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HomeMy WebLinkAbout96-00886 ~ ~ .e) ...; ~ a. -j " ., " " " \ , , // ;....y ;' ~ f- a I -9 a- .; o "< ., , J' -~ ~- - -, r{ , - ''; ....., .'.; .... .J J. t~ ,~"i - f",l.,J n; '....I ..,,- '.j 'J !~, (! 'j"'l , , !") ~. ....I \-4~ () (" '. , ':j. ,~: '7: l:1 ~I ~' "'t " c..: ,II '..J Y ,~ V ^(jYl.ONOHlO~d .,'~O'...... .......-I'~ "''IJ''''~'''''' GJ.l Y.1.S~~'::l l.t'>lIVlJI'KD 'OJl;6l ,..........s.if...'Vvtu~...... 'I, !i . GEORGE F. DOUGLAS, III, ESQUIRE ATlURNEY I.D. # 6111116 DOUGLAS, DOUGLAS & DOUGLAS 27 West High St. 1'.0. Box 261 Carlisle, Pa. 17013 Telephone: 717-24J..1790 Ath,rney for Plaintiff EMMETr G. BIBB IN THE COURT OF COMMON PLEAS VS. or CUMBERLAND COUNTY, PENNA. CIVIL ACTION LAW : NO. Cf V - '60 I.c C~"..Q T€,,,'" GARY PATRICK NonCE You have been sued in Court. If you wish to defend against the class 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 attorney and filing in wriling 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 Cllurt without further notice for any money claimed in 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 :~ET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HEI.P. DOUGLAS, DOUGLAS & DOUGLAS j}~Jl\f (' ~lgC (1 {>. 'u.~. GEORGE " DOUGLAS, I ,ESQUIRE Attorney for Plaintiff f I. f t , i ! , ! Court Administrator Fourth Floor Cumberland County Court House I Court House Square Carlisle, Pa. 17013 717-240-6200 :1 I , \ .- COMPLAINT 1. The plaintiff,Emmett G. Bibb, is an individual residing at 1201 Grandia Flora Drive, Mech,micsburt;, Cumberl.ul(f County, Pa. 17055-53J3. 2. The defendant, G,lry Patrick, is an individual residing at 6280 Carlisle Pike, Mechanicsburg, Cumberl,md County, Pa. 17255. 3. On March 28, 1995, the pl,lintiff was the mvnt'r of a 1992 Ford Explorer. 4. At or about 2:45 P.M. on the aforesaid d,lte, the plaintiff was opt'rating the said vehicle on Williams Grove Road in Mechanicsburg, Cumberland County, Penna. 5, At the same time and place, the defendant was operating a Ford Ranger pickup on Williams Grove Road and traveling in the opposite direction to the pJ.lintiff. " I ~ , ! , , ! 6. The defendant made ~ left turn to enter an Exxon Gas Station when he collided with the plaintiff's vehicle. I I 7. The collision was caused by the negligence of the defendant in the following respects: a. In failing to operate his vehicle in a safe and prudent manner. I 1 f b. In failing to keep a proper lookout for oncoming traffic. 8. As a result of the negligence of the dt'fendant, the plaintiff sustained damages to his vehicle in the amount of $4,785.96, as is more fully set forth in the attached Exhibit A. 9. Attached hereto are copies of the billsl estimates in this matter, which are provided pursuant to Pa.R.c.P. DOS (b) (3). l- . , 'i I, j WHEREFORE, the pl.lintiH d.lims llf the ddendilllts il sum of $4,7H5.lJh. an amount requiring compulsory referr.ll to .lrbitration under the local rules of court. DOUGLAS, DOUGLAS &: DOUGLAS , By\~Lt~\.-y_' 'fJcrvi,'n,l- \..\ George F. Douglas, 1/1, Esquire Attorney fur Plaintiff " AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ; 55: COUNTY OF CUMBERLAND ) Emm~tt G. Bibb, b~ing duly SWurn according tor.lW, d~plJses and says that the averments of the within Compl.lint are true imd wrrect tu th~ b~st of affiant's knowledge, infllrm.ltion and belid. ~tt .IJ.l1;.n imml'tt G. Bibb Sworn to and subscribed before me this the / ( I ,4.()--t'~ \,: l Notary - day ofF:"; .19%. / 1 I . r. /' ~J'- ! _Selli "... M. Co>..~triIY p,_ CakNt Boro CumC).l<' It {i'. Infy MvC4,)lTl~E"JoiIl'_' l"l} I . q1 j. ,. , 1', l J " I "..J\ II..:: 'd 't: 'j'. L: :~j I)."!, E~L J~: ~1~1-"11: ';7:' " 0'1 I ~ i.cUit't!ll Pr:flle !:: )0 :: j:~ SlnTE m~ HV1~fIL lHSURAW:E 1l~ :.I~E~,ll~ 1~AQ ~U:~ r:t~2r.~.lNin Pli ~"~r:'! ~117~ i7\~~~2! ~ ~ - lM-f-- , ;:.' 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M'~ SmLE~E!lT TO T:1!S EST!M!E MT 8E AU!HCR!~EC 3~ A STATE F;~~ ;CJLSTEo.. ~~rJCE: ~E?A!~S m THIS 'JEH!t.LE ."!IW ~f'~UI~E SFE:;:~r~ ~E~~!H~ E~tP~~T AS RECC"~ENCEa ai THE ~A~~r"CTV~E~. :JT:~ll~E ~f\lL~ 'iC/'!E~~: E ::.~s "'1~'r= :8..:1:.r:~ ...~:..l~.; :J~J,'~r~::, ",;~~:; /'" r';j!".':: ':C l'}~l), ~;":';:J~ >t,!,,,.::.;~r:JI Ii:! ~~j..~~ ~~:(~r,e~ FJge 3 ,/ J '---' , ~, J "! - ~. " ,. c '.' ., -' I .. ('. .. - ,. .. <: .. '" " ~ " ~ " . - '. ~ " . . ,. ;. ? ~ i [ I ~. , t t ! >- ! ~;:: >~: I tn;i ... 'J ,..- f ....;, "'.. ~f~ :!J-" i ;:u p~l [ ~:; ! {~ :; ... -' ., ! 13;:: ,';"Ie.. i vo- .., .. ; ~ ".. ! ,. ., f " i ,.. .. \ I I i r-' i I ~ .,... , ,.... I ~~- f ! OJ - r ., ; >2 ! " - > .. ,.. ", ~ - f .:: " .., " ). f o. 6'~ :J~ 0.: ,.',. - . ~-; -I~ ~ .: l"f", '. _..#i . '-1 NO 38-7111-178 POLICY NO 6970-837-38A 001 LOSS D~I! 03/28/95 DUH NO D~IE ~MOUNI 1 13 947033 J 03/30/95 $....3,192.79 I t ! EMMETT 0 SlBB & JUL9A T BIBB AND HARBOLD'S rORO 1201 ORAND A FLORA RIVE MECHANICSB RO PA 1 OSS-5333 38-232257694 COVERAtE COLLISION CLOMV) 400-2 13,192.79 ;(5 'ED 8Y Shelby R Senic ~ STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY PENNSYLVANIA O~~ICE PNC NAIIONAL BANK 62-15/311 COIr4COIl:DVlllE, PA Harrisburg 1].114 ,-! NO JATE :0 38-7111-178 POLICY NO 6970-837-38A 001 ClAIMVNII 561 03/26/95 BIBB,' . EMMETT 1 13 947033 J DAlE 03/30/95 VRA~ CalL/SIaN (lOMV) 400-2 53.192.79 I ..........................................Ex..\crL't THREE THOUSAND ONE HUNDRED NINEf't-TWO AND 79/100 DOLLARS $l;_I;~'_i:~~..i-~-rr""i~~7"i,; "'...".........~"'-,t_,..~u>:,'" ,'ht' ,! EMMETT G BIBB , JULIA T BIBB AND 1201 GRANOlA FLORA DRIVE MECHANICSBURG PA 17055-5333 HARBOLD'S FORO IIN 38-232257694 'VIN SSENI APPIOVED BY !I I;!. ~ I'~ 'j'J P.l,::i.: rt.! ~ ~~,\ ~,; ') C~::~:~J iJf ~ ~ C'. ~ I ~ Nt) LC:ii DA:E I 'i;',,~t:) J;J - /1 11- 11:3 Ij 'j i I J -;: l J 1 / ~?!3 / (J'j i;..j,\;. r ',d 1 1 I ) /'3 'J" '3 j 06/19/95 ~ It If It.lt It It *:3.j. 5:', 1.:.:1 1 " - I:J,.\' ',,; i:,\:: ;;.I.n O.l!TE tJ..~:J~();.D:;..E'n~l~) ,(.)~.I ~A{;C: r u. I,:.J NA P. 1') r.l),..; d 0: (.LSilIJRG Pr\ 1./'): J Ii : :) 1~ ,t~r)~." r ::...\:.\::::"j' Ja - 2 ) 2 2 5 -;" ').1 CO'JE;l~GE CGLLI~IC~ CLnMV) '\:IJ.$ ld6.H Shelby R Senle STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY pe:"~~nV.\~IA OFFice ~~c N.\ffOHAl.. B.lNI( 62-15/J11 CONCORO~ILLe. PA Inrri$burg 1]-114 1 13 378028 J we 06/19/95 '--'-'-' . CavE-trAGe' COLLI $10' CLOMV) 400,] 186.56 38-7111-178' 'O'.lC' '0 6970-8J7-38A 001 CLAIM u'll 561 OJ/211/95 B [aB, EMHETT .... ........... .............. ..."...................................elCACTL Y E IGHr'-SI.c AHO 56/100 DOLLARS ~ *..:t..". 8 6 . 5 6 Po/V I" 1I1( t",J,-fll! CLAIM NO PAYEE IIN AE,l4AAU C'EAleD BY ....I.... A .......,\ CLAIM NO LOSS DATE INSUAED HARBOLOS FORD ON ACCT 700 HR RT 15 NORTH DILLSBURG PA 17019 ~ OF EMMETT BIBB TIN 38-232257694 AuT. SSENI APPRoveD BY 38-7111-178 POLIC' '0 6970-837-38A 001 LOSS DA Ie 03/28/95 OUf! '0 1 13 949836 J DAre 05/04/95 AMOU'T $....1,256.61 ~~~~~G~!lFbiDN~~O~9 38-232257694 coveu~e COLLISIO' ClOMV) 400-1 11,256.61 Honique 5 Termln STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY PE"SYLVANIA OfFICE P'C HATlOHAL BANK 62-15/311 CONCOADYILLe, PA HarrlsbYrg 13 114 1 13 949836 J OAle 05/04/95 ,- coveT,fGE----- COLLISION (LOMV) '00-1 1'.256.61 38-7111-178 POLICY '0 6970-837-38A 001 CLAIM U'IT 561 03/28/95 BIBB, EMMETT .....................~.....~................EXACTLY ONE THOUSAND TWO HUHOAfO 'IFTY-SiX AND 61/100 DOLLARS $ '" Ii.'.'", 1 ~2-5'6:6i PJV tlJ Ih~ OrJ..rcJf HARBOLOS FORD 700 MR RT 15 NORTH D[~LSBURG PA 17019 II' 38-232257694 AUI. SSENI APPIIO~EO 111 '. , f ~ ~. .. j. ~ . , . ..-.,' ~. .- ~<.. A . ."...: :-...~ -, ~:i.'~~ ......... '"'-0-; , , I:' j l i. ~'. , . '\~ .. .......~ ','. "~.:~ - .' "",I .' __,:',:~l':.#.i,""" . \ . j .' r\ r,..J( "'- '" . --;jI':~' .'. ~, :,::~~ ~:~1 "...- .. -- - 1~ I. '01) ... "?:',*iIT1' "iIf'>:'~~ - . , , -'",- ,.. , .' 6(11!1# ~~"1i~I.Uo<".-:'!1II'- ;.iJr '~. .' ... ". ....: ~ . / J . .. ". .. . .:'~ ... .:f .' . - ....~..;. . .'. . ~ . .... . ..... _J> lJ""""'" , ."'. .f. 1.1 I }';;~kl1 I ~I .411 , , l , \ - .f. r" , . ~ ."1,. , I,.. '.", .... I , ~...' 'to !. .' I~ -.-- ----- -- . ~ ; ~. , --.~' ;~...~ . " ....~...' ~,z...'t.t; ,.,;;. , . .(i ~ ., . , .......1 ~ """of- . ';.,'.---~ . ..~r_ . '. .~~ .........J . ! ...~. - ~ "i ..:~):.'..- . 'J: -;. -,'r, , ~-' ... ,!",', . i J )'0'1 -,,' .~ I: i ' I '); : " r\ ,-1-",: 11r. .. . ~ I ;- h:l t-, ..~ 'i1.}' j,...' ~ . II L 1. 'l'; 11 i: L ;ie,' If',!';; fi! C hI" if 1 ':.r: " 'I; ,'ir ('. '* I ! . fATI' ",.' 'J."" " , I i ",I b 1-,,:. '. (j I ':'I~:d ~,"'::' H,~, ~l 1 r; h':";j ~'~.l ~,''''L .... H ,~, "i'i.:o f ( f i.l r 0- l' ~', r : j, I 'r! -; I~;", r ~ j ':' '!' ~ , - I,) t", w 1 t, h 1 /; ri'.1 d: ,>,! ,-1 ,-. f } ,::' .\ \;.:.; .t..,- At-ll: L.F~'T t'j;) F_:~!r"';<j:\f":!~'ln.:-_~ "_..1"0 " ,)~:'!' r,,'FFI'-F:... 1-:3 . ,':-If:, 1l:':' C'," /":. c, .. ': .', ~,' ~; .' ./-/ .L.,"~' !. . ~:""'-d~ /' ,"c- -.' . ~'.. ' ." ",.-".- - +- -- P.. ~!.,' ,_., .1. ;'". n-l.-. , -r' :/".:, Iff" , " ';".", ;fL.:, -. "! ;~ ',71",;' ,\' ,I ! ~: 1 . f' ,-,~. ~- I r"=' " ~~ 91, ,) "-)"; IA- G' ~.....-. 4.Sl/.rj . .10 DOUGLAS. DOUGLAS. DOUGLAS J7 W. HIGH ST. POB 261 CARLISLE PA 1701l TELEPHONE 717.24J-1790 W1l.LIAM P. DOUOLAS. ESQ. Supremo Coort 1.0.' 37926 x OEOROE P. LXJUOLAS, m. ESQ. Supromo Court J.D.' 61886 INlHE COURT OF COMMON PlEAS OF CUMBERLAND COUNTY PENNSYlVANIA EMMETT G. BIBB, PLAINTIFF 1996 - nnAAn. CIVIL TERM \6 GARY PATRICK. CIVIL ACTION LAW DEfEr\llANT To: Lawrence E. Welker, Prothonotary fRAEmE Please reinstate the complaint in this case and have the Sheriff attempt service on the defendant at 6280 Carlisle Pike, Lot 524, Mechanicsburg, Cumberland County. Pennsylvania. Date: March 25, 1996 DOUG,LAS. OOUG~ & OOUGLAS~_ by ~ I- 9?>~ Attorney or the Plaintiff ..... ~. . ) .~ i_ , . I . -, ; , 1 .,-, -" i ;-',.) 1:1 C'", ; t? ,::> ~;I ~M f~.." " I "." N _:! CO -~ \;.:. ", I ! I , I ~-L .1', I' I 1 W . , 1: ,-, i I ; ':1 , I 1 .' w . J i'I ;;1 , , I ,J l I id . , , " I r , " I " " , . ,I , , I n I .I , ~ < It ,j n J I \", ,'j i I 1 .I " Il t .., I I h I I , , lit ,- ~, 11 l I ,i' ATh):' \,1'\[-",' . '-:1': ~ I 1.1 11~ !.' "1 t l.'~ .=--,_'k. tl,:' ~.hl:'C,.:~tl:'rt.3 l,;}t~urn:. :.r, il. .;\ :- 'i r - : :::\ '.' r . ~\,.-: '.. L ': L ~;, i. . !. ' . r , ,. _~ ':1 .- . : ,:. ~. . - ;'~ (.\' J ',-',E!. [iF: F E~l", A ~1 ~'. ,fi r r, ..!i:JT "'F"I' ;\ ~ I : r' i;:': '..,1:\ E {"'I ~~'-I :\' r'I': \.f r TH j"HE ~.' . I)i:'~;' j \;. E. ,,' '7/:/ .. -, ....,./ / .-~!-:' - ~...-::.,;;~~~.""- i.' ..; h 'n~;'L, T:! U;;".- -" . .-".,;./ /~~ ":f7l'f" i' fr' '4_'__"_'~' 1\ ,'I " .. (.: i: i',' '.'1',1 ," il'l" I-)~.!:'.LN'; [.-:>f.1UGI,^::; ;'" ,:"n, a.. Qln-. '0 "~I. ~ /1 ~ 7(,. (+/~ Q. nt...i'e...... . >LOp) , , ,". J.~ . . DoulI..... DOUG"'. & DOUGLA' . . ""_NO. At IJlW eY .. ".... "..., ....... ... CM,-'..... I'CNHa.,,,w,NIA ,,-- ':,;:.: ,'>,.'" .... .. - --_:~:~ _...----<{.,J __ _ _ _JI! - ,~".'4 ....... . '"<' -"i~ ". . - " .~ .....llS. CFlll{CI': F. /)llL!CI...\S, III. 15(]L!IRE xnc l!{N EY I.l 1. n hi KH(, IlUUC,I./\S, lJUU(;I.AS &: LlUUl;I.N, 27 \Vest High Sl. p,o. [lux 261 ClrlisiL', r.l. 170Ll TelephonL': 717.2-13.17</0 Attorney ror l'lilintiff . Ef\If\IETT G. IIIBB IN THE courn 01' COf\IMON PLEAS OF CUMBERLAND COUNTY, PENNA. V5. GARY ['AmICK CIVIL AC nON LAW : NO. q(p - y'l G, c'/lJ"ll fe.( VV\ NOTICE You have been sUl'd in Court. If you wish to defend against the class scl forth in the f"lIowing pages, you must t.lke action within twenty (20) days .1fter this wmplaint and notice art' servL'd, by entering a written appearance persolhll1y or by attorney .lIld filing in writing with the Comt your defenses or t1bjections to the claims set torth against you. You arc warned that if you filiI to d,. S,), the case milY proceed witll\1ut you and .1 judgment nl<lY be L'ntered ag,linst you by the Court without furtllL'r notice tor any llloney claimed in Clll11pl.lint or fI'r .my other claim or relid requested by the plaintiff. You may lose money or property or other rights important to you. YOU 51 IOULD TAKE TillS P..\PER TO YOUR LAWYER AT ONCE. IF YOU DO NOT I-l/\VE A LA\vYEr{ OR CANNOT AFForm ONE, GO TO OR TELEl'HONE TIlE OFFICE SET FORTI r BELOW TO FIND OUT WHERE YOU CAN CET U,CAl.IIELP. Court Administr.ltor Fourth Floor Cumberland County Court House I Court House Square Carlisle, [',1. 17013 717.2.10-6200 " DOUGl.AS, DOUGLAS & DOUGLAS . "1\''- , . , , J",.- I I -, I' i ,"} . k '. r'l "., \ C. GEORGE r.. DOUGLAS, Ill, E~QUIRE Allorne)' ror I'I.lintiff r R\ 'E COpy FR , ' ; OM RECORD .; 1 ',.,tliI'O!1'J W!,e'i.Or. I hare unto set my hall<l , ::". ,-... if",,.. , ,'..,d. 0, :.111. ,,01;:1 ell Carlisle. Pa i' '-11..:_',1-'-. day of reb. , 19 clc; -. lw..LU J L~..!'2'!.:J .i) i; , ProlhooolarV .-_046. '; .! ~: '1J ~~ 1~ I;:;: j), "I E ~~ . !~: :.J."ll: : ~'i ,~c...: tt~l: PrJf:!c lC: Jj :: :~: r:-J ' . I STArE FAR~ "UTeAL IHSURhH~r l~S ~:'''E~,:~'i ~:~hO 'IE'. f,UttEE?lAH!) ?ii l~C'{\ (717: 77"9~:! ~ SJ ~ CM.1- ;. ' F:I ANY QliESTlCtlS mARDIN<; Tm WI"HTE /LEASE (ON'''';T Th, lHOIWED eLAT!S HANlJlE~ _.........._......___......_.._.__. C,.ay. A.,.".d 9,r RAt iOHO 3001131 "J: ,". ~:~ -: T,ce::f Lau: Ca!H1V'" (SFe:' J;lttJf l,:a~: 0:1/:9/95 DeJl,ctibla: 1S0.00 !"ure~: EIlI'PT Wi AJdr",: 1,01 GRANOlA FLOM OIl';E !ECHANICSBUAG P,l 1:055-5331 ~aae F~~nt: (?1~) 76e~'~QS ~- ~ ;;- - - "iteh.1l S"'II~.: 9la6Z1 Omri;',,': 1992 FOlD EXPLORER UTILITY 'iW: If!DUJlX9HUOSBIl1 L;e.".: ~1'I31 PA "Uug.: 11,5\5 OE,...AL!: 0 S.mh Ced.: DiUP Ort,",,: PCVEl DCCR LJCK, POIlER VIHOCi, POUER STEEilIIG, ':RUISE CONTROL, I-ODOR, v-6 ENGINE, I'UNEEL DRIVE. (F 8 - ? :.e," ~..: LPd :::t,'", Later U11e !tn Par! T,F'! Oollar Lobar m Nc>bor !:ia. ~'B-_ Q;.ju..ti:n Part tluoller 6lIQllIlL ILuiL 'lilOSOO FRA"E-AOO'L LAICR O/R'UNTIODYIFIAHE !H(LUCIHG SETUP SUILET 188.00' 90050'! BCO'( -.cO'L LAlOR IlfR'RUST COAT ..QUAl RfPL PART 8.00' 0.3' 9105:)0 !lf0H 'A~n L.ICCR OPR.FRT SUSP,HS!Dtl AllGH~nlf SCBLE! 39.00' ,;urQ iOD', O':ElHAUL m IU"?[R r,ssY 1.5 \ 01)[000 BG~Y ~E~Gl.jE,I~EPt"CE F~T IU"PER FACE BA~ F3f! 11751 C 277.05 ItKL I ijl):0e:) 3DDY RElO'ifiRE?L,10E L FRT SU"FER HOUNTING AR~ FlTZ 11m 9 71.B1 INCL J~ 1 ~ ,~~ :CC'f RE~CIJE 'rtE?lrtCE L m IIJIIPEi PLATE Fm mass A 31.25 INCL 1~01 ~ ';0 980'( RE'evE/REPL.ACE FRT iU~PER I"PACT STRIP F1T! mmA 31.31 lNCL J ':o~:~u SCOt RElG':EiR[?Lil<:E FiT IUIlPE~ ':ALMICE FAliEL ESTZ 17S1S A 106.91 ItICL i') '~Ol::u SDOY RElC~EIRmACE FRl IU"PER STONE DEFLECTOR Fm l1i73 I 17.17 0.5 . 11 I~L'!J lff!H REf!NISH FRT srONE CE,LECTOP 1.0 " 1.l~:'~30 3CO~ ~:~G~IE:'~E~~,1r: FlT SL~PEl F!LLEi TO 1'"':1 EST! t7E907 A 71.23 INeL I " :"~:~C'J gO~'f ~E:'C1J(/~E?~JfE G?!~LE OR1lER m~ CEALER 156.59 IH(L . :. ':'J:S,}~ ecc'i aE~ul,E.i~ErL-1(E L rlILAlF SE::, mz mEI N \,.91 INCL I :l':C7'1 3CD" .~E'1G~'E ..cEc~.~,:: L ffiLrlr~ 11c~:r~~ Fl!Z ISI'll A 32.75 O.B I :; t~t. ~1 lODI (HE';,/AO,usr :jE';~U!"P~ 0.1 " JC:l:~ 9GDY ~E~Gt:E,'QE?~,l;.'E L PHRX/S!L;~Al, I'tl;~r:;~ l"MP "S$E~el y FiT! 13:01 C 37.53 ltleL .3 :1;::10 3DC'f ~E;'!C!~E. 'PEFLli(E L ~AP.KE,1 Lr;.~P ASSE:19U mz 15A,01 A 1..15 INtL : '~ 110::lJ SCO.f ~E.'a~'E/AE~L~C: ~ MA~KE~ LrU!P 3Ul3 CIA: I3ISO C o.s2 SHCL " J~:';O :~O'f ,~E'ArR .~cco ?qNE 2,0' :1 .U~l lEFlN mlNISH ~CCO !l'~rS!:E C 7.7 'U:"\O ,DC! ;E~CI'!E/~E?Ulr.E (OiJUHG R~l~;:R SLPF:Rr ,HZ 16139 E 111.68 6.0 I ., ,lUD ~E~!!i ~E~nHSH R"OI~r1R SUFPc;r 1.5 :' .(:~~(J :"!:':H 1E<4QI.'E. ~E'~MlE E;:AtU"~E \ .E(H,;F;E ,1:~ CCHWICNINr, .! 1.\ '" JC:490 ~r::i ,~E~Ct.'!,'QE?~,;CE 41R I;C~ ~E~QrGE,Mjr ~E'~c';n't -" 0.3 :s :'l:~l'i ~E(H iiE~C~F..ir..srl'l~ .l\!~ '~~IO ,~~tlCE~'SE,~ ." 0.5'1 :'!~CG:~ 9::0'" ~E~C')E, ~E~L,KE S;~!FE t~t; sc:v j~:S CRCER FRO" DEALE~ 63.10 0.8'1 ,~ ~. -" ,.,.. ~ -- >:..:. f~. n;'. :;.:; {1~ S; Pi'; G ~: :-~ :-." ;;~ ,';~ I:.. - - :.( ~. ~-' '-~ A :>..; t ... - .,. ' -" ~.. ;: ;:.:. e~ ~: . - ~: ..1":1: ~,.. Zi:, - - >::. ::':.t <'. r"~ ~,)~:~I;:t ~E:,1L~ 11~:~~::1: r:,:1:: ..':.~:... :i:.~:::-:43 "l.::~~:l ~,l~J ,:t'~,:..;,~: '"r.; _~~..:. ':.:;.r,r': .~' ::~:, "'1~:,~,C~~ i~t~r"JtIJ~,al Pas. 1 or 3 "" ~: i'.~! i I!::'C~ ,~:: JC..JtQ 80C':' PE'1C'.'E REPL;'([ L F~~C[~ P';~jL. ;w,G REFI~ !EFINISH l FENCE; aur,l" ;wfG REF!N 'EFINISH l 'ENO(R Eee: ;.GSr,~o sent ;E,~i':~ 'L HSOE~ L~NE~ fttit[.. ':'JSCSO BODY REm)~'E/RE?~!ttE L t'EHCER ~ErNrJR("E:r Hui') HEFrl1 ~SFnHSH :. 'E~CE~ REI!IF IO~SOO MECH '~OO'L L~eOP. OIF'FF,DNIOIL 005090 iO~1 ,E"avE/REFLACE L FENOEi ~F1CN ASSl 005100 800Y REMO~E/REILA(E L FENOEi RE~R ADHESIVE ~,La!NG 0caooo ",CH RE~OvE/'EFLACE L FRI SUSI SPINCLE 9C,}jcO BODY '''MOIJjiREPLAOE 'L I m llRE "'miALhIlCE emE1MENf . I !.1 m 1m "NmAL;oif :5,')') ~:la!~ SeD! ~[?ArR 'l~FT HINGE P:L~AR mw ,IEfI'I!:Hi'EP;!R LEFT HUlCE PILLAR 017000 eooy lEFAlR 'L FRT OOCR SHELL n,iO REfIN R(FINISH L FRI OOOP. CUTS leE 100500 500Y 'AOO'L L;BOR OFR'CH!' MAT 01921e 900Y RE,~OVE.'!E?L^CE L FRI OOO! AOHE3!'!E "CUL"HlC AUTO REF!H AOO'L LABOR OIR CLEAR COAl 99EeOl AOO'L COST TOWING AUTO AOO'L COST PAIHI MATERrALS , J~dgelent (te. I L,ccr Nate Appli" C rn~l~dcj .n CleJr C:Jt CJlc 2:1 ,'J '.' 3,. J5 36 r: J3 -ll 1: .~ 1 H 15 \0 \7 19 !\wr!l ~.f) !!nlli Jlli 27.3 30.00 13.\ 30..JO 3.0 JO.OO labor SlJbtot,]l LJt;~ fa. f 5.00~ lJt~r :~~IJrJ T~tal~ 13.1 !. Labor Subto:al~ ecd, Reflni~h l'le::h~r.icJl II!. Addittcnar C05t3 r J',.Jb1e C~S~1 SJle: TJ~ i 6.CC~ X;:r,:J...Jb:~ ':;~t.s T;~Jl ti::;1:tlJnJl C;:lSt3: (~~t~Aer "l:'~J~~C: ,1.00 h~Fe:ti~"'\ ~~~~: ~::Lj :s~. ~3~ ~et Total: ;l=iR,t ;f !"F.!~~: :~ ~~~1' F=CST ,~~~Ijr.i ~~j~ Sh~p: H~;:Ct:S FC~~ I,!,II m.co 402.00 SO.~O I,Jll.CO i8.cS 1.jE~.~5 A,:unt Z~1l.;:C lZlS 35..:,: '~H.~6 C~,t:~~r ~~~;;~~~~i::~f: .. ~ . ~~ =r:"-,,' :: ~:;. ~ ..:: -f ,', r:~: I ~::'.: ,\ -M ..qUAl ~EF~ p~~r F3TZ lE.j5~ A F HZ 15M3'} At FOr: 31:1 A II-QUill ;'EFL p~G ~ .-QUAL F.EFL FARf ORDER FIC~ CEHlER , II. 'Jr~ R,ploc,..nt Suu,ry r."blo Port! Par!. Ad)",!",! 10.00. S.lo. I" I ..001 fct31 Repla::!!I!!~,t P,):"t5 AaOlJnt: 1. 1,!.1 L,cor: I!. Total hi=L~ce'.e": rar~3: II!. T:tat A~d!tiJnal C~st~: '.110343 :ctJl: E~:::'!ME 4~i:illL tlL~?G: ::.-:~. jS ~~;J::SE :2-7tll~173 "1~'::-C~: ~JtJ t.'c:"~i~~: ."1~S gS :; ~':PH:jr.t ;:::. l~~~, ~1~.:h~~; !~:~I"J:::r.J~ ~;. ~:~~.: ~CJ~f_e1 . " " .j .., "j ::':.0: :,j 1 1.5 J.I;1~ ::,7~ 2.0 ').0 30.00" :\,68 0.3 I 13,37 0.1 190.13 o.a I 79.00' 0.)- ..:3 1.1)' 1.0- 4.5'1 C 1.9 5.00' 0.3- \1.65 0.2 1.9 35.00- 201.00- " ! ,,;~ 0' > , i~ - ~. ~ ::;:" (IE Ataunt 1,851.39 150.;'- I02.H l,e09.25 .. ....,_. =<- >;; ~ ?: ....:;.: 'T';,- ~~ :: c.~ n= ,..~, >:J :-c ;~ "'- 3.-: ?i3 .:..,... ,.. - ::: - ~ 1,389.66 1,809.:6 2\8.0. ~-: ~~ ~.~: 3,\45.!8 3,19:.79 I ~ ~~ -~ :;- > "- ~~ ::.~ ~ ~: ..,-:: >:: ;::- 1: J~ P.!jI 2 af 3 -.. ~~ ::;= ~ - " -:i:.: ~" "~., ".-:; ....- Z:~ ~ . >" -- :'0 m~ ;:. ,,"" ;', I. 2: . ~ ":. ~J';. : ~ : ] j " 't. ::':'! ::': :e.":::-r"! " C;i1 ~~,~': ". ~,. I. 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"'.- :'t (/)"'e ;::1 '04:"'1 ,.,~ -nr= ~~ ~u eE ,:~ ~,':; -"l is::: ~r; "," z~ :; ; ~= <0, r2 ~ ,I", I.... ~_. ... ,,;: "' >~ .." ...- >~ -,.. ::~ :>z :1:- !':'J1 .-,:' ~,.. i-:; C\: =" :!",: ~~ "'~ ,..- ~l.:~~;. :JtJ ~er~;:~: ~~~ ~5 ; '\'i::,r;'r.t +:Ci l~gl), ~:~c~cll :;".tl!t'''')T:1~r.J~ ill: ::1; j".~~ ~C:l.lr .e:: P.~. J ~I 1 "i: ~~ ~~ 'it ::;r!i1ti~E ~l\ll~ ~lU1'H.,: J';. :~, ~S :1 :J::55 :S....l:: .r,"e \ 1 ',j .'1,," T,", :; 'U~.. j :-::.u;; j j f rAl ~ ;:-_.ti~ /oj') ~ :i; Cl.t T ~ : 'j ;'.~[J ... j:-; - I 1 1 1 - 1 I J ,'.1 "''I i) ') l i; - ,:, i " I) '> / ,!;~ I 'J'J [Hi-HI,..I) 1 1 J j laU28 J o.rE 06/19/95 AMCl;~ I $ . It " . . If " 8 6 . 5;" , . . ):,."\ 1)111 l '" (1'\:'. fl.',l.j()~ Wi FI-:Jf/Q Clil ,\I.'l;T (J.' ~>1:1~l'r B:~HI ,:j! !"\:~ Ri 1 =, Nr:J:;r~i U r ~,L5:.il":H\~ PA 1 };) t J CO'JEUGE t.:JLLISIG~ (LOP'W) 400,) 58..\' la-2J22576r).; Shelby R Senic STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY PE~"'SH,V"'H" OHICE Itlr;C H4fIO~Al. 8MU( 62-1'/111 C~N(Q~O~ILLE. PA Iflrr'i1bur1 1)-114 1 13 378028 J DArE 06/ 19/95 ----. 'COIJEAAc.e COLLISION lLCHV) 400.] 586.\' 33 -7 111-178' 'OIICY '0 6970-837 -) SA 001 CLA'M UN' I 561 03/28/95 B r BB, ENNETT ............... ...... ...............................................elfAcn 't eiGHTY 'SI:C AND 56/100 OOLLA"S $ .:'!~,~_~~..~_,~,~_.* 8,.6 1t.5 6 P.l~ ~" //!,'!' I), f,'f,-f CL"I" NO PA1EE llN ~eM.AiI.(5 t:kEATEO BY "."'''. A ,........\ CLAII4 ".0 lOSS OATE INSuRED HARBOLDS FORD ON ACCT 700 MR RT 15 NORTH DILLSBURG PA 17019 OF EMMETT BIBB TIN 38-232257694 AulN S5 ErH ~ A"ROVED IY 38-7111-178 6970-837-38A 001 03/28/95 1 13 949836 J 05/04/95 $....1,256.61 'OLlCY '0 LOU DAlE DUf! NO DAII AMQJN' J~2~~~~!dF~iDN~~~~9 38-232257694 COVERAGE COLLISION (LOMV) 400'1 ".2~6.61 Honique 5 Termin STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY .e"SYLVA,'A 011 ICE 'NC NA'IONAL .ANK 62-15/311 COHCOROVlllE, PA Harrlsbur9 1]-114 1 13 949836 J DATE 05/04/95 coveUCE COLLISION (LOMV) 400-' ",256.61 ~ 38-7111-178 .0LlCY NO 6970-837-38A 001 CLAIM UNIl 561 03/28/95 BIBB, EMMETT L .....I...............,......................exACTLY ONE THOUSAND T~ ~ND.eo 'l,rY-SIX AND 61/100 DOLLA.S $'i".--'~dIIDJ .;t,LIIIilW(:j;oi" P.I~ I., Ih~ O,.J<f III IIARBOLDS FORD 700 MR RT 15 NORTH DILL5BURG PA 17019 "N 38-232257694. .uIN S5ENI AP'IOVED BY ~ ..rJ ~. .~.. . ...;.... ..... ........'. ....~~ ":'-~... . 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