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MINUTES - 08052003 - C.30
CLAIM BOARD OF SUPERVISORS OF CONTRA.COSTA COUNTY • BOARD ACTION: AUGUST >0-51_ 2043 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note ail "Warnings°'. AMOUNT: $661.00 l > CLAIMANT: JUNE GARRINGER ATTORNEY: UNKNOWN DATE RECEIVED: JUNE 23, 2003 ADDRESS: 5550 ROLANUA STREET, BY DELIVERY TO CLERK.ON: JUNE 23, 2003 LONG BEACH, CA 90815 BY MAIL POSTMARKED: JUNE 21, 2003 .FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETE , I Dated: JUNE 24, 2003 By: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. { ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 914.8). ( } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( ) Other: Dated: ' By: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2) { ) Claim was returned as untimely with notice to claimant(Section 911.3). IV, BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUGUST 05. 2003 JOHN SWEETEN, CLERK, By , Deputy Clerk WADING (Gov. code sect' n 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, You should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of penury that I am now, and at all times herein mentioned,have been a citizen of the United States,over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated. _ AUGUST 06, 2003 JOHN SWEETEN, CLERK.By Deputy Clerk June 19, 2003 %' y Silvano S Marchesi County Counsel Contra Costa County JUN 2 3 20L1 651 Pine Street Martinez, CA 94553 CONT cOTA���RD 0OsACO,�s s E Re: Claim for reimbursement for damages Dear Mr. Marchesi: On March 26, 2003, a limb from a tree located on county property between the sidewalk area and Wellington Street, in the terrace area, directly beyond my property line at 241 Wellington Avenue, Clyde, California 94520 fell and did damage. Mr. Thomas Wright of Mr. T's Construction Company who cut up the limb and deposed of it said it weighed approximately a ton. The tree did damage to a wrought iron fence. I am requesting reimbursement for the following: $361.00 for cutting up the tree and deposing of material, and $300.00 for replacement of wrought iron fence section. Additionally, please see my request of May 6, 2003 to the CCC Public Works Department. This tree needs to be removed or to be trimmed. There is another heavy limb that if it fell could do damage to my house at 241 Wellingon, or damage to property at 237 Wellington. If the tree fell it could do more damage to vehicles or property or injury to people. Please call me at 562-7956146 if you have any questions or if you need anymore documentation. Also, please call Mr. Wright or Eagle Iron Works if you need additional information. Your cooperation is appreciated. Sincerely, June Carringer 5550 Rolanda Street Long Beach, CA 90815 cc: Check and bill for$300.00 to Eagle Iran Warks Check and bill for $361.00 to Mr. T's Construction Company Acme Fill receipt of 4-28-03 Acme Fill receipt of 4-28-03 3 pictures May 6, 2003 letter to CCC Public Works Department r "F tw f� r Imms Was of a 4:7 Y got AN } Ms f f f k� iff i tib . k a MIMI As to ru a „. _.: . ..... .-. 1 f j } ..........H - .., .. f . 4 {: # f. 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MR.T CONSTRUCTION Tree ltemaval Electrical Ypoatat Might p1 mblas x Feoeln8 Deets 254 W6111189188 Ave. Comorditiyde,CA 04525 Lie.#848027 (825) sst-0805 p's 1 Fli LL CN TO ... Ly 2 pot- -nN _ .. C X5� `'� h CN I "o-c' t Ll i F � k r _.a `rs c 3. rl i .,. � 1 ' r f :� f ' R ✓ . ` : r FOY x �ypr c. �. N 7 »:na',r�`'tel �fi✓ w f „,�.-r :t�� k�4 iS , •y�r y-r , , 4. c% s ,c ..^ x / :< y lW f y : x r / L � 3 s: k -y 4 t. %' 'Ur'rir rtrrW % rof rfrrf%{ ,4{ r Vg", : A ✓. J�f .. �d.6' R' ¢y r�,�q rte{ l�. c z 9 • fir✓ � >4'iJ`f�Y, 'E " : ?k <:::,�'" f; :fff•,/rf ,.fir . F sit"R V.. i r IF •; COMPLETE THIS SECTIONs 0 Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. l:t Agent ■ Print your name and address on the reverse X 13 Addressee so that we can return the card to you. g. Received by(Printed Name) C. t iv • Attach this card to the back of the mailpiece, _ or on the front if space permits. 1. Article Addressed to. D.Is delivery address different from item 1? C1 Yes Wilt, if YES,enter delivery address below: 13 Na 3. Service Type Certified Mail d Express Mail {h° Registered 0 Return Receipt for Merchandise n o\ 13 Insured Mail ©C,O.D. 7'7 Jam + 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number (Transfer from service/abet} 7002 0860 0 007 0 414 8016 PS Form 3811,August 2001 Domestic Return Receipt 102695-02-M•1036 May , 2003 M . n Yee - e Division Mai :.......... a ,............... � er { Maintenance ena Division x v. .. Public •Y u b€ V Works Department :..,..., - Cont } F r Costa 255 Glacier Drive Martinez, CA 94 553 ;.:.}'.:}}: ................... .. su Sin } Dear Mr. Yee, .:.i :...:......c ... ...... ..... ......,..:.... ... Last Friday,y May 2, 2003; 1 left telephone massage a the ttrentxbl1 Works telephone numbers, 313-2220, 313-2000 and 313-?'t�00 n rag d t t I.W6` . large trees near my property at 241 Wellington Avenue, Ctyde, Calo'nia 2 . Although, these trees are not on my property, it appears that if they fall,they would do significant damage to my house, other people property, including vehicles, or worse, injury to people. Therefore, I am requesting that these trees be promptly removed and trimmed to prevent any damage. Furthermore, I've noticed that there are other trees in Clyde that should be trimmed or removed to prevent any potential damage to property or life. I appreciate any assistance you could provide. Please contract me if you have any questions. Thank you. Sincerely, .lune Garringer 5550 Rolanda Street Long Beach, CA 90815 562-795-6146 cc: Centra Costa County Board of Supervisors CLAIM BOAAtD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: AUGUST 05, 200 Claim Against the County, or District Governed by ) the Board of Supervisors,Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California.Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and f' 915.4. Please note all"Warnings". AMOUNT: $8 ,003 . 73 CLAIMANT: CALIFORNIA STATE AUTOMOBILE ASSOCIATION FELLY SEYMON FOR: HAROLD L. OR ELISE M. LAWTON ATTORNEY: UNKNOWN DATE RECEIVED: JUNE 24 , 2003 ADDRESS: P.O. BOX 920 BY DELIVERY TO CLERK ON: JUNE 24 , 2003 SUISUN CITY, ,CA 94585-0920 BY MAIL POSTMARKED: JUNE 20 COQ FROM; Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET , Dated: JUNE 24, 2003 By: Deputy II. FROM: County Counsel TO. Clerk of the Board of Supervi ors This claim complies substantially with Sections 910 and 910.2. { } This Claire FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). { } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { ) Other: )IDDat : By: Deputy County Counse III. FROM: Clerk of the Board TO County Counsel(1) County Administrator(2) { ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER.: By unanimous vote of the Supervisors present: (X) This Crim is rejected in full. { } Other. I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUGUST 05, 2003 JOHN SWEETEN, CLERK,By ,Deputy Clerk WARNING(Gov. code sectio 9.13) Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or depositee in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United States,over age,18, and that today I deposited in the United States Postal Service in Martinez, California„postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUGUST 06, 2003 JOHN SWEETEN,CLERK By Deputy Clerk 'JUN-12-2003 09.23 CCC RISK MANAGMENT 925 335 1421 P.02 Claim to: BOARD OF WPERVISORS W a3HTn =A attR 1 y A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented .not later than the 100th shay after the accrual of the cause of action. Claims relating to causes of action for.death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later* than we year after the accrual of the cage of action. (Govt. Code 5911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, Ginty Administration Building, 551 Pine Street, Martinez, CA 94553. C. If claim is against a, district governed by U,�e Board of Supervisgrs, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E.' Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this RE. Claim By } Reserved for Clerk's filing. stamp RECEIVED Aga nst the C=Xty at` Mat Costaor � JUN 24 2003 District) C`LHK BOARD OF-SUPERVISORS iz1 name) CO NTRA DOTS ACO, The undemigned claimant hereby takes claim against the County of Contra Costa or the above--named District in the sum of � ��.��I -3 and in support of this claim represents�as follows: 1. When did the dam p_or injury owur? (Give exact date and hour) 2. Where did the damage or injury occur. (include city and county) ('fn Yi p.k,LA aq AV tru-VLK 5 .,_...s 3. Hou dial the damage or injury occur? (Give full details; use extra paper if required) ' A. Nhat particular met or sion on.thft part of o0unty or district officers, 3 ervants or.employees caused..the.injury or.damage? ',TLH-12®2003 09.23 CCC RISK MANAGMENT 925 335 1421 P.03 wnat are the names of county or district +officers, servants or employees causing the damage or injury? L"LL-42 .... ,..,..r.o ` a w dir) 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the ammmt claimed above computed? (Include the estimated amount of any prospective injury or damage.) �.yfn.iY.a.. .iFw+..i..r�i,�� w.W..i+r.i i.i4..q�.w•aw..a 6. Names and addresses of..witnelfses, doctors and hospitals. 9• List the expenditures you made on account of this accident or injury*. DATE ITEM AMMWT Gov. Code Sec. 91042 provi..des: . #The Claim mast be signed by the claimant SEND NOTICES TO: (Attsarrsor by sow Derson on his.behalf." Mame and Ad ess of Attorney 1 igna,ture e0 Address, Telephone No Tel.ephgne No. �. ULa/ C NOTICE Section ?E of the Penal Cade provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any minty, city or district board or officer, authorized to allow or pay the 3=0 if.genuinet any false or fraudulent claim, hill,, account, voucher, or smiting, is punishable either by imprisorisent in the county „fail.-for a period of not more th4m cme-year, by a fuse of not exceeding one thousand ($1.,000), or by'both such. IMprisonment and fine, 'car by imprisonment In the state prison, by a fine of not exceeding ten thousand dollars ($100000, or by boas such imprisonment and fine. TOTAL P.03 "JUN--12-2003 : 19:23 CCC RISK MANACMENT 925 335 1421 P.01 County Administrator Risk manargstnent Division Contra. t t}ra 2530 Ahold t)M,SUKee 140 Gaeta Martinez,Calitomia 94553. r,% 1�j �� �tlsk lVas�sgeai Lt Administradon (925)93S«1450 ra Fax Number (925)335.1421 m ' 24Ul L Ctsw Car; FACSIMILE-TRANSMITTAL. Rv's �s DATE: „ " . f T0: FAX NUMBER. NUMBER.OF PAGES TO FOLLOW: REMARK. FROM. tPL-2 TELEPHONE NO. (925) 335- � California State Automobile Association Inter-Insurance Bureau f?O B=3x20' . Suisun City CA 9$585-0920 June 20, 2003 Contra Costa Risk Management 2530 Arnold Dr.,Ste.#140 Martinez,CA. RE: Your Insured: Kemp Duamonte John Paul Vaughn Your Claim No.: unknown Our Insured: Harold L Or Elise M Lawton Our Claim No.: 14721159-2 Date of Loss: 03/17/2003 Dear Contra Costa Risk Management: This will confirm our subrogation interest arising from this loss. We have settled the claim with our insured and based on the following facts,request payment directly to California State automobile Association Inter-Insurance Bureau (CSAR-IIB): Your employee/insured,backed out of the driveway of 3545 Cranbrook Way,when it was unsafe to do so and collided with our insured vehicle. He is in violation of CVC 22106-Unsafe Backing. Please refer to Police Report #03-6824 enclosed. This is a clear case of liability. Please submit payment immediately. Documentation to support our claim is enclosed. Please issue payment of$8003.73 for the following expenses: Repair Bill $7,853.73 Deductible $150.00 Loss of Use $0.00 Tow/Storage $0.00 Miscellaneous $0.00 -------------------------- TOTAL $8,003.73 Please be advised that any payment in an amount less than that set forth in this letter that is forwarded to CSAA without its prior authorization as described below will not constitute a full anti final settlement and will be accepted as partial payment only. Since payments received in the mail are processed by clerical staff and deposited as a matter of course without examination,unauthorized payments for less than the full amount demanded may be processed inadvertently. Although such payments may be demarked as"payment in full"or have other words of similar meaning written on them, their processing will not constitute an accord and satisfaction,as CSAA has not agreed to acceptance of such payments. Only an authorized Subrogation Specialist may communicate,orally or in writing,CSAA's specific agreement to accept an amount less than that demanded in this letter. Sincerely, Mf �Wna/m Subrogation Specialist 925-521-5030 Enclosure STA'Mo,W4. 2003 8.20PM LCIS REPORT SERVICE-6022710160; No.4714 P. 38/46 TRAFFIC COLLISION REPORT ,. " tt CHP 555�W t{test."7) OPt 042 , Page 1 w SPECiM tYrFICITG7Ns MOWCRY "DICIAOM37}E m LOCAL REPORT PRNNSER ,,- t,*S - T5 t a ,51 w„x WEPDRTINODIBTRICT 0 DALIiEKkiOCCLYtR!&D OH M0. DAY YEAR TME` None POR ml o w 2 0-70q 0 DAYOFWWK TOWM"Y PHOTOGRAPHS Ify., I<— S&)T W T F S 16 YES No FEETrMrLEs OF 0AT tNTERi9EC'TION MTM } �e 1 sTATE NYW mn Otk �N1LE8 co � � ib 1 YES lK NO cmrum NytPsMKYILL':usTt -- _--_. OMDRAW"NAME� � PdRd3t tdTY}t4YATEtzIF f +J Osa1+6 rtti r�F ttiCLEOPte7RD�Rs 'M OFFtCEAg DRIVER [:]OTHER vtl)ICT• YR EYES ¢ 16_t4T� &tIiTNM/TY��J,�p� ® wr `d PRIdRMBCHAtNCALGEFECTS: NDI+fEAPPAfRBfT ftEFERTONARRRr�TIYE MEN HOMECUSlHESS VEHICLE IDOMFICATM NCLMBER: � CHP US9 ONLY (D'ESSCRIB�E VEHICLE DAMAGE "DE IN C AD D AREA DI CY.f'7RhVE4 dN dR H NrV $"ED tSMR CA COT I ter.✓ r � OAE.T TCP1PIic-McAvC„ PARTY E.hpSfS NVMEg.R TE CU88 8AFETY VETT.YNAR 00SUCOLOR UCENBE NUMBER STATE 2 CA 00m NAUX(PARSTMWOM'Asn ------ NAME— i...USE vmNEtrB NAraE ( ! SAME A8 DRIVER MW ST-REE)TADDREStS, {-T4 Tao G.. Y 1 .. r awHE1Yg ADUItEBe SAME AS DRIVER rr�Ran aT>�rzw i { Dt8P08RKNf OF v�EayH+IyCL�L=�dH aRD>/eRa dI�*F� J`� 11 OFFICER DRIVER C]OTHER BICY NEiaw nw BIRTHDATE PACE ���"'mow+. X.,..i!F^�f++ PINTDeT Yei PR1aR RrE:t,KANtCAL DEFECTS: Nth APPARENT REFFA Til NARRATN'E a HOMtl1 '}4 SLAWE'SSPHONE y VW40I.P IDENTTWICATION WA*ER: C"Use ONLY DE8CR=VEWLE DAMAGE SN AM IN 0AMAM AREA WWJP�A TCE CMR" PduCY NLIMSSR VE}BCA.E TYPE 11 UNK. 0 NONE �MINOR AAA } /N""''lA/•»lc .�..i G. 10MOD. L]MAJOR ROLL�OVEN CUR OFTPAVv-ONSTRWTORHtcwty.Y SPEED LWr > CA GOT a e cu,.T _ ._......TcwPac PARTY D"We I.IC ME NUMBER STATE GABS SAPkTY VSMK YEAR ! m Lc0LIIR NSE NUNASER STATE 3 �7rg+TD y'gt r,IsC�+' Ay�P"! 7}� MOP. - !-•.- -- Me NAME rFiRSr MIDDLE.LAST) yT'cON R1J1»r'k.+#.`Nl/Di CUM i 0 7+V LIS w,e ty,t c�WK S{NAMEE t t�l SAME AS DRIVER STREEF ADISS �N"aJ �F�:.i t..�'�'4/ �3h if 1� Released to: �BADDRi S8 + AS D`RIV�E�R (; PF CITYISTATf ar • ' " �++N swr`>j �w.. Released by: sSPOSRION OF rt N Oft>BtS OF: K DIGER DRIVER OTHEh T X JHAA JEYES YE:FDNT SiRTHDATE RACE t, - A Ma. D" Yuen _ -1 El PRbR MECNAMCAL DE ROM NDNEAPPMW RF}E'R TO NARRATIVE aTNEI PHONE 8 i FIiD#E V@MOLE tiSE}itWiOATK4N NlikN{€R: i.� CNF Ub!OHLY DESCRIBE VEHME DAMAGE�t SHADE IN DAMAGED AREA INSUNANCB CARRIER POLICY NUMB" Vem"e TYPE [D UNK 11 NONE []MINOR ' '��• I MOD. MAJOR ROLL-OVER f ti I Ok OETRAVELJON STREETORWOHWAY cetSPEED�+�UUmiT > CA OOT 14 CAL•T TCP�PSG_.._.........,,,,,,,,.NK .+C>..�,... ._..,. {{ DFSPAT TWIED REVIEWER'S NAME DATE REVIEWED � � 4 t,YES []NO []WA ��--'- ,+ I Apr . 4. 2903 8:21PM L&S REPORT SERVICE 6922716161 No'4714 P. 39/46 STATE•OF CALIFORNIA TRAFFIC COLLISION CODING +� CHP 565,?Vo Rev,!M OPI 042 OATH arCCXk#AlpN"a TIM � ! t„J� OFf'#GER I.D. NUM46J@ l/✓ j 4✓S✓ dYVlfCR'A N4A#E C7V4lVER'A AGDR@88 t1t}TR"}£i7 PROPERTY v€s ND DAMAGE DncmwncN of c mAw SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE PANTS L-AIR SAG DEPLOYED DA t C BICYCLE-HEIMI=T A- CHICLE M-AIR SAG NOT DEPLOYED 0:NOT EJECTED B-UNKNOWN N-OTHER DRIVER t-FULLY EJECTED C-LAP BELT USED P-NOT REQUIRED V-NO 2•PARTIALLY EJECTED D-LAP BELT NOT USED W-'LES 3-UNKNOWN 1 2 3 O-DRIVER E-SHOULDER HARNESS USED 5 6 2 TO 8-PASSENGERS F-SHOULDER HARNESS NOT USED CH ILD RESTRAINT PASSENGER 7-STATION WA'GAN REAR G:LAPISHOULDER HARNESS USED a-1�V E D X-NO 8-REAR OCC.TRK OR VAN H LAPMHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED Y-YES 9-POSITION UNKNOWN J-PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN ( 7 4-OTHER K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U-NONE IN VEHICLE I FE#h8 MARKED SEL OW FOLLOWED BY AN ASTERISK(`)SMOKi D BE EXPLAIFiED IN THE NARRATIVE PRIMARY NAFALIST NTRAFFIC CONTROL O�CS MED PR EDING7I2 I OV C } A rJ ,C> CMB rs 3 CONTROLS FUNCTIONING A PASSENGER CAR t STATION WAGON A OPP # ...GGG CONTROLS NOT FUNCTIONING, S PASSENGER CAR W/TRAKERL3 PROCEEDING STR41t3 T B OTHER IMPROPER DRIVING. C CONTROLS OBSCURED C MOTORCYCLE I SCOOTER I C RAN OFF R 612 ,. D NO CONTROLS PRESENT I FACTOR" ID PICKUP OR PAN L TRUCK MAKING RIOT nft C OTHER THAN ORIVER- TYRE OF COLLISION E PICKUP i PANEL TRUCK VIA'TRAILER E MAKING LEFT TURN i D I,N,#KNOM* A HEAD-ON P TRUCK OR TRUCK TRACTOR IYL0.KING E FELL ASLEEP' SIDE SWIPE TRUCK/TRUCK TRACTOR WI TRLR Ci BACKING C REAR END H SCHOOL BUS H SLOtMNG t STOPPING WEATHER OA48K I 1 O 2 JTS f$ D BROADSIDE OTHER 9U8 ) PASSING OTHER VEHICLE CLEAR g HIT OBJECT J EMERGENCY VEHICLE CHANGING LANES }CLOUDY F OVERTURNED mawAY CONST.EQUIPMENT K PARKING MANEUVER I C RAINING G VEHIGLEIPEDESTRIANL BICYCLEI L ENTERING IiAFf1 D SNOWING H OTHER`. IIA OTHER VEHICLE AM OTHER UYMFE TUR INC . FOG 1 V ESI33##TY FT. N PEDEBTR#AN N XING INTO OPPOSING LANE F OTHER" MOTOR VEHICLE INVOLVED WITH 0 MOPED PARKS IQ WN12 A NON-COLLISION P M RG#NG LIGHTING a PEDESTRLAN QTRAVELING WRONG WAY DAYLIGHT C OTHER MOTOR VEHICLE 9 ;2!3 OTHER,ASSOCIATED FACTOR(S) R OTI LER': B DUSK-,DAWN D MOTOR VEHICLE ON OTHER ROADWAY (U4RK t TO 2ITEMS) vcs�cnaslvnflH cxra .0 DARK-STREETLIGHTS E pARKIrDMOTOR VEHICLE A YES r) DARK•NO STREET LIGHTS F TRAIN ISI E DARK-STREET LIGHTS NOT G BICYCLE snanaa wausw+t On** YEA f FUNCTIONING' ANIMAL; t ^J SOSRIETY-DRUG 1 ROADWAY SURFACE ' ,�r va secT+on wain crmv I C OEs 1 2'3 PHYSICAL DRY I FIXED OBJECT. 1 (MARK f TO 2ITEMS) B WET A HAD NOT BEEN DRINKING C SNOWY-K Y OTHER OSJEC'I., E VISION OBSCUREMENT: 1 B HBO-UNDER INFLUENCE ID SLIPKRY imuoay.OILY ETC. tNAT"ENTK7N' C HBD-NOT UNDER INFLUENCE' ROADWAY CONDITION(S) I ( G STOP&GO TRAFFIC D HBO-#MPARMENT UNKAIOWN` (MARK f TO 21TEIrtS) PECORSTRIAWS ACTIONS H ENTERING I LEAVING RAMP ) 9 UNDER DRUG WFLU€NCE• A HOLES,DEEP RUT- NO PEDESTRIANS INVOLVER I PREVIOUS COLLISION IMPAIRMENT-PHYSICAL' B LOOSE MATERIAL ON ROADWAY' a GROSSING IN CROSSWALK L.UINFAMILIAR WITH ROAD G IMPAIRMENT NOT KNOWN OSSTRUCT#ON ON ROADWAY' AT INTERSECTION ! K DEFECTIVE VEH EOU#P CITED H NOT APPLICABLE D CONSTRUCTION-REPAIR ZONE C CROSSING IN CROSSWALK-NOT yps I fi PY I FAT# E REDUCED ROADWAY WIDTH AT INTERSECTION Hyp SPECIAL INFORMATION F FLOODED` D CROSSING-NOT IN CROSSWALK^� i I I L UNINVOLVED VEHICLE A HA7,AROOUs MATERIAL G OTHER': E IN ROAD-INCLUDES SHOULDER fM OTHER-. — F- H NO UNUSUAL CON TIONS NOT IN ROAD i r N NONE APPARENT I Q APPROACHING 1 LEAVING SCHOOL BUS 0 RUNAWAY VEHICLE SKETCH r k3i MISCELLANEOUS l IQ,57 �`f +� V 1 �� - I is Imo' a APr . 4. 2003 $:22PM L&S REPORT SERVICE 6022710161 No,4714 P. 40/46 STAATE`OF C IFORNIA TRAFFIC COLLISION REPORT CHP 50 a"I Rev.8-S OPI 042 P� SP€CIALOONfWMNa Nf~ 'enuw CI Jj=tALDW"WT LOCAL Wow MAISM tum Tr, "Wiltwu" WrAAUN i�YlowmjGT SEAT f 0y .' " COLUS$ON OCCURRED ON � MO. DAY YEAR OM 4144 NCI_ z • C2> Ic Mit1.P"OST SiPd1tMATION GAY OF V.E€K AWAY PHOTOGRAPHS SY- FEETMMLSa OP Nth U SAT W T P 3 YES NO AT ItiTiOT1ON YsSTH S#hTL°MPII REi t OF YES NO PARTY ORNERS UCENS@NUA4 tt STATE lct,4m lwmy t� SCR f LICENSE �l2jUl�AtB€R STAlC�A y NAZI!I�RSt,Afk7OLE iA57) l• -- f OV**RS NAM€. SAME AS DRIVER STR€ETAbOREBa # OVO4"ADDRESS SAME RS DRMR DraPowt aP v€Nlc ON ORts Rs oP: orF"R DRIVER OTHER SEX fihiR EYES HEIOHTDAY WE1GHt at 7E Y El OWK PRIOR Ma .ICAL,,FvCTS: NONE APPARENT REFS T(3 NARRATIVE "m HOMH PHONE mstNESS PHONE iCI.E IDaNT'IFtCATiON tiflMEEit CNP USS ONLY DESCRISE VIIH I=DAMAGE SHADE IN DAMAGED AREA vv"CLA TYPE INSURANCE CA"Ie't POUOY N WaaR + 1:1 LINK NONE XMINOR ;JIAdy- MOO. Q OR L]ROLL-OVER > Din OP VEL �ON STREET OR HIGHWAY aPCP.D l."T CA DOOirT ��t 00 � a CAL.7 PARTY DRiVERStiCEttffig NUM6aR STATE CLASS SA>•ETY VER.YEAR 'Im-76-0-0 SEtd-OLOR luc"7777 STATE BGUIP. 2 _ ___ ------------ --- ___ __- �WMfit NAME(RBST,ANOMA LAST} El OV*M'i NAME E3 SAME A$DRIVER KOM STREET ADOR'ESS t�,xe OMMS AOORESS Ll SAME AS DRIVER PAI CITYISTATE�C#P t�_.•.•tt f WSPOICTION Of VEHICLE ON ORMSIIF: OFFICER DRIVER f—I OTHER Way. 8EX lfAfR CYSS HEIGHT LMLIGH7 � S DAY7E Ybmf RACE j� PRIOR MSCHANIC.AL n CTS: pl M APPARM I PE£t(L?t EATW 6Tfi81 HOME t- i PHONE SUSINaSS PHONE VEHICLE WVNTIPtCAT18N NUMBER: CHP USE ONLY DCSCRISa VEHICLE DAMAGE SHIADIS IN D AMA[SED ARlrA INSLVAMICARM R POUCYNUMSER VEHICLE TYPE ©UNK, NONE MINOR MOO. MR3OR ROLt DYER L R OF TRAV�,ON STREW OR Hf~y VE20 LIMIT CA DOT PARTY ORNW8 UCEHS€NUMBER 8TAT1? CLASS SAFETY VEN.Y@AR MAKEIMODEL/GOt.OR LMENSS NuMSaR STAT€ EOUW. __ _ ....__-__ _ , . .. -__ _ _ . __ Dow NAME tpmT.ANL1'J A wn - El OWNE"NMW SAME AS DRIVER T" StAEET ADatroSS t"1 av4HaR 3 ADDttE�s SAME AS DRIVER PAM CITYISTATWIP YfSk1,i DISPOSITION OF VE►A=ON ORDERS OF: 0 OFFICER�DRIVER �OTHER CZE SEX MIR BYEB HEIGHT "ZIGHT � SIRTHDAtE Yaex' RAC & lf PR"MECHANX:AL D CIS: NONE APPAREidT REFER TO NARRATIVE y "OM FHONE Bus"&&PHONE VEHICLE VENT11 4CAMN NUMa@Ht clCNP USS ONLY OESCRISS WHICLS OAMAOE SHARE IN OAfMAOeD ARBA INSURANCE CARRIER POLICY NUMBER VIIH101.t TYPE ®UNK. NONE MINOR ElMOD, MAJOR ROLL-OVER DIN OF TRAVEL JONOMEET OR HfGHV AYSPEE37 L"r CA DOT CAL•T TOPA+SC DISPATCH NOTIFIED REYIEYIER`$NA I � DATE REVtE4N'EC7 73-yes ED NO C]NLA ✓ Apr 4. 2083 8:22PM L&S REPORT SERVICE 6422718161 No,4714 P. 41/46 STATE OF CALIFORNIA T�RAFFIC COL ISIONW POP Rev.8-97) PI CODINGor 042 F TS OF 00"M{trKl. DAY YEAR) TIAAL"Dam N=o df�iCSikt_Gt. NUMHIFt -. g ApIESkI NOTIFiEG t PROPERTY YES NO ! DAMAGE I E$MFr�N dF e S SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE OCCUPANTS L-AIR BAG DEPLOYED III t C BICYCLE.HELl41ET F �fEHICLE M-AIR BAKE NOT DEPLOYED 0-NOT EJECTED B-UNKNOWN N:OTHER DRIVER i•FULLY EJECTED C-LAP BELT USED P•NOT REQUIREO V-NO 2-PARTIALLY EJECTED D-LAP BELT NOT USED W-YES 3-UNKNOWN .1 2 3 t-DRIVER E-SHOULDER HARNESS USED 2 TOO-PASSENGERS F-SHOULDER HARNESS NOT USED CHILD R TRA)NT PASSENGER 5 6 7.STATION WAGON REAR G-LAWSHOU.DER HARNESS USED D X-NO s-REAR OCC.TRIC OR VAN H-LAWSHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED Y-YES 8-POSITION UNKNOWN J-PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN 7 K-PASSIVE RESTRAINT NOT USED T-IN VEHCLE IMPROPER USE 0 OTHER U-NONE IN VEHICLE Fin WARKE6 BELOW FOtj 4WEO BY AN ASTERISK C)SHOULD BE EXPLAINED IN THE NARRATIVE. PPJMARY COLLISION FACTOR TRAFFIC CONTROL DEVICES TYPE F VEICL2 3 PRECEDING LISTNUM OUR N OF PARTY AT FAULT � LLISION A %""c+s�tmmo ATC) aate>z CONTROLS FUNCTIONING A PASSENGER CAR I STATION WAGON A STOPPED G B CONTROLS NOT FUNCTION!W B PASSENGER CAR W I TRAILER 13 PROC EDING gMN T B OTHER IMPROPER DRIVING, C CONTROLS OBSCURED C MOTORCYCLE IRC—OMR C RAN R AD NO CdHTR{SLS PRESENT t FAGTi)R' C PICKUP Oft PANEL TRUCK _ M D MA T TURN (.OTHER THAN DRIVER" TYPE_ OF COLLISION _ E PICKUP I PANEL TRUCK WI TRAILER E MAKIN43 LEFT TURN {��}W W HEAD.pN F TRUCK OR TRUCK TRACTOR NG U TURNUNK FELL ASLEEP" — $SIDE SWIPE G TRUCK TRUCK TRACTOR MTRU:L G BACKING C REAR ENC! IN SCHOOL BUS IN SLOWING I STOPPING VATH£R RX f T8 z tTEfi15 BROADSIDE 1 OTHER BUS 1 PASSING OTHER VEHICLE iA CLEAR E H T OBJECT J EINERC"etICY VEHICLE J CHANGING LAt4E CLOUDY F OVERTURNED i K HIGHWAY CONST,EQUIPMENT K PARKING MANEUVER { C RAINING G VEHICLE I PEDESTRIAN L BICYCLE L ENTERIVG TRAP€e SNtYWINO H OTHER. M OTHER VEHICLE M ODjF.PUNSAFE TURNINCP i E FOG I VISIBILITYFT N PEDESTRIAN N XING INTO OPPOSING LANE r o moTQR VENU LE INVOLVED WITH t MOPED F OTHER" C}PAR D WHO A NON-COLLISION.,_ _ I P MERGING L)CHTINQ PEDESTRIAN I Q TRAVELING WRONG WAY A DAYLIGHT C OTHER MOTOR VEHICLE 1 !213 OTHER ASSOCIATED€ACTCRCS) OTHER-- 19 MOTOR VEHICLE ON OTHER ROADWAY (MARK t 70 2-ITEMS) bUSK-DAWN C DARK-STREET LIGHTS R VEHICLEVEHUCLE PARKED MQTOl r A aKwa anau crrsa YES D DARK-NO STREET LIGHTS 1 TRAIN E DARK-STREET LIGHTS NOT l BICYCLE B VC 6FCTX*V=Araw cmto YES €UNGTIOAINO' ANIMAL: A N6 f SOBRIETY-DRUG + w —.=DCCT MLATh' OTE T t 2!,3 PHYSICAL ROADWAY SURFACE �:«'-? YES Il ! (.4ofA 2K I TO 2 fTEMS) A DRY 1 FIXED OSJHCT: r 'D .rz+r,•; .,.-,•�.�.: -.� .?>.:. I A HAD NOT BEEN DRINKING WET - SNOWY•ICY J OTHER OBJECT I VISION OBSCUREMETiT i B MOD-UNDER INFLUENCE SLIPPERY LMUDDY,OILY,ETC. MCROSSWALVK F INATTENTION- C HBO•NOT UNDER INFLUENCE` ROADWAY CONO TIONIS) STOP&GO TRAFFIC D HSD-IMPAIRMENT UNKNOWN' i (tAAFtk i TO 21T EMS) DESTRIAN 5 ACTIONS H ENTERING I LEAVING RAMP E UNDER DRUG INFLUENCE' HOLES, P RUT` NOPEDESTRIANS INVOLVED 1 PREVIOUS COLLISION F IMPAIRMENT-PHYSICAL` B LOOSE MATERIAL ON ROADWAY' �CROSSING Id CROSSWALK UNFAMILIAR WITH ROAD i G NPAIRMENT NOT KNOWN C OBSTRUCTION ON ROADWAY• RSECTION j DEFECTIVE VEH EQUIP_ CITED H NOT APPLICA8LE Ll Cf)NSTRUCTKNd-REPAIR Z(SNF �, CROSSING IN CROSSWALK-NOT v + I -1 SLEEPY IATifsUED k E REDUCER ROADWAY WICSTH RSECTION _- �Ni3 �� SPECIAL INFORhIATION I FLOODED` D NG-NOT�I CROSSWALK i ! L UNINVOLVED V4NK LE ' A HALARDQU5 MATER4ALI -INCLUDES Sk iOt3LDER MOTHER}I NO UNUSUAL CONDlT)ONS F OAD N NONE APPARENTCHING I LEAVING SCHOOL BUS RUNAWAY VEHICLE ISKETCH 0MO MISCELLANEOUS INGI A�.r . 4. 2003 8:23PM L&S REPORT SERVICE 6022710161 No.4714 P. 42/46 STATE OF CAL*OMbk I UREat WrrNr:SS 1 PASSE14GERS DATE fv W. ON.% DAY 0-104 (. . 0-6— ("I'a Z L wln+Eas PASBENDER EXTENT`OF INJURY("X"ONE) INJURED WAS("X"ONE) pATy SEAT sAFETY LNCM ONLY ONLY AQ 8EX FTRTAL mm" OTNEKYMNSt.E COMPLAINT D11NER FAN. FID. UICYCLIBT OTHER Ni1MBE1! POS. ECUI►. aNURY NVJUttY E'IJURY DFS 1�O.6.f AUDRi$S$ t TAKEN TO: DEQ NwR vfCTn�r b>r v(�LENT cRu+E r/eT�F�n rcl 209 ONLY) BY' I TAKEN TO: a DESCR83BFNA�IEB ri`.iWV"y tsT 3 _ VICTIM OF VIOLENT CRIME NOnmo ❑' ' © Cl ❑ ❑ ❑ 10 ❑ LEI I ❑ 1111 NAME/D.6.8.I ACOF=S TELEPHONE �ONAJ IED ONLYt TRANSPARTEO SY: TAKEN M DESCRIBE INA*W8 VICTIM or VIOLENT CRIME NOTIFIED '❑� ❑ ❑ to I ❑ C_l ❑ ❑ ❑ ❑ ❑ B.I AODRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES VICTIM OF VIOLENT CRIME NOTIFIED ❑# ® ❑ ❑ Cl ❑ ❑ 171.101,11 ❑ NAME/D.O.B./ADDREW TO.EYHCNE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE)NJURIda VICTIMDF VIOLENTCRIME NOTIFIED 11 NAM@lD.O.B.rADDRE85 TELEPHONE (NAJR80 ONLY)TRANBPORTBD®W. TAKEN TO: OES AIN INAIRIES VICTIM OF Vt=W CRIME NOTIFIED I.O.NiN1B@R MO. DAY YEAR REVIEN+ER`S NAME ¢a,o. MD. DAY YEAR Apr . 4. 2003 8:24PM 1.&S REPORT SERVICE 6022710161 No-4714 P• 40/46 STATE OF C,ALI. ORNIA NARRATIIMUPPLEMENTAL CHP W Pw 1-90 OPi 042 Date of IncidenttOcMtertce Time(2400) NCIC NUMBER OFFICER ID* TNUMBER 03117103 I= 0704 0334 I 03.88?A Ir ONE `X°ONE TYPE SUPPLEMENTAL(-r APPLICA8i.E) X I Warrmema i Collision Bjpwt AA U Semi Hit and nut uodate iem+sntdi othrier Hazgrdoua mataelals School bua C7iher. CITYICOUNTYIJUDiCIAL.DISTRICT REPORTING DIST/BEAT CITATION NUMBER Concord t Contra Costs I ML Diablo 61 LOCATIONISUBJECT STATE HiGHWAY RELATED Cranbrook urt r Yes x No jf 0 i Ml...fh i, ON i Cin 03/17/03 at 1530 hours I was dispatched to a non-injury collision involving four vehicles at the intersection of Cranbrsk Way and Vancouver Way. I arrived on scene at 1538 hours. All speeds and measurements are approximate. jUMIt ARY/STATEMENTS. D#2/Lawton identified herself as the driver of V#2,and I confirmed her identity be her valid California driver license. D#2 stated she was traveling N/B on Cranbrook Way at approximately 20-25 mph. D#2 stated V#1 backed out of a driveway,and D#2 stated she did not have any opportunity to brake. D#2 stated she swerved in an attempt to avoid the collision,but struck V#1 as it was backing. D#2 stated after V##2 struck V#1,it then struck V##3, which was parked adjacent to the east curb of Cranbrook Way. V#3 was then pushed into the rear of V#4, which was parked adjacent to the east curb, in front of V#3. I noted both V#3 and V#4 were legally parked. D#1/Vaughn identified himself as the driver of V#1,and I confirmed his identity by his valid California driver license. Officer Kincannon had arrived on scene prior to me,and had spoken with D#1. D#1 advised Officer Kincannon that he was backing out of the driveway of 3545 Cranbrook Way,when V#2 struck the left rear bumper of V#1. When I spoke with D#1,he stated that he had placed V#1 in reverse,but he had not started any backing movement. I asked D#1 if he was sure he had not started backing V#1,and he then stated he had just begun backing V#1,when the collision occurred. I asked D#1 if he had been wearing his seatbelt,and he stated he did not have time to put it on. D#1 then stated he was wearing his seatbelt,and he then complained of back pain. V#3 and V##4 are both registered to 3551 Cranbrook Way. Officer Kincannon attempted to contact the residents, and no one was home. I left a CPD information card on V#3 and the front door of the(residence advising them of the collision. AUI: Refer to pace 2. CAUSE: Based on driver statements,and the vehicles' points of rest,it is my opinion, D#1 caused the collision when he backed out of the driveway of 3545 Cranbrook Way,when it was unsafe to do so. D#1 was in violation of 22106 CVC-unsafe backing. PREPARER'S NAME ANIS E.D.NUMBER RE1/I 42'3 NAA .. � HATE 03.13416 34 c3 0 N CHECK NO.: 708 L587670— —R. M DATE: 04-26-2003 0 W > NAME AND ADDRESS INFORMATION: U.1 U W MIKE ROSE'S AUTO BODY INC 2001 FREMONiT ST CONCORD CA 94520 INSURED: LAWTON,HAROLD,L;OR ELISE M PAYMENT INFORMATION/DESCRIPTION: DATE OF LOSS: 03-17-'03 CLAIM NO.: 14--J21159-2 CLAIMANT: LAWTON,HAROLD,L;OR ELISE PAYEE: MIKE ROSE'S AUTO BODY INC AMOUNT: $7,853.73 IN PAYMENT OF: REPAIRS LESS DED ADJUSTER: GREGORY T . GURTNER ADJUSTER NO.: 30671 KIND OF LOSS: COL 18810302 DETACH AND RETAIN FOR YOUR RECORDS No. 708 L582670-0-R DATE OF LOSS CLAIM INSURED'S NAMEDATE 03-17-03 14—J21159-2 LAWTON,HAROLD,L 'OR ELISE M 04-26-2003 POLICY TYPE KIND OF LOSS SUFFIX CLAIMANT'S NAME PAY AUTO COL 01F LAWTON HAROLD L 'OR ELISE S7,853,73 , D.O. ADJUSTER NO. IN PAYMENT OF BANK 0t9 AMERICA 64-1278 DRN 30671 REPAIRS LESS DED Cant of America Customer Connection fill Banc of America, N.A. TIN. 94-2$21349 Atlanta, Dekatb County, Georgia PAY "SEVEN THOUSAND EIGHT HUNDRED FIFTY THREE 73/100+ MIKE ROSE'S AUTO BODY INC This check be properly endors on the reverse side by all payees. TO THE ORDERgauk-A Ag OF 11"7118 58 2 6 7011' 11:0611127881: 329 977 668411' e w f Date 041"18F03 30 19 - Estimate ID Al, Estimate Version. 0 Committed (My FINAL C� Profile ID: CSAR CV MIKE ROSE'S AUTO BODY INC. 2001 Fremont St Concord, CA 94520-2616 (925) 686-1739 Fax:(925) 689-1144 Tax ID: 94-2621349 BAR #: BAR# AA075624 EPA #: CAD 981159189 Damage Assessed By Contreras Sal Appraised Far: Cinde Casey Condition Code: Fair Type of Loss: Collision > Date of Loss: 03/17/03 Arrival Date: W Accident Date: .a Payer: W Claim Paid: Policy NO: Claim Number: A14s21159201 Deductible: 150.00 File Nunber: None Owner: HAROLD LAWTON Insured: EAROLD LAWTON Claimant: Address: Telephone: Work Phone:Home Phone: Mitchell Service: 910776 Description 1997 Nissan Pickup SE Vehicle Production Date: 9/96 Body Style: 2D PkupXCb 6" Bed 116" WE Drive Train: 2.4L Inj 4 Cyl 2WD VIN: 1N6SD16S5VC311311 License: 6DI5629 CA Mileage: 37,775 OEM/ALT: A Search Code: 094518 Color: WHITE Options: "ALL CRASH PARTS ON THIS ESTIMATE ARE "NEW" ORIGINAL EQUIPMENT MANUFACTURER PARTS, UNLESS OTHERWISE SPECIFIED. PARTS DESCRIBED AS RECBROMED, RECORED, REMANUFACTURED OR, RECONDITIONED ARE CONSIDERED ESTIMATE RECALLNUMBER: 04/18/03 15:10:07 A14721159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: APR_03 A Copyright (C) 1994 - 2002 Mitchell International Page 1 of 8 UltraMate Version: 4.8.012 All Rights Reserved Date: 04/IB/03 3:10:29 pm Estimate ID: .A14J21159201 Estimate Version: 0 Committed FINAL Profile ID: CSAA "REBUILT" PARTS. CRASH PARTS DESCRIBED AS "QUALITY REPLACEMENT PART" ARE NON-ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET NEW PARTS." Line Entry Labor Line Item Part Type/ Dollar Labor CEG Item Number Type Op Description Part Number Amount Units Unit 1 000840 BUY REMOVE/REPLACE INFORM LABEL EMISSION CONTROL ORDER FROM DEALER 2.57 * T 2 000880 BUY REMOVE/REPLACE INFORM LABEL VACUUM ROUTING ORDER FROM DEALER 1.51 * T 3 900500 BDY* REMOVE/REPLACE PANEL RETAINERS **Qual Repl Part 2.76 * 0.0* T 4 900500 BDY* REMOVE/REPLACE POWER STEERING FLUID **Qual Repl Part 6.50 * INC* T 5 AUTO BUY OVERHAUL FRT BUMPER ASSY 1.0 01.0 6 000332 BUY REMOVE/REPLACE FAT BUMPER FACE BAR **Qual Repl Part 150.00 * INC #1.0T 7 000333 BOY REMOVE/REPLACE R FAT BUMPER ESCUTCHEON **Qual Repl Part 27.26 * INC #0.4T 8 000353 BUY REMOVE/REPLACE L FRT BUMPER ESCUTCHEON **Qua( Repl Part 2?.26 * INC #0.4T 9 000361 BDY REMOVE/REPLACE R FRT UPR BUMPER BRACKET "Qua! Repl Part 31.29 * INC 1.OT 10 000362 BUY REPAIR L FRT UPR BUMPER BRACKET Existing 0.3* 1.0 11 000387 BOY REMOVE/REPLACE FRT BUMPER VALANCE PANEL 62650-SSGOC 70.54 0.3 #0.3T 12 AUTO REF REFINISH FRT VALANCE PANELr 1.2 1.2 13 002360 BUY REMOVE/REPLACE GRILLE 62310-55GIC 171.88 0.2 0.4T 14 000006 BUY REMOVE/REPLACE GRILLE RETAINER 62380-U7400 2.35 * T 15 5 REQUIRED 16 000006 BUY REMOVE/REPLACE GRILLE RETAINER 62380-07400 INC * T 17 002560 BUY REMOVE/REPLACE R H/LAMP ASSEMBLY B6010-01GOO 84.73 INC 00.4T 18 AUTO BOY CHECK/ADJUST HEADLAMPS 0.4 0.4 19 003190 BUY REMOVE/REPLACE R PARK/SIGNAL LAMP ASSEMBLY **Qual Rapl Part 23.48 * INC #0.3T 20 003650 BUY REMOVE/REPLACE R MARKER LAMP ASSEMBLY **Qual Repl Part 31.40 * INC 00.3T 21 004250 BUY REMOVE/REPLACE COOLING RADIATOR SUPPORT 62500-15730 271.37 7.6 07.6T 22 AUTO REF REFINISH RADIATOR SUPPORT COMPLETE 2.5 1.5 23 000336 EDT REMOVE/REPLACE COOLING RECOVERY TANK ORDER FROM DEALER 49.75 INC 0.3T 24 006070 BUY REMOVE/REPLACE LOW NOTE HORN ASSY 25620-SOMOO 50.13 INC #0.3T 25 000470 BUY REMOVE/REPLACE HOOD PANEL 65100-IS730 306.78 1.2 1.2T 26 AUTO REF REFINISH HOOD OUTSIDE C 2.8 2.8 27 AUTO REF REFINISH HOOD UNDERSIDE 1.4 1.4 28 000472 BUY REMOVE/REPLACE HOOD EMBLEM (ADHESIVE) 65869-3B000 21.93 INC #0.2T 29 011160 REP BLEND R FRONT APRON PANEL 1.0* 1.0 30 PARTIAL REFINISH ONLY 31 900500 BDY* REMOVE/REPLACE CORE CHARGE-STEERING GEAR Recored 89.00 * 0.0* T 32 NON REUSABLE CORE 33 011220 BOY REMOVE/REPLACE W/ANTENNA 1.0 1.0 34 039493 BUY REMOVE/REPLACE R FENDER PANEL 63112-92G35 192.10 2.7 #2.7T 35 AUTO REF REFINISH R FENDER OUTSIDE C 2.0 2.4 36 AUTO REF REFINISH R FENDER EDGE 0.5 0.5 EST 22�'4s TE RECALL NUMBER: 04/18/03 15:10:07 A14J21159201 UltraMate is a Trademark of Mitchell international Mitchell Data Version: APR_03 A Copyright tC) 1994 - 2002 Mitchell International Page 2 of 8 UltraMate Version: 4.8.012 All Rights Reserved Date: 04/18/03 3:10:19 pm ' .EstL te.ID: A14J21159201 Estimate Version: 0 Committed FINAL Profile ID: CSAR 37 011380 BOY REMOVE/REPLACE FENDER ANTENNA ASSY 28206-78GOO 25.00 * INC 1.0T 38 011490 BDY REMOVE/REPLACE R FENDER SKIRT PANEL 63880-01G01 56.52 0.4 0.4T 39 011580 BDY REPAIR R FENDER APRON ASSY Existing 5.5*06.5 40 011780 BDY REPAIR R FENDER SIDE UPPER RAIL Existing 1.0*02.0 41 000425 BDY REMOVE/REPLACE R STRIPE TAPE SET ORDER FROM DEALER 63.63 * 0.5* T 42 FENDER AND DOOR ONLY 43 014340 BDY REMOVE/REPLACE WHEEL **Qual Repl Part 216.00 * 0.3 0.3T 44 015170 MCH ACCESS/INSPECT R FRT SUSP CALIPER -M Existing 0.0*#0.5 45 015280 MCH REMOVE/REPLACE R FRT SUSP BRAKE HOSE -M 46210-OIGOD 20.01 0.3 00.3T 46 015350 MCH REMOVE/REPLACE R UPR FRT SUSP CONTROL ARM ASSY -M 54526-92GOO 89.08 1.3 #1.3T 47 01410 MCH REMOVE/REPLACE R UPR FRT SUSP CONTROL ARM SHAFT -M 54536-OIGOO 50.60 INC 01.3T 48 015430 MCH REMOVE/REPLACE R UPR FRT SUSP CONTROL ARM BUSH -M 54506-89500 11.12 INC 01.3T 49 015430 MCH REMOVE/REPLACE R UPR FRT SUSP CONTROL ARTS BUSH -M 54506-89500 11.12 INC #1.3T 50 015460 MCH REMOVE/REPLACE R FRT SUSP SHOCK ABSORBER -M ORDER FROM DEALER 24.75 0.5 #0.5T 51 018150 MCH REMOVE/REPLACE R STEERING TIE ROD -M 46510-DIG25 128.75 0.5 0.5T 52 018240 MCH REMOVE/REPLACE STEERING RELAY ROD -M 48560.OIG25 159.77 0.5 #0.8T 53 020340 MCH REMOVE/REPLACE STEERING GEAR ASSEMBLY -M Remanufactured 584.95 * 1.6* 1.6T 54 REBUILT O.E.M-OK PER INSURED 55 024170 REF BLEND R CAB PILLAR C 0.4* 1.0 56 024190 REF BLEND CAB COWL TOP C 57 000114 BDY REPAIR R CAB HINGE PILLAR Existing 4.0* 6.6 58 WELD TABS FOR PULL 59 024340 BDY REMOVE/REPLACE R CAB RETAINER 66827-OIGO1 9.97 T 60 024350 BDY REMOVE/REPLACE L CAB RETAINER 66827-OIGOI 9.97 T 61 024470 BDY REMOVE/REPLACE R CAB GRILLE CLIP 66614-01GOO 2.46 * T 62 024480 BDY REMOVE/REPLACE L CAB GRILLE CLIP 66814-01GOO 2.46 * T 63 000044 MCH REMOVE/INSTALL INSTRUMENT PANEL ASSY -M 1.0* 4.0 64 LOOSEN FOR ACCESS TO ANTENNA REPLACEMENT 65 000182 BDY REMOVE/REPLACE R FRT DOOR SHELL HOIOO-57GCM 507.62 3.5 3.5T 66 AUTO REF REFINISH R FRT DOOR OUTSIDE C 2.0 2.4 67 AUTO REF REFINISH R FAT ADD FOR JAMBS 6 INSIDE C 1.0 1.0 68 029320 BDY REMOVE/REPLACE R FRT UPR DOOR HINGE 80402-01600 31.90 0.3 #0.3T 69 AUTO REF REFINISH R FRT UPR DOOR HINGE 0.2 0.2 70 900500 REP* REPAIR COVER CAR **Qual Real Part 5.00 * 0.1* T 71 900500 MC11* ADD`L LABOR OP 2/W ALIGNMEMT Sublet 55.00 * 0.0* 72 900500 REF* ADD'L LABOR OP MASK JAMB OPENINGS FOR PAINT Existing 0.3* 73 900500 MCH* REMOVE/REPLACE R/F TIRE **Qual Repl Part 101.00 * 0.3* T 74 900500 MCH* ADD`L LABOR OP MOUNT & BALANCE Sublet 22.00 * 0,0* 75 PER INVOICE-SPECIALTY WHEEL 76 029340 BDY REMOVE/REPLACE R FRT LWR DOOR HINGE 80422-OIGOO 30.82 0.3 #0.3T 77 AUTO REF REFINISH R FRT LWR DOOR HINGE C 0.2 0.2 ESTIMATE RECALL NUMBER: 04/18/03 15:10:07 A14J21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: APR m03 A Copyright ;C) 1994 - 2002 Mitchell International Page 3 of 6 UltraMate Version: 4.8.012 All Rights Reserved Date: 04/18/03 3:10:19 pm Estimate ID: A14J21159201 Estimate,Version: 0 Committed FINAL Profile ID: CSAR 78 936001 ADD'L COST TOWING 430.00 79 AUTO REF ADD'L OPR CLEAR COAT 2.6* 60 933006 FRM AWL OPR FRAME./RACK SET UP 1.5* 61 AUTO ADD'L COST PAINT/MATERIALS 407.10 * T e2 AUTO ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * * - Judgement Item - Labor Note Applies - Included in Clear Coat Calc Recycler Information, section.- Prior ection:Prior Damage NONE J Remarks FINAL OK TO PAY 04/18/03 Add'1 Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 30.5 56.00 0.00 0.00 1,708.00 Taxable Parts 3,757.09 Bdy-S 0.0 56.00 0.00 0.00 0.00 Parts Adjustments 123,06_ Refinish 17.7 56.00 0.00 0.00 991.20 Glass 0.0 56.00 0.00 0.00 0.00 Glass Adjustments @ 0.000 0.00 Mechanical 6.0 56.00 0.00 77.00 413.00 Sales Tax @ 8.250 299.8; Frame 1.5 56.00 0.00 0.00 84.00 @ 8.250 Taxable Labor Non-Taxable Parts P Labor Tax @ 0.000 0.00 arts Adjustments 0.00 Non-Taxable Labor Non-Taxable Labor3,196.20 Glass Adjustments @ 0.000 0.00 Labor Summary 55.7 3,196.20 Total Replacement Parts Amount 3,933.84 111. Additional Casts IV. Adjustments Amount Taxable Costs 407.10 Insurance Deductible 150.00 EST'I.MATE RECALL HUMBER: 04/18/03 15:10:07 A14J21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: APR_03 A Copyright (C) 1994 - 2002 Mitchell International Page 4 of 8 UltraMate Version: 4.8 012 All Rights Reserved Date., 04/18/03 3:10:19 pm Estimate ID: A14J22159201 Estimate Version: 0 Committed FINAL Profile ID: CSAA Betterment 0.00 Sales Tax @ 8.250 33.59 Appearance Allowance 0.00 Related Prior Damage 0.00 Customer Responsibility 150«00- < Nan-Taxable Costs 433.00 Tota:.. Additional Costs 873.59 I. Total Labor; 3,296.20 II. Total Replacement Parts: 3,933.84 Iii. Total Additional Costs: 873.69 Gross Totals 8,003.73 IV. Total Adjustments: 150.00-- Net Total: 7,853.73 Related Prior Damage Labor Subtotals Unita Rate Totals RL-Body 0.0 56.00 0.00 RL-Refinish 0.0 56.00 0.00 RL Taxable Labor 0.00 GST - E Tax @ 0.000 0.00 Labor Tax @ 0.000 0.00 Labor Tax 0.00 RL-Non-Taxable Labor 0.00 Related Prior Damage Labor Summary 0.0 0.00 Part Replacement Summary Amount RL-Taxable Parts 0.00 GST - E Tax @ 0.000 0.00 Sales Tax @ 8.250 0.00 Sales Tax @ 8.250 0.00 RL-Non-Taxable Parts 0.00 Related Prior Damage Parts Summary 0.00 ESTIMATE RECALL HUMBER: 04/18103 15:10;07 A14S21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version; APR 03 A Copyright (C) 1994 - 2002 Mitchell International Page 5 of 8 UltraMate Version: 4.8.012 All Rights Reserved Date: 04/19/03 3:10:19 pm Estimate ID: A14321159201 Estimate Version: 0 Committed FINAL Profile ID: CSAR Related Prior-Total Labor: 0.00 Related Prior-Total Replacement Parts: 0.00 Related Prior-Damage Total: 0.00 Unrelated Prior Damage Labor Subtotals Units Rate Totals UN-Body 0.0 56.00 0.00 UN-Refinish 0.0 56.00 0.00 Lad-Taxable Labor 0.00 GST - k Tax @ 0.000 0.00 Labor Tax @ 0.000 0.00 Labor Tax @ 0.000 e.e0 UN-Non-Taxable Labor 0.00 Unrelated Prior Damage Labor Summary 0.0 0.00 Part Replacement Summary Amount UN-Taxable Parts 0.00 GST - E Tax @ 0.000 0.00 Sales Tax @ 9.250 0.00 Sales Tax @ 9.250 0.00 UN-Non-Taxable Parts 0.00 Unrelated Prior Damage Parts sumnary 0.00 Unrelated Prior-Total Labor: 0.00 Unrelated Prior-Total Replacement Parts: 0.00 Unrelated Prier-Damage Total: 0.00" * Total does not include overlap or labor adjustments ESTIMATE RECALL NUMBER: 04/10/03 15:10:07 A14S21159201 U1traMate is a Trademark of Mitchell International Mitchell Data Version: APR-03 A Copyright (C) 1994 _ 2002 Mitchell International Page S of 6 UltraMate version: 4.9.012 All Rights Reserved Date: 04/18/03 3.10:19 pm Estimate ID: A14J21159201 Estimate Version: 0 Committed FINAL Profile ID: CSAA THIS ESTIMATE HAS SEEN PREPARED EASED ON THE USE OF CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAN BY THE ORIGINAL MANUFACTURER Of YOUR VEHICLE. Point W of Impact I Right Front Corner (P) Insurance Cc: Address: Telephone: Fax Phone: Body Shop: Mime Rose-Fremont St.-Concord Inspection Site: None Address; 2001 Fremont St Address: Concord, CA 94520 Telephone: Inspection Date; ;925) 686-1739 Fax Phone: (925) 666-1744 State Lic. No: Company Code: Drop Off Date: 03/19/03 Time: 10:40 Repair Dates; Promise Date: 04/17/03 Start bate: 03/19/03 Pick Up Date; 04/17/03 Completion Date: 04/17/03 is Vehicle Driveable (Y/N)?: Assisted With Rental (Y/N)?: WARNING; Accidental air bag deployment is possible. Personal injury may result. Avoid area near steering wheel and instrument panel even if air bags have deployed. Dual-stage air bag modules may be present that could contain an undeployed stage.When disposing of a deployed dual-stage air bag, always treat it as a "live" module. See appropriate MITCHELLO AIR HAG SERVICE & REPAIR MANUAL, or OEM information. THIS ESTIMATE HAS SEEN PREPARED BASED ON TEE USX OF CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE ESTIMATE RECALL NUMBER: 04/18/03 15:10:07 A14J21159201 UltraMate is a Trademark of Mitchell international Mitchell Data Version: APR 03 A Copyright (C) 1994 - 2002 Mitchell international Page 7 of 8 UltraMate version: 4.8.00 All Rights Reserved Date: 04/18/03 3:10:19 pm Sstiirate III: A14S21159201 Estimate Version. 0 Committed FINAL Profile III: CSAR PROVIDED BY TEE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAN BY THE ORIGINAL. MANUFACTURER OF YOUR VEHICLE. ESTIMATE RECALL NUMBER: 04/19/03 15.,10:07 A14021159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: APR_03 A Copyright (C) 1994 - 2002 Mitchell International Page 8 of 8 UltraMate Version. 4.8.012 All Rights Reserved if Y iI fs :4 qtx W ak NEW Y r ti° f f f x r f. � l d > K, r" t 3s f ire . 4` 74 r ✓v r r mm M { b F' r :xr, r. 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(: f ;r r t ky ,d > S S Y z .`�� .�+'✓.�� 'mow, e'� a s� �' f. X, ?. t S , f l n- Y f f y f t, � f x r h t k f. L W`4 5 s Date: 03/25/03 12:54:05 pm Estimate ID: A14J21159201 Estimate Varsion: 0 Preliminary Profile ID: CSAA :O MIRE ROSE'S AUTO BODY INC. 2001 Fremont St Concord, CA 94520-2616 O (925) 666-1739 r[ Fax:(925) 689-1744 r� Tax ID: 94-2621349 BAR #: BAR# AA075624 EPA #: CAD 981159189 Damage Assessed By aennings Kirk Appraised For: Cinde Casey LCt Condition Code: Fair Type of Loss: Collision Cate of Lori: 03/17/03 Arrival Date: Accident Data: W Payer: ,{ Claim Paid: )!j Policy No: Claim Number: A14J21159201 Deductible: 150.00 File Number: None Owner: HAROLD LAWTON Insured: HAROLD LAWTON Claimant: Address: Telephone: Work Phone:Home Phone: Mitchell Service: 910776 Description 1997 Nissan Pickup SE Vehicle Production Date: 9/95 Body Style: 2D PkupXCb 6' Bed 1161' WB Drive Train: 2,41, Inj 4 Cyl 2WD VIN: 1116SDIGS5VC311311 License: GD15629 CA Mileage: 37,775 OEM/ALT: A Search Coag: 094518 Color: WHITE options: "ALL CRASH PARTS ON THIS ESTIMATE ARE "NF,W" ORIGINAL EQUIPMENT MANUFACTURER PARTS, UNLESS OTHERWISE SPECIFIED. PARTS DESCRIBED AS RECH OM£D, RECORED, REMANUYACTURED OR, RECONDITIONED ARE CONSIDERED "REBUILT" PARTS. CRASH PARTS DESCRIBED AS "QUALITY ?--PLACEMENT PART" ESTIMATE RECALL NUMBER: 03/25/03 14:07:55 A14J21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: MAR 03 A Copyright (C) 1994 - 2002 Mitchell International Page 1 of 7 UltraMate Version. 4.$.012 All Rights Reserved Date: 03/25/03 12;54:05 pm Estimate ID: A14321159201 Estimate version; 0 Preliminary Profile ID: CSAA ARE NON-ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET NEW PARTS." Line Entry Labor Line Item Part Type/ Dollar Labor CEG Item Number Type Op Description Part Number Amount Units Unit I AUTO BOY OVERHAUL FRT BUMPER ASSY 1.0 01.0 2 000332 BOY MOVE/REPLACE FRT .BUMPER FACE BAR ** QUAL REPL PART 113.15 INC, 41.0T 3 000333 BOY REMOVE/REPLACE R FRT BUMPER ESCUTCHEON ** QUAL REPL PART 11.00 INC #0.4T 4 000353 BOY REMOVE/REPLACE L FRT BUMPER ESCUTCHEON ** QUAL REPL PART 11.00 INC #0.4T 5 000361 BDY REMOVE/REPLACE R FRT UPR BUMPER BRACKET ** QUAL REPL PART 11.70 INC 1.0T 6 000362 BOY REMOVE/REPLACE L FRT UPR BUMPER BRACKET ** QUAL REPL PART 11.70 INC 1.OT 7 000387 BOY REMOVE/REPLACE FRT BUMPER VALANCE PANEL 62650-55000 70.54 0.3 #0.3T 6 AUTO REF REFINISH FRT VALANCE PANEL C 1.2 1.2 9 002360 BOY REMOVE/REPLACE GRILLE 62310-55G1O 171.88 0.2 0.4T 10 000006 BOY REMOVE/REPLACE GRILLE RETAINER 62380-U7400 0.47 T 11 5 REQUIRED 12 002600 BOY REMOVE/REPLACE R H/LAMP RETAINING RING 26023-0610 15.12 INC #0.4T 13 002620 BOY REMOVE/REPLACE R N/LAMP SEALED BEAM 99990-H6054S 15.44 INC #0.4T 14 002650 BOY REMOVE/REPLACE R H/IMP HOLDER 26029-F9900 7.96 INC #0.4T 15 002670 BDY REMOVE/REPLACE R H/LAMP MOUNTING RING 26017-D1601 22.50 INC 00.4T 16 AUTO BDY CHECK/AD3UST HEADLAMPS 0.4 0.4 17 002690 BDY REMOVE/REPLACE R H/LAMP HOUSING 26025-OIGOO 42.41 0.6 #0.6T 18 032710 BDY REMOVE/REPLACE R H/LAMP RETAINING SPRING 26024-H861O 2.98 T i9 002730 BDY REMOVE/REPLACE R H/LAMP ADJUSTING SCREW 26022-78501 0.60 T 20 002750 BDY REMOVE/REPLACE R H/LAMP GROMMET 26025-NO500 1.59 21 003190 BDY REMOVE/REPLACE R PARK/SIGNAL LAMP ASSEMBLY ** QUAL REPL PART 19.50 INC #0.3T 22 003650 BDY REMOVE/REPLACE R MARKER LAMP ASSEMBLY ** QUAL REPL PART 23.48 INC #0.3T 23 004250 BDY REMOVE/REPLACE COOLING RADIATOR SUPPORT 62500-IS730 271.37 7.6 #7.6T 24 AUTO REF REFINISH RADIATOR SUPPORT COMPLETE 1.5 1.5 25 000470 BOY REMOVE/REPLACE HOOD PANEL 65100-IS730 306.78 1.2 1.2T 26 AUTO REF REFINISH HOOD OUTSIDE C 2.8 2.8 27 AUTO REF REFINISH HOOD UNDERSIDE 1.4 1.4 28 000472 BDY REMOVE/REPLACE HOOD EMBLEM (ADHESIVE) 65889-3BOOO 21.93 INC 00.2T 29 011220 BDY RL-40VE/REPLACE W/.ANT=XA 1.0 1.0 30 039493 BDY MOVE/REPLACE R FENDER PANEL 63112-92G35 192.10 2.7 02.7T 31 AUTO REF REFINISH R FENDER OUTSIDE C 2.0 2.4 32 AUTO REF REFINISH R FENDER EDGE 0.5 0.5 33 011490 BDY REMOVE/REPLACE R FENDER SKIRT PANEL 63880-OIGO1 56.52 0.4 0.4T 34 011580 BDY REMOVE/REPLACE R FENDER APRON ASSY 64100-55630 244.85 5.0 06.5T 35 AUTO REF REFINISH R APRON PANEL 2.0 2.0 36 011780 BDY REMOVE/REPLACE R FENDER SIDE UPPER RAIL 64180-92G11 40.08 INC 02.OT 37 000425 BDY REMOVE/REPLACE R STRIPE TAPE SET ORDER FROM DEALER 71.18 T 38 014340 BDY REMOVE/REPLACE MEL **Qual Repl Part 125.00 * 0.3 0.3T ESTIMATE RECALL NUMBER: 03/25/03 10:07:55 A14J21159201 UltraMate is a Trademark of Mitchell international Mitchell Data Version: MAR-03_A Copyright (C) 1994 - 2002 Mitchell International Page 2 of 7 U1traMate Version: 4.8.012 All Rights Reserved Date: 03/25/03 12:54:05 pm Estimate ID: A1021159201 Estimate Versions 0 Preliminary Profile ID: CSAR 39 015350 MCH REMOVE/REPLACE R UPR FRT SUSP CONTROL AAM ASSY -M 54526-92G00 89.08 1.3 #1.3T 40 024170 REF BLEND A CAB PILLAR C 0.4* 1.0 41 024190 REF BLEND CAB COWL TOP C 0.5 1.2 42 000114 BOY REPAIR R CAB, HINGE PILLAR Existing 2.0* 8.6 43 000044 MCH REMOVE/INSTALL INSTRUMENT PANEL ASSY -M 2.0* 4.0 44 LOOSEN FOR ACCESS TO APRON REPLACEMENT 45 000182 BOY MOVE/REPLACE R FRT DOOR SHELL H0100-57GCM 507.62 3.5 3.5T 46 AUTO REF REFINISH R FRT DOOR OUTSIDE C 2.0 2.4 47 AUTO REF REFINISH R FRT ADD FOR JAMBS & INSIDE C 110 1.0 48 029320 BOY REMOVE/REPLACE R FRT UPR DOOR HINGE 80402-01600 31.90 0.3 #0.3T 49 AUTO REQ' REFINISH R FRT UPR DOOR HINGE C O.2 0.2 50 900500 RXF* REPAIR COVER CAR **Qual Repl Part 5.00 * 0.1* T 51 900500 MCH* ADD'L LABOR OP 2/W ALIGNMENT Sublet 55.00 * 0.0* 52 900500 REF* ADD'L LABOR OP MASK JAMB OPENINGS FOR PAINT Existing 0.3* 53 900500 MCH* REMOVE/REPLACE R/F TIRE **Qual Repl Part 85.00 * 0.3* T 54 900500 MCH* ADO'L LABOR OP MOUNT & BALANCE Sublet 15.00 0.0* 55 029340 BOY REMOVE/REPLACE R FRT LWR DOOR HINGE 80422-OICOO 30.82 0.3 00.3T 56 AUTO REF REFINISH_ R FRT LWA DOOR HINGE C 0.2 0.2 57 936001 ADD'L COST TOWING 430.00 56 AUTO REF ADD'L OPR CLEAR COAT 2,6* 59 933006 FRM ADD'L OPR FRAME/RACK SET UP 1.5* 60 AUTO ADD'L COST PAINT/MATERIALS 430.10 * T 61 AUTO ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * - Judgement Item tl - Labor Note Applies ** QUAL REPL PART - Quality Replacement Parts C - Included in Clear Coat Calc SJ TRADING COMPANY, INC. COLLISION PARTS NETWORK KEYSTONE AUTOMOTIVE 2038 CONCOURSE DRIVE 14300 WICKS BLVD 1069 HENSLEY SUITE B SAN JOSE CA 95131 SAN LEANDRO CA 94578 RICHMOND CA 94801 {408) 434-9222 (800) 498-9808 (510) 234-6960 (800) 660-6069 (510) 895-8257 (800) 794-6911 5 ** D54U5 11.70 2 ** N11002127 113.15 3 ** NI1039101 11.00 6 ** D5406 11.70 22 ** M12551107 23.48 4 ** W11030101 11.00 21 ** D6119 19.50 ESTIMATE RECALL NUMBER: 03/25/03 10:07:55 A14J21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: MAR_03 A Copyright (C) 1994 - 2002 Mitchell International Page 3 of 7 U1traMate Version: 4.8.012 All Rights Reserved Date: 03/25/03 12.54:05 pm Estimate ID: A14J21159201 Estimate version: 0 Preliminary Profile ID: CSAA Recycler Information Section: Prior Damage NONE Remarks PRELIM Add'1 Labor Sublet 1. Labor Subtotals units Rate Amount Amount Totals ET. Part Replacement Summary Amount Body 26.8 56.00 0.00 0.00 1,500.80 Taxable Parts 2,632.20 Bdy-S 0.0 56.00 0.00 0.00 0.00 Parts Adjustments 110.78- Refinish 18.7 56.00 0.00 0.00 1,047.20 Glass 0.0 56.00 0.00 0.00 0.00 Glass Adjustments @ 0.000 0.00 Mechanical 3.6 56.00 0.00 70.00 271.60 Sales Tax @ 8.250 208.02 Frame 1.5 56.00 0.00 0.00 84.00 @ 8.250 Taxable Labor Non-Taxable Parts Parts Adjustments 0.00 Labor Tax @ 0.000 0.00 Non-Taxable Labor Non-Taxable Labor2,903.60 Glass Adjustments @ 0.000 0.00 Labor 5uwAry 50.6 2,903.60 Total Replacement Parts Amount 2,729.44 TIE. Additional Costs IV. Adjustments Amount Taxable Costs 430.10 insurance Deductible 150.00 Betterment 0.00 Sales `Pax @ 8.250 35,48 Appearance Allowance 0.00 Related Prior Damage 0.00 Customer Responsibility 150.00- Non-Taxable Costs 433.00 Total Additional Costs 898.58 I. Total Labor: 2,903.60 ii. Total Replacement Parts: 2,729.44 III. Total Additional Costs: 896.50 Gross Total: 6,531.62 IV. Total Adjustments: 150.00- ESTIMATE RECALL NUMBER: 03/25/03 10:07:55 A14J21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: MR 03 A Copyright (C) 2394 - 2002 Mitchell Internat.0r.41 Page 4 of 7 UltraMate Version: 4.8.012 All Rights Reserved Date: 03/25/03 12:54:05 pn Estimate ID: A1021159201 Estimate Version: 0 Preliminary Profile ID: CSAR Net Total: 6,381.62 Related Prior Damage Labor Subtotals Units Rate Totals RL-Body 0.0 56.00 0.00 RL-Refinish 0.0 56.00 0.00 RL Taxable Labor 0.00 GST - E Tax @ 0.000 0.00 Labor Tax @ 0.000 0.00 Labor Tax 0.00 RL-Non-Taxable Labor 0.00 Related Prior Damage Labor Summary 0.0 0.00 Part Replacement Summary Amount RL-Taxable Parts 0.00 GST - E Tax @ 0.000 0.00 Sales Tax @ 8.250 0.00 Sales Tax @ 8.250 0.00 RL-Non-Taxable Parts 0.00 Related Prior Damage Parts Sumstary 0.00 Related Prior-Total Labor: 0.00 Related Prior-Total Replacement Parts: 0.00 Related Prior-Damage Total: 0.00 Unrelated Prior Damage Labor Subtotals Units Rate Totals M-Body 0.0 56.00 0.00 UN-Refinish 0.0 56.00 0.00 UN-Taxable Labor 0.00 GST - E Tax @ 0.000 0.00 ESTIMATE RECALL NUMBER: 03/25/03 10:07:55 A34,321159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: MAR 03 A Copyright (C) 1994 - 2002 Mitchell International Page 5 of 7 UltraMate Version: 9.8.012 All Rights Reserved Date: 03/25/03 12x54:05 pm Estimate ID: A14J21159201 Estimate Version: 0 Preliminary Profile ID: CSAR Labor Tax @ 0.000 0.00 Labor Tax @ 0.000 0.00 UN-Non-Taxable Labor 0.00 Unrelated Prior Damage Labor Summary 0.0 0.00 Part Replacement Summary Amount UN-Taxable Parts 0.00 GST - E Tax @ 0.000 0.00 Sales Tax @ 8.250 0.00 Sales Tax @ 8.250 0.00 UN-Non-Taxable Parts 0.00 Unrelated Prior Damage Parts Summary 0.00 Unrelated Prior-Total Labor: 0.00 Unrelated Prior-Total Replacement Parts,. 0.00 Unrelated Prior-Damage Total: 0.00* * Total does not include overlap or labor adjustments This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. THIS ESTIMATE HAS BEEN PREPARED BASED ON TIM USE OF CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAN BY THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. Point(s) of Impact 1 Right Front Corner (P) Insurance Co: Address: Telephone: Fax Phone: ESTIMATE RECALL NUMBER: 03/25/03 10:07:55 A14J21159201 UltraMate is a Trademark of Mitchell International Mitchell Data Version: MAR 03_A Copyright iC) 1994 - 2002 Mitchell International Page 6 of 7 UltraMate Version: 4.8.012 All Rights Reserved Date: 03/25/03 12:54:115 pm Estimate ID: A24J21159201 Estimate Version: 0 Preliminary Profile ID: CSAA Body Shop: Mike Rose-Fremont St.-Concord Inspection Site: None Address: 2001 Fremont St Address: Concord, CA 94520 Telephone: (925) 686-1739 Inspection Date: Fax Phone: (925) 686-1744 state Lic. No: Company Code: Drop Off Data: 03/19/03 Time: 10:40 Repair Dates: Promise Date: Start Date: Pick up Date: Completion Data: is Vehicle Driveable (Y/N1,2. Assisted With Rental (Y/N)?t WARNING: Accidental air bag deployment is possible. Personal injury may result. Avoid area near steering wheel and instrument panel even if air bags have deployed. Dual-stage air bag modules may be present that could contain an undeployed stage.When disposing of a deployed dual-stage air bag, always treat it a$ a "hive" module. See appropriate MITCHELL& AIR BAG SERVICE REPAIR MANUAL, or OEM information. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF CRASH PARTS SUPPLIED BY A SOURCE; OTHER THAN THE MANUFACTURER OF YOUR MOTOR VERICLE. ANY WARRAN'T'IES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAx BY THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. ESTIMATE RECALL NUMBER: 03/25/03 10:07:55 A14J21159201 U1traMate is a Trademark of Mitchell International Mitchell Data Version: MAR_03 A Copyright {C) 1394 - 2002 Mitchell International Page 7 of 7 UltraMate Version: 4.8.317 All Rights Reserved st " : S; R...- Y v x= � 'g `✓s'?N Ya�r' h�fl- z VY' 'fit .� � �, ' i W l vp a K NO -�`` MI e, r h t } /f r 1 it ., i ✓" ��NrY�Y%'�Y� n.yU �3 4t K'1 .'ss' n�ZW , r low TANS MANTIS Toms FF F 1 Ed- i mom at MOMXi Tom 10 � F F .,.{,�/.,V n./s..!}1�'i'K......:,. �,:"�:.L nu. .,.`;v;_'f.{r:.h"'✓?,�`.a^,.�.".J�t'Y:' . a . \ r� l✓ x x e Y e � R " n 'S n Mtt f ftn,�ry �� `✓ � �h K r 2 ` '254 A; � Kir.•. � z qtr s a [ s S .. r � z F� � rF rr WIN Kjf X x„�"I � � 1 t 60 " `y>u r�`r✓ �'rf 40� � xxS"> s} 5 P— 4 M"r2'r. 3 11i"I'llkmvh .. rqys � t ":� ,w,x ,,�, �`x cv .� � � mfr ace � �"r.."` � r i � r- wrxwxwq�M1 �. M � �Y F5� t.,. � �F?«r `C� 'yrvv�.�, yn i t 7 }� � �� .� {, _.. .� . ..1.. �'�. f_ ......... _......._._.._. _.. ....... ._.._. ..............__.._.. ........ ........ _...... ......... ......... __ _ LHkG. � f r f s " xf z t �r' 3 f f ',d 8:e:�t CLAIM BgAR OF SUPERVISO&S OF CONTRA COSTA COUNTY BOARD ACTTC3N: AUGUST'' 2003 Claim Against the County, or District Governed by } the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to } The copy of this document mailed to you is your California Government Codes. } notice of the-action taken on your claim by the Board of Supervisors. (Paragraph IV below), give Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings". AMOUNT: $225.00 CLAIMANT: JIM WILLIAASON f ATTORNEY: UNKNOWN DATE RECEIVED: JUNE 26, 2003 ADDRESS: 1.55 EAGLE LANE BY DELIVERY TO CLERK ON. JUNE 26, 2003 BREN'I W OOD, CA 94513 BY MAIL POSTMARKED: JUNE 25, 2003 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: JUNE 26, 2003 By: Deputy JOHN SWEET , e k II. FROM: County Counsel TO: Clerk of the Board of Supervis6rs This claim complies substantially with Sections 910 x10.2. { } This Claire FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( } Other: Dated. �, By: Deputy County Couns III. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2) { ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (X) This Claim is rejected in full. ( } Other: I certify that this is a true and correct'copy of the.Board's Order entered in its minutes for this date. Dated: AUGUST 05, 2003 JOHN SWEETEN, CLERK, By , Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions,you have only six(6) months from the date this ndtice was personally served or deposit( in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney ofyour choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice, AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States,over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage full; prepaid a certified copy of this Board Order and.Notice to Claimant, addressed to the claimant as shown above. Dated: AUGUST 06, 2003JOHN SWEETEN, CLERIC By Deputy Clerl Clain to: BOARD OF SUPERVISORS OF CDNTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause ,of action. Claims relating to any ether cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 5911.2.) B. Claims must be filed with the Clerk of the Hoard of :Supervisors at its office in Roam 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be .filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE. Claim By } Reserved for Clerk's filing stamp s y 'Son } JR30P Against the County of Contra Costaor {( ,..fzk ( wtl lDistrict)ryf ✓Pill 1 3t( �2' > The undersigned claimant hereby arses claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) .. ...... ............._.w.........a_...._ t.......—....--- 2. Where did the damage or injury occur? (Include city and county) C,hf SJ-rwk:t 13 3. How did the damage or injury occur? (Give full details; use extra paper if required) r' uai of k -e cit, - `O CK 0 ..Q �.i�wr�.iYM+iMua +Ki+MM��eV��i�+MY+e'.�iM�w�Mww#'Y�+W�+Yrt+Mw s 4. What particular act or omission on the part of county or district officers, servants or .employees caused. the in or e? - # 4 (over) 5. wnat are the names of county or district officers, servants or employees causing the damage or injury? iT `f 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. , s . t i e /s, s 4- o b"v t 4 3 r vn c7ti # cn {Ws x £ is,� s 1.�E�.�f.,.�'' i,.3'�t" U`; � �-.' ice!' 7. Haw was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) r , yr� �- 4 bar a - 1 9 8. Names and addresses of witnesses, doctors and hospitals. ,..._......__........___,...__ __� _......._..__._...__r.._----------...._ ....,.____-- q. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT iL Gov. Code Sec. 910:2 provides "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by 00 is- behalf." Name and Address of Attorney laimant's Signature �At' ss xZ Telephone No. Telephone No. t C c N O T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if .genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceed Ing one thousand ($1,000), or by both such imprisonment and fine; or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,0001 or by booth such imprisonment and fine. J#WM Construction Invoice Ptd Box 722 � SATE INVOICE Knigbtsen,CA 94548 -� (925)516-1266 E6/225/2,003 648 (925)516-6566 Fax —' BILL TO #Jim Williamson 185:34e Lane {BruOvo4 CA 94513 i C P.O.NO), TERMS PROJECT QUANT I tY� DESCRIPTION RATE AMOUNT Steam clean road oil off,wash and wax I 225.67 F � 225.77 I f j I � I i i ' I i 1 All work is comphul + Total $225.77 ti "9 Tom, r