLAUGHLIN I _ O Are money damages requested? ® Yes ❑ No Dollar Amount Requested: ® within arbitration limits N (check one) [3outside arbitration limits Is this a Class Action Suit? ❑ Yes 12 No Is this an MDJ Appeal? ❑ Yes E0 No A Benjamin W. Lawrence, 209032 Name of Plaintiff/Appellant's Attorney: ❑ Check here if you have no attorney(area 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 B C3 Product Liability(does not include [3 Employment Dispute Mass tort) Discrimination C 13Slander/Libel/Defamation C3 Employment Dispute: Other C3 Zoning Board 'j Other: ❑ Other: I 5Uh✓o��"i�� ❑ Other:. O - 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 is TSF `` '^ ! qj,nr • LA 12 P&I 12. 4 0 CUI'IBER I l;ND COUNTY v P EINN S Y LVA N-11 A IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION Progressive Advanced Insurance Company n Plaintiff No: c2015- 0001024 Divi I Teri VS . COMPLAINT IN CIVIL ACTION STEDMAN MCLAUGHLIN 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 20473094 C Y Jer JIH X115, r?5 PO Am( 11871 r7b5 P,*- 315510 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION Progressive Advanced Insurance Company Plaintiff VS . Civil Action No STEDMAN MCLAUGHLIN 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 1 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 #20473094 PROGRESSIVE ADVANCED INSURANCE COMPANY Court of Common Pleas CUMBERLAND County vs. STEDMAN MCLAUGHLIN 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 DR, MAYFIELD HTS, OH 44124. 2. Defendant is an adult individual who at all times pertinent hereto resided at 121 E LOUTHER ST, CARLISLE, PA 17013. 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 April 23, 2013 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 Harvey Taylor Bridge Bypass and Route 11, East 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 Plaintiffs vehicle; c. Failing to keep a proper lookout; d. Traveling too fast for conditions; e. Disregarding traffic control devices; .f. Failing to abide by the Rules of the Road and the Motor Vehicle Code of Pennsylvania; g. Being otherwise negligent under the circumstances; and, h. Being negligent as a matter of law as may be relevant through discovery and/or at the time of trial. 6. As a direct and proximate result of Defendant's negligence, the Plaintiff Insured's vehicle sustained property damage and/or incurred rental charges in the total amount of $2,477.25. 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 $2,477.25 plus interest and costs. WELTMAN, WEINBERG & REIS, CO., L.P.A. -tl Benjamin Lawrence, Esquire PA I.D. # 9032 325 Che tnut Street Suite 501 Philadelphia, PA 19106 (215) 599-1500 WW R#20473094 EXHIBIT 1 Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts PROGRESSIVE 1851 Charter Lane,Lancaster,PA 17601 Damage Assessed by: Lic#442911 Mike Curzi Claim Rep: SARAH KOHLER (717)730-1577 For supplements please contact Mike Curzi at 717-577-0681 or email at. mcurzil@progressive.com Product Type: Auto Date of Loss: 4/23/2013 "Deductible: 500.00 Claim Number: 13-2817703-01 Insured: VIJAY PATEL Owner: BHANU PATEL Address: 106 SGRIGNOLI LANE,ENOLA,PA 17025 Telephone: Work Phone: (717)579-7909 Home Phone: (717)728-8937 Contact Phone: (215)954-8179 Mitchell Service: 917775 Description: 1997 Nissan Altima GXE Vehicle Production Date: 4/96 Body Style: 4D Sed Drive Train: 2AL Inj 4 Cyl 4A VIN: 1 N4BU31D7VC1 10944 License: MRUGESH PA Mileage: 154,877 OEM/ALT: A Search Code: LANCASTERI Color: BLUISH/GREEN Options: CD CHANGER,PASSENGER AIRBAG,DRIVER AIRBAG,POWER LOCK,POWER WINDOW POWER STEERING,REAR WINDOW DEFOGGER,MANUAL AIR CONDITION,CRUISE CONTROL TILT STEERING COLUMN,AUTOMATIC TRANSMISSION,TINTED GLASS AM/FM STEREO CASSETTE,FRONT BUCKET SEATS,POWER LIFTGATE\TRUNK Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units Wheel 1 700039 BOY REMOVE/INSTALL Spare Tire/W heel 0.2 Luggage Lid 2 723060 BOY REMOVE/REPLACE Luggage Lid Panel Used/Recycled 95.00 ' 1.0 3 REF REFINISH Luggage Lid Outside C 2.3 4 REF REFINISH Luggage Lid Underside 1.1 5 Line Markup%25.00 23.75 6 700141 BOY REMOVE/REPLACE Luggage Lid Adhesive Nameplate ORDER FROM DEALER 26.88 0.1 7 "Altima" 8 727127 BOY REMOVE/REPLACE Luggage Lid Adhesive Nameplate ORDER FROM DEALER d19.35 0.1 9 "GXE" 10 723180 BOY REMOVE/INSTALL Luggage Lid Latch Existing INC r 11 Off LKQ Lid 12 723190 BOY REMOVE/REPLACE Luggage Lid Latch Striker 84620-85E00 18.63 INC 13 723220 BOY REMOVE/INSTALL Luggage Lid Lock Cylinder Existing INC r Rear Body 14 725360 BOY REMOVE/REPLACE Rear Body Panel 79110-98030 301.30 7.5 # 15 REF REFINISH Rear Body Panel 1.1 16 REF REFINISH Add For Inside 0.8 17 725738 BOY REMOVE/INSTALL Rear Body Trim Panel Existing INC r 18 725740 BOY REMOVE/REPLACE R Upr Rear Body Plate 84992-1E000 36.87 0.2 # 19 725750 BOY REMOVE/REPLACE L Upr Rear Body Plate 84993-1E000 36.87 INC # 20 725870 BOY REMOVE/INSTALL Rear Body Carpet Existing r 21 725880 BOY REMOVE/INSTALL Rear Body Spare Tire Cover Existing r Rear Lamps 22 700149 BOY REMOVE/REPLACE R Rear Combination Lamp Assembly '"Non-OEM 108.00 INC ESTIMATE RECALL NUMBER: 06117/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13_V MAPP:APR_13—V Copyright(C)1994-2013 Mitchell International Page 1 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts 23 700150 BDY REMOVE/REPLACE L Rear Combination Lamp Assembly **Non-OEM 96.00 INC 24 726390 BDY REMOVE/REPLACE R License Lamp Assembly Used/Recycled INC* INC r 25 License Lamp Included w/Bumper Assy 26 726400 BDY REMOVE/REPLACE L License Lamp Assembly Used/Recycled INC* INC r Rear Bumper 27 BDY OVERHAUL Rear Bumper Cover Assy 0.6 28 726920 BDY REMOVE/REPLACE Rear Bumper Cover Used/Recycled 150.00 ' INC 29 REF REFINISH Rear Bumper Cover C 2.2 30 Line Markup%25.00 37.50 31 727010 BDY REMOVE/REPLACE L Rear Bumper Bracket 85221-OE710 32.52 INC 32 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 ADDITIONAL OPERATIONS 33 REF ADD'LOPR Clear Coat 1.4 MANUAL ENTRIES 34 900500 FRM' ALIGN TIE DOWN AND MEASURE Existing 1.0* 35 900500 FRM` REPAIR PULUALIGN REAR UNIBODY Existing 1.0* 36 Pull Rear Body for R&R/Floor 37 900500 BDY* ADD'L LABOR OP CORROSION PROTECTION Sublet 15.00 ' 0.2* 38 900500 BDY* ADD'L LABOR OP WELD THRU PRIMER Sublet 8.00 * 0.2* 39 900500 BDY * ADD'L LABOR OP CAR COVER Sublet 4.00 * 0.2* 40 900500 REF * REMOVE/REPLACE FLEX ADDITIVE Sublet 8.00 * 0.0* 41 900500 BDY ' ADD'L LABOR OP SEAM SEALER Sublet 12.00 ' 0.0* 42 900500 BDY* ADD'L LABOR OP UNDERCOATING Sublet 10.00 * 0.2* Additional Costs&Materials 43 ADD'L COST Paint/Materials 249.20 *-Judgment Item #-Labor Note Applies d-Discontinued by the Manufacturer **Non-OEM -Non-Original Equipment Manufacturer Replacement Part C-Included in Clear Coat Calc r-CEG R&R Time Used For This Labor Operation KEYSTONE AUTOMOTIVE JOHNSTOW N BUMPER MART 320 DOBSON ST. W INDBER PA 15963 (800)438-2510 (814)467-5531 22 "N12801123 108.00 23 **N12800123 96.00 Recycler Information Section: Triple Nickel,Inc. 2956 Lincoln Way West Chambersburg PA 17201 800-933-8627;717-267-1008 28 1997 Nissan Altima REAR BUMPER ASSY 132872 VA 150.00 Description:GRN,4DR,4CO, , Carlisle Auto&Truck Salvage,inc 10 Gasoline Alley Carlisle PA 17015 717-238-1500/717-76:717-249-8477 2 1997 Nissan Altima LID&GATE 120143 VA 95.00 Description:WHT,4DR,PW„W/O SPOILER, ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13V MAPP:APR_13__V Copyright(C)1994-2013 Mitchell International Page 2 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts Disclaimer:The price indications on recycled parts are real or composite values,based on the pricing option selected with ORP. Prices are the latest available at time of inventory download and are subject to change and availability. To determine actual repairer net or wholesale price,call the automotive recycler of your choice. Certain parts located for this quote are interchangeable but are not an exact match. Call the automotive recycler of your choice. Prior Damage: See W CTL notes 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 I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 10.5 48.00 0.00 49.00 553.00 T Taxable Parts 929.42 Refinish 8.9 48.00 0.00 0.00 427.20 T Parts Adjustments 61.25 Frame 2.0 50.00 0.00 0.00 100.00 T Sales Tax @ 6.000% 59.44 Taxable Labor 1,080.20 Total Replacement Parts Amount 1,050.11 Labor Tax @ 6.000% 64.81 Labor Summary 21.4 1,145.01 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 252.20 Insurance Deductible 500.00- Sales Tax @ 6.000% 15.13 Customer Responsibility 500.00- Total Additional Costs 267.33 Paint Material Method:Rates [nit Rate=28.00 t. Total Labor: 1,145.01 H. Total Replacement Parts: 1,050.11 III. Total Additional Costs: 267.33 Gross Total: 2,462.45 ESTIMATE RECALL NUMBER: 06/17/201312:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13_V MAPP:APR_13—V Copyright(C)1994-2013 Mitchell International Page 3 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/1712013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts IV. Total Adjustments: 500.00- Net Total: 1,962.45 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 6 Rear Center(P) Alt.Location: PROGRESSIVE INSURANCE Inspection Site: HOME Address: 106 Sgrignoli Ln Enola;PA 17025 (717)979-3038 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 anv 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 DA.IvIAGE 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 COST=ADDITIONAL COST, ADD'L OPR=ADDITIONAL OPERATION, FRT=FRONT, RR=REAR, L=LEFT, R=RIGHT,UPR=UPPER,LWR=LOWER, ESTIMATE RECALL NUMBER: 06117/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13_V MAPP:APR_13_V Copyright(C)1994-2013 Mitchell International Page 4 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6117/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts OTR=OUTER, INR=INNER, ASSY=ASSEMBLY, SUSP=SUSPENSION, EXT=EXTENSION, BRK=BRP.CKET, 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 ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR 13_V MAPP:APR__13_V Copyright(C)1994-2013 Mitchell International Page 5 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts PROGRESSIVE 1851 Charter Lane,Lancaster,PA 17601 Damage Assessed by: Lic#442911 Mike Curzi Claim Rep: SARAH KOHLER (717)730-1577 For supplements please contact. Mike Curzi at 717-577-0681 or email at mcurzil@progressive.corn Product Type: Auto "Date of Loss: 4/23/2013 Deductible: 500.00 *Claim Number: 13-2817703-01 Insured: VIJAY PATEL Owner: BHANU PATEL Address: 106 SGRIGNOLI LANE,ENOLA,PA 17025 Telephone: Work Phone: (717)579-7909 Home Phone: (717)728-8937 Contact Phone: (215)964-8179 Mitchell Service: 917775 Description: 1997 Nissan Altima GXE Vehicle Production Date: 4/96 Body Style: 4D Sed Drive Train: 2.4L Inj 4 Cyl 4A VIN: 1N4BU31D7VC110944 License: MRUGESH PA Mileage: 154,877 OEM/ALT: A Search Code: LANCASTERI Color: BLUISH/GREEN Options: CD CHANGER,PASSENGER AIRBAG,DRIVER AIRBAG,POWER LOCK,POWER WINDOW POWER STEERING,REAR WINDOW DEFOGGER,MANUAL AIR CONDITION,CRUISE CONTROL TILT STEERING COLUMN,AUTOMATIC TRANSMISSION,TINTED GLASS AM/FM STEREO CASSETTE,FRONT BUCKET SEATS,POWER LIFTGATEITRUNK Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units Wheel 1 700039 BDY REMOVEIINSTALL SpareTire/Wheel 0.2 Luggage Lid 2 723060 BDY REMOVE/REPLACE Luggage Lid Panel Used/Recycled 95.00 ' 1.0 3 REF REFINISH Luggage Lid Outside C 2.3 4 REF REFINISH Luggage Lid Underside 1.1 5 Line Markup%25.00 23.75 6 700141 BDY REMOVE/REPLACE Luggage Lid Adhesive Nameplate ORDER FROM DEALER 26.88 0.1 7 "Altima" 8 727127 BDY REMOVEIREPLACE Luggage Lid Adhesive Nameplate ORDER FROM DEALER d19.35 0.1 9 "GXE" 10 723180 BDY REMOVE/INSTALL Luggage Lid Latch Existing INC r 11 Off LKO Lid 12 723190 BDY REMOVE/REPLACE Luggage Lid Latch Striker 84620-85E00 18.63 INC 13 723220 BDY REMOVE/INSTALL Luggage Lid Lock Cylinder Existing INC r Rear Body 14 725360 BDY REMOVE/REPLACE Rear Body Panel 79110-96030 301.30 7.5 # 15 REF REFINISH Rear Body Panel 1.1 16 REF REFINISH Add For Inside 0.8 17 725738 BDY REMOVE/INSTALL Rear Body Trim Panel Existing INC r 18 725740 BDY REMOVE/REPLACE R Upr Rear Body Plate 84992-1 E000 36.87 0.2 # 19 725750 BDY REMOVE/REPLACE L Upr Rear Body Plate 84993.1 E000 36.87 INC # 20 725870 BDY REMOVE/INSTALL Rear Body Carpet Existing r 21 725880 BDY REMOVE/INSTALL Rear Body Spare Tire Cover Existing r Rear Lamps 22 700149 BDY REMOVE/REPLACE R Rear Combination Lamp Assembly Non-OEM 108.00 INC ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13_V MAPP:APR_13_V Copyright(C)1994-2013 Mitchell International Page 1 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6117/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts 23 700150 BOY REMOVE/REPLACE L Rear Combination Lamp Assembly "Non-OEM 96.00 INC 24 726390 BOY REMOVE/REPLACE R License Lamp Assembly Used/Recycled INC* INC r 25 License Lamp Included w/Bumper Assy 26 726400 BOY REMOVE/REPLACE L License Lamp Assembly Used/Recycled INC* INC r Rear Bumper 27 BDY OVERHAUL Rear Bumper Cover Assy 0.6 28 726920 BOY REMOVE/REPLACE Rear Bumper Cover Used/Recycled 150.00 ' INC 29 REF REFINISH Rear Bumper Cover C 2.2 30 Line Markup%25.00 37.50 31 727010 BOY REMOVE/REPLACE L Rear Bumper Bracket 85221-OE710 32.52 INC 32 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 ' ADDITIONAL OPERATIONS 33 REF ADD'L OPR Clear Coat 1.4 MANUAL ENTRIES 34 900500 FRM* ALIGN TIE DOWN AND MEASURE Existing 1.0* 35 900500 FRM* REPAIR PULLIALIGN REAR UNIBODY Existing 1.0* 36 Pull Rear Body for R&R/Floor 37 900500 BDY* ADD'L LABOR OF CORROSION PROTECTION Sublet 15.00 ' 0.2* 38 900500 BDY* ADD'L LABOR OP WELD THRU PRIMER Sublet 8.00 ' 0.2* 39 900500 BOY* ADD'L LABOR OP CAR COVER Sublet 4.00 ' 0.2' 40 900500 REF * REMOVE/REPLACE FLEX ADDITIVE Sublet 8.00 ' 0.0* 41 900500 BOY* ADD'L LABOR OP SEAM SEALER Sublet 12.00 ' 0.0* 42 900500 BDY' ADD'L LABOR OP UNDERCOATING Sublet 10.00 ' 0.2* Additional Costs&Materials 43 ADD'L COST Paint/Materials 249.20 ` * Judgment Item #-Labor Note Applies d-Discontinued by the Manufacturer **Non-OEM -Non-Original Equipment Manufacturer Replacement Part 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 22 **N12801123 108.00 23 "N12800123 96.00 Recycler Information Section: Triple Nickel,Inc. 2956 Lincoln Way West Chambersburg PA 17201 800-933-8627:717-267-1008 28 1997 Nissan Altima REAR BUMPER ASSY 132872 VA 150.00 Description:GRN,4DR,4CO, , Carlisle Auto&Truck Salvage,lnc 10 Gasoline Alley Carlisle PA 17015 717-238-1500/717-76:717-249-8477 2 1997 Nissan Altima LID&GATE 120143 VA 95.00 Description:WHT,4DR,PW„W/O SPOILER, ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13V MAPP:APR_13__V Copyright(C)1994-2013 Mitchell International Page 2 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts Disclaimer:The price indications on recycled parts are real or composite values,based on the pricing option selected with ORP. Prices are the latest available at time of inventory download and are subject to change and availability. To determine actual repairer net or wholesale price,call the automotive recycler of your choice. Certain parts located for this quote are interchangeable but are not an exact match. Call the automotive recycler of your choice. Prior Damage: See WCTL notes 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 DP24AGE 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'1 Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 10.5 48.00 0.00 49.00 553.00 T Taxable Parts 929.42 Refinish 8.9 48.00 0.00 0.00 427.20 T Parts Adjustments 61.25 Frame 2.0 50.00 0.00 0.00 100.00 T Sales Tax @ 6.000% 59.44 Taxable Labor 1,080.20 Total Replacement Parts Amount 1,050.11 Labor Tax @ 6.000% 64.81 Labor Summary 21.4 1,145.01 III. Additional Costs Amount IV. Adjustments Amount - --- ..........._...... Taxable Costs 252.20 Insurance Deductible 500.00- Sales Tax @ 6.000% 15.13 Customer Responsibility 500.00- Total Additional Costs 267.33 Paint Material Method:Rates Init Rate=28.00 1. Total Labor: 1,145.01 II. Total Replacement Parts: 1,050.11 111. Total Additional Costs: 267.33 Gross Total: 2,462.45 ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13_V MAPP:APR_13_V Copyright(C)1994-2013 Mitchell International Page 3 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts IV. Total Adjustments: 500.00- Net Total: 1,962.45 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 6 Rear Center(P) Alt.Location: PROGRESSIVE INSURANCE Inspection Site: HOME Address: 106 Sgrignoli Ln Enola,PA 17025 (717)979-3038 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 anv 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 COST=ADDITIONAL COST, ADD'L OPR=ADDITIONAL OPERATION, FRT=FRONT, RR=REAR, L=LEFT, R=RIGHT,UPR=UPPER,LWR=LOWER, ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR 13V MAPP:APR__13__V Copyright(C)1994-2013 Mitchell International Page 4 of 5 Software Version: 7.0.485 All Rights Reserved Date: 6/17/2013 12:59 PM Estimate ID: 13-2817703-01 Estimate Version: 0 Committed Profile ID: CPA:All Parts OTR=OUTER, INR=INNER, ASSY=ASSEMBLY, SUSP=SUSPENSION, EXT=EXTENSION, BRK=BRP.CKET, INST=INSTRUMENT, ATG=ASSEMBLY TIME GUIDE. IF THIS APPRAISAL HAS BEEN PREPARED BASED UPON THE USE OF AFTERIIJARKET 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 ESTIMATE RECALL NUMBER: 06/17/2013 12:59:07 13-2817703-01 Mitchell Data Version: OEM: APR_13_V MAPP:APR_13_V Copyright(C)1994-2013 Mitchell International Page 5 of 5 Software Version: 7.0.485 All Rights Reserved M Q 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 awrence Date