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HomeMy WebLinkAboutMINUTES - 12092008 - C21 (7) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY . BOARD ACTION:. DECEMBER 09, 2008 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 r2/The copy of this document mailed to California Government Codes. is our notice of you y the action taken o �Qg IId� p on your claim by the Board of Supervisors.(Paragraph IV below), NOV ,0 5 2008 given Pursuant to Government Code AMOUNT: $2;716.47 Section 913 and 915.4. Please note all COUNTY COUNSEL "Warnings". CALIFORNIA STATE AUT01081MRSS. CLAIMANT: FOR: LYNN ARNONE BY: SUBROGATION RECOVERY TEAM C MICBELLE GELLEIt . NOVEMBER 04, 2008 ATTORNEY: UNKNOWN DATE RECEIVED: ADDRESS: P.O. BOX 920 BY DELIVERY TO CLERK ON: NOVEMBER 05, 2008 SUISUN CITY, CA 94585-0920 BY MAIL POSTMARKED: OCTOBER 27, 2008 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. NOVEMBER 05, 2008 DAVID TWA, CI Dated: By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Sufervisors (0Ts 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 910.8). (4) 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). O Other: Dated: By: �'r1 Deputy County Counsel 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: (L This Claim is rejected in full. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Datedez-&mbC-Y` o9e5�AWAID TWA, CLERK, By Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions,you have only sig(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 Notion 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. DateWtcAvv j6 //nOAYID TWA;CLERK, By Deputy Clerk BOARD OR SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT . . .. . ... . ....... .......... . ... A. A claim relating to a cause of action for death or for injury to person or to personal property or growing crops shall be presented not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be,presented not later than one year after the accrual of the cause of action. (Gov. Code § 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 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. aa[feQe el[[[■ce[[eeee■fefeeae eLa cQ[ceeelftrc[e[e4 c eaeeQ eCeetecQe Qarte[![cef real RE: Claim By: Reserved for Clerk's filing stamp � S-A as SK hO!W far UA KA Aym m Againnt the County of Contra Costa or ) District) (Fill in the name) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ 01'41 b. Ll-- and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) U�.�IVYL�"2 �>l�� � -{° (T rem `�.� far �► �� � �- 3. How did the damage or injury occur? (Give full details;use extra paper if required) he,(, e, '{ 's j�5 ���d �� �� 1 � (�-�V o N 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? �4va.4)W 5 What are the names of county or district officers, servants, or employees causing the damage or injury? 6. WL-a damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) l s - i'e.f r D ��ri ►'vet =e 0-pa I CS 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you made on account of this accident or injury: DATE ckl f av AMOUNT ■ sa■■awnsa/■aa■a[■eKn■■ta a Keanon/aa/■■/a•as■la•tulu/t■■[/a[wt■///ea[■■sea/swans/tsaal ) .Gov. Code Sec. 910.2 provides "The claim shall be ) signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney) Name and address of Attorney ) ( laimant's Signature) )_ lob 66X Q 0- (Address) _U > Lt vs �t Telephone No. )Tele hone No.`6(6 b 0 — � 6 a'6 k � ,'-q 9 �[CUrn 15 10 ■/■/wua•t/a/a/ua/a■Nunn aaawas■ta a[K a/a ltnsa//[/[■[usr/aatta■Kart[[■Knauss ■aewwa■/tr/1 PUBLIC RECORDS NOTICE: Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any attachments, addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. ■ ■n■■sat aatt/■Oast■mass*woman/tnc/ara/naa/[ea■■/r/na/wn aa/at/a//aaa■/a[aa /O a Nazi Owens NOTICE: 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 exceeding one thousand dollars ($1,000.00), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000), or by both such imprisonment and fine. California State Automobile Association Inter-Insurance Bureau P.O. Box 920 Suisun City, CA 94585-0920 October 23, 2008 Clerk of the Board of Supervisors 651 Pine Street,Room 106,County Admin Bldg Martinez,CA 94553 RE: Your Insured: David Dudley,Contra Costa County Sheriff Our Insured: Lynn Arnone Our Claim No.: 12-P 12751-0 Date of Loss: 09/15/2008 Dear Clerk of the Board of Supervisors: 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 (CSAA-IIB): the Contra Costa County Sheriffs Bus, while making a right turn,collided with and caused damages to our insured's vehicle. In order to assist with and expedite the evaluation and processing of this subrogation demand, we enclose the relevant documentation in support of our claim. This information may contain personal or privileged information about our insured,and is being provided to you pursuant to California Insurance Code Section 791.13 and may not be used for any unauthorized purpose. Based upon this information,we ask that you issue payment of$2,716.47 Repair Bill $2,507.47 Deductible $0.00 Loss of Use $209.00 Tow/Storage $0.00 Miscellaneous $0.00 -------------------------- TOTAL $2,716.47 ---------------- --------------- 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 and 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. If you have any questions, please feel free to contact the CSAA Subrogation Department. Sincerely, Subrogation Recovery Team C 888 900-6520 extension 6299 Fax 707-863-9052 Enclosure \§ < \ 2 x �� � � � : � \:2 � .�� \ ®. � � � © «� « . . : .��v� y.s <: � ° � v ° � 4 ���z ��- v. � ��2 � ` z � ©� & ? a\\�i.�! %y���� . , w �< » > .. : � \� ��/\2 � \ � \ » x : \ � �: �g . . a . � . � . »< . »�:�l `e�S`a' y..,, � , t��'' � �,�ro v e � `�, d. '.�}�� �`� �,. -. m .. r� .�^mv7 .�� :# a� ���,� v � , ,t �� �. .�,�,� u:,..�... 4{ Y� ��, _ tBp Ag b'l�N ��'�ik��;,`e!N•` p� M Vbw L Cs p :, •`tea § :a Y yf° �yA�.?.`��g119���y �.ti 9_ y 4 �+ ..........pnia e z , � t T,�* ella�i� 1� ryp{e ���'h'Q '�,3 f�}�4�=llt,q�•a,�Af'^°o- I � 4 r S � s a a \ J ` .. � , . < � ��© �/�\� �� � � � d « 2� .«» . � w .:. � .�/ � � � \ � ` / . .� �».2� < « � »»�§ � < , :�z , m �+« � : , fit � « �� . . w \ � ® � �� ^ . d\ �: �t . < . . - �� � » �� </�^ w � t « \ \ �y . _ » ƒ y � �«� . « �. � ��» ^ . w« . «�°~� .x:����� x «�\� � � �, » � « + . w<« � � \ y � �?\ �% � � �� w � § � � � 2:\ < »��\/ \ »* � .\ �. � ��:��ƒ® � � & . � �»> � «2 « «» . . . , . � g i ° ° {p . . . > _ > �a � �m d� �� ¥ r »« « £ «�� «:��§ �\ _ . �� . � : �� . , . � � ° � .? zm«< :% � : : : z &§� ° »�.���\ . � ?»���©©» � r��a\. \�\ ƒ: . . ` \ � , ° . <\\ . � �y��9 � ��% ��x° \</ \ : � ���^^^ � \�§ °��k� /��) , arti � ���� �r �:/� Jf � � \\ aC , 6v � �\� �\/ �«» / ^ ^ 00 o - 0 N w O O r U CHECK NO.: 712 L467382-4—R m DATE: 10-07-2008 0 LU > NAME AND ADDRESS INFORMATION: LU U W MIKE ROSE'S AUTO BODY INC It 2260 VIA DE MERCADOS CONCORD CA 94520 INSURED: ARNONE,LYNN PAYMENT INFORMATION/DESCRIPTION: REPAIRS PAID IN FULL DATE OF LOSS: 09-15-08 CLAIM NO.: 12—P12751-0 CLAIMANT: ARNONE,LYNN PAYEE: MIKE ROSE'$ AUTO BODY INC AMOUNT: $2 ,507 .47 IN PAYMENT OF: ARNONE REPAIRS PAID IN FULL ADJUSTER: LAURA EBHERT ADJUSTER NO.: 35615 KIND OF LOSS: COL 15510702 DETACH AND RETAIN FOR YOUR RECORDS No. 712 L467362-4-F DATE OF LOSS CLAIM INSURED'S NAME DATE 09-15—OS 12—P12751-0 ARNONE,LYNN 10-07-2008 POLICY TYPE KIND OF LOSS SUFFIX CLAIMANT'S NAME PAY AUTO COL 01F ARNONE,LYNIN $2151[17.47 D.O. ADJUSTER NO. IN PAYMENT OF BANK OF AMERICA DR2 35615 ARNONE REPAIRS PAID IN FULL Bank of America customer Connection 5 Bank of America. N.A. TIN: 94-2621349-00 Atlanta, Dekaib County, Georgia PAY *TWO THOUSAND FIVE HUNDRED SEVEN 47/100* MIKE ROSE'S AUTO BODY INC This check must be properly endorsed on the reverse side by all paye TO THE ORDER OF 00 o 0 N iZ N 01 OA7 4 (j) CHECK NO: 712 L455266-1—R U m DATE: 09-27-2008 W > NAME AND ADDRESS INFORMATION: LU U W THE HERTZ CORPORATION PO BOX 26141 OKLAHOMA CITY OK 73126 —' INSURED: ARNONE,LYNN PAYMENT INFORMATION/DESCRIPTION: VENDOR PAYMENT FOR DATE OF LOSS: 09-15-08 INVOICE#: A18387553 CLAIM NO: 12—P12751-0 BATCH#: 1082690 CLAIMANT: INSURED PAYEE: THE HERTZ CORPORATION AMOUNT: $209 . 00 IN PAYMENT OF: A18387563 1082690 ADJUSTER: ACH REP ADJUSTER NO: ACH01 KIND OF LOSS: XLU 16610702 DETACH AND RETAIN FOR YOUR RECORDS No. 712 L455266-1 -F DATE OF LOSS CLAIM INSURED'S NAME DATE 09-15-08 12—P12751-0 ARNONE ,LYNN 09-27-2008 POLICY TYPE KIND OF LOSS SUFFIX CLAIMANT'S NAME PAY AUTO XLU 02F I INSURED $209 .00 D.O. ADJUSTER NO. IN PAYMENT OF BANK OF AMERICA rA LRW ACH01 A18387563 1082590 Bank of America Customer Connection 5 Bank of America, N.A. TIN: 13-1938568-00 Atlanta, Oakall, County, Georgia PAY *TWO HUNDRED NINE 00/100* THE HERTZ CORPORATION This check must be properly endorsed on the reverse side by all paye TO THE ORDER OF THE HERTZ CORPORATION Rental Agreement #: A1838-7563 Invoice Date: 09/25/08 Batch: 1082690 Insured: ARNONE, LYNN Renter: LYNN ARNONE HERTZ LOCAL EDITION PO BOX 26141 OKLAHOMA CITY, OK 73126-0000 TIN: 13-1938568 CSAA INSURANCE ATTN: MAIL CENTER P.O. BOX 920 SUISUN CITY, CA 94585-0920 Claim #: 12-P12751-0 Suffix: 02 KOL: XLU Loss Date: 09/15/08 Rental Car: N/L CAMRY Rental Veh License #: 6CUJ909 Hertz Local Edition Store: 0726002 CONCORD CA Rented On: 09/16/08 Returned On: 09/24/08 Total Rental Days: 0009 FRP: 209.00 Extra Days: 000 @. 00 . 00 Subtotal: 209. 00 Upgrade: .00 Damage Waiver(CDW/LDW) : .00 PAI: . 00 Fuel and Service: .00 Customer Paid: -.00 Time and Mileage: -.00 Amount Due: 209.00 Billing Inquiries: PHONE: 1-888-777-3700 FAX: 405-775-6413 E-MAIL: CUSTOMERBILLING@HERTZ.COM Date: 10/03/08 04:05 PM Estimate ID: 4377 E stim ate Version: 1 Supplement 1 (F) 09/24/08 10:11:50 AM FINAL Profile ID: CSAA DRN Mike Rose Auto Body, Inc. 2260 Via De Mercados,Concord,CA 94520-0920 (925)689-1739 Fax: (925)689-0991 Tax ID: 94-2621349 BAR#: 0969527 EPA#: CAR 000004317 Damage Assessed By: JASONTONER Supplemented By: DAMON SMITH 0 C 0 Condition Code: Good N Date of Loss: 09/1508 Arrival Date: 09/16/08 0 Final to Owner. 09/24/08 o Payer. Insurance Deductible: WAIVED r' File Number. F Policy No: P127510 Claim Number: Al2P12751001 to V Insured: LYNN ARNONE } Owner: LYNN ARNONE IM Address: 4776 INNWOOD CT,CONCORD,CA 94521-0000 Telephone: WorkPhonec (510)637-1654 Home Phone: (925)6878619 7 W Mitchell Service: 910017 0 W Description: 2006 Honda Accord EX Navi Body Style: 4D Sed Drive Train: 2.4LInj4 Cy15A FWD VIN: 1HGCN5678GA123715 License: 5UJZ122 CA Mileage: 19,857 OEMALT: A Search Code: C754827 Color: RED Options: ALUNVALLOY WHEELS,LEATHER SEATS,AUTOMATIC TRANSMSSION,NAVIGATION SYS. POWER DRIVER SEAT "ALL CRASH PARTS ON THIS ESTIMATE ARE "NEW" ORIGINAL EQUIPMENT MANUFACTURER PARTS, UNLESS OTHERWISE SPECIFIED. PARTS DESCRIBED AS RECHROMED,RECORED,REMAHUFACTORED OR, RECONDITIONED ARE CONSIDERED "REBUILT" PARTS. CRASH PARTS DESCRIBED AS "QUALITY REPLACEMENT PART" ARE NON—ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET NEW PARTS" Line Entry Labor Line Item PartType/ Dollar Labor CEC Item Number Type Operation Description Part Number Amount Units Unit -- FRONT BUMPER 1 BOY OVERHAUL FRT BUNPERCOVER ASSY 2.3 # 2.3 S1 2 004193 BOY REMOVE/REPLACE FRT BUMPER COVER Remanufactured 192.00 ' INC # 2.31 3 REF REFINISH FRT BUMPER COVER C 2.7 2.7 4 000393 BOY REMOVE/REPLACE L FRT BUMPER COVER BEAM 71190-SDA-A10 16.75 INC 1 5 004196 BDY REMOVE/REPLACE L FRT BUMPER SPACER 71198-SDA-A10 6.68 INC 1 S1 6 004197 BDY REMOVE/REPLACE FRT BUMPER IMPACT ABSORBER 71170-SDA-A70 41.05 INC 2.31 GRILLE ESTIMATE RECALL NUMBER: 09/19/200809:51:19 4377 Mitchell Data Version: OEM AUG_08_V UltraMate is aTrademark of Mitchell International Copyright(C)1994.2008 Mitchell International Page 1 of 4 UltraMate Version.. 6.5.020 All Rights Reserved Date: 10/03/08 04:05 P M Estimate ID: 4377 Estimate version: 1 Supplement 1 (F) 09/24/08 10:11:50 AM FINAL Profile ID: CSAA DRN 7 004201 BOY REMOVE/REPLACE GRILLE 71121-SDA-A10ZA 68.65 0.1 # 0.41 8 004202 BDY REMOVE/REPLACE GRILLE MOULDING 71122-SDA-AIO 51.07 INC # 0.21 9 004203 BDY REMOVE/REPLACE GRILLE ADHESIVE EMBLEM 75700-S9A-GOO 6.33 INC # 0.21 FRONT LAMPS S1 10 000964 BDY CHECK/ADJUST HEADLAMPS OA 0.4 S1 11 000960 BDY REMOVE/REPLACE L FRONT COMBINATION LAMP ASSEMBLY 33151-SDA-AOI 236.10 INC # 1.61 HOOD 12 001383 REF BLEND HOOD OUTSIDE C 1A 2.4 FRONTFENDER 13 000866 BDY REMOVE/REPLACE L FENDER MUDGUARD INC 0.2 14 000837 BDY REMOVE/REPLACE LFENDER PANEL 04630-SDA-A90ZZ 244.07 2.1 # 3.41 15 REF REFINISH L FENDER OUTSIDE C 2A 2.0 16 REF REFINISH L FENDER EDGE C 05 0.5 17 000841 BDY REMOVE/REPLACE L FENDER LINER 74151-SDA-A00 44.13 INC # 0.41 18 003514 BDY REMOVE/REPLACE L FENDER WHEEL OPENING MLDG 08P21-SDA-1M011 32.00 0.3 0.31 MANUAL ENTRIES 19 900500 BDY' REMOVE/REPLACE DOOR EDGE MLDG NEW NON OEM 7.00 ' 02` 1 FRONT INNER STRUCTURE 20 003049 BDY REPAIR L FRONT BODY SIDEMEMBER ASSEMBLY S Existing 0.3"# 7.5 21 REF REFINISH/REPAIR L FRONT BODY SIDEMEMBER ASSEMBLY S 05'° 1.0 ENGINE UNDERCOVER 22 004048 BDY REMOVE/REPLACE ENGINE SPLASH SHIELD 74111-SDA-A00 27.78 OA 0.41 AIR CLEANER S1 Z3 002529 BDY REMOVE/REPLACE AIR CLEANER RESONATOR CHAMBER 17230-RAA-A00 56.57 021 # 0.31 ROCKER/PILLARS/FLOOR 24 002764 BDY REMOVEINSTALL L ROCKER MOULDING INC # 0.4 FRONT DOOR 25 OW743 REF BLEND L FRT DOOR OUTSIDE C 02 2.0 26 000661 BDY REMOVE/INSTALL L FRT OTR BELT MOULDING 05 # 0.9 27 000663 BDY REMOVEINSTALL L FRT DOOR MOULDING 03 # 0.7 28 CLEAN AND RETAPE MLDG 29 BDY ADD'L LABOR OP L FRT DOOR MOULDING 02" 30 000665 BDY REMOVE/INSTALL L FRT DOOR MIRROR INC 0.3 31 000733 BDY REMOVE/INSTALL L FRT DOOR TRIM PANEL INC 0.4 32 000531 BDY REMOVEINSTALL L FRT OTR DOOR HANDLE 0.7 # 0.7 ADDITIONAL OPERATIONS 33 REF ADD'LOPR CLEAR COAT 2.0' 34 LKQ SEARCH CAD-NO BRYAN-LKQ-NO COREY-APU SOLUTIO ADDITIONAL COSTS&MATERIALS 35 ADD'L COST PAINT/MATERIALS 285.00 . 1 36 ADD'L COST HAZARDOUS WASTE DISPOSAL 2.38 x -Judgment item #-Labor Note Applies C -Included in Clear Coat Calc Remarks FINAL BILL ESTIMATE RECALL NUMBER: 091191200809:51:19 4377 Kitchell Data Version: OEM AUG-08_V UltraMate is aTrademark of Mitchell International Copyright(C)1994-2008 Mitchell International Page 2 of 4 UltraMate Version: 6.5.020 All Rights Reserved Date: 10/03/08 04:05 P M Estimate ID: 4377 Estimate Vers ion: 1 Supplement 1 (F) 09/24/08 10:11:50 AM FINAL Profile ID: CSAA DRN Estimate Totals Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals ll. Part Replacement Summary Amount Body 8.1 64.00 0.00 0.00 518.40 Taxable Parts 1,030.18 Refinish 9.5 64.00 0.00 0.00 608.00 Parts Adjustments 41.56- Sales Tax a 8.250% 81.56 Non Taxable Labor 1,126.40 Total Replacement Parts Amount 1,070.18 Labor Summary 17.6 1,126.40 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 285.00 Insurance Deductible WAIVED SaiesTax LID 8.250% 23.51 Customer Responsibility 0.00 Non Taxable Costs 2.38 Total Additional Costs 310.89 1. Total Labor: 1,126.40 II. Total Replacement Parts: 1,070.18 III. Total Additional Costs: 310.89 Gross Total: 2,507.47 IV. Total Adjustments: 0.00 Net Total: 2,507.47 Less Original Net Total: 2,455.92 Net Supplement Amount 51.55 S7: DAMON SMITH 51.55 THIS ESTIMATE HAS BEEN PREPARED BASED 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(s)of Impact 12 Front Center(P) Insurance Co: CSAA Address: 2055 MERIDIAN PARK BLVD. CONCORD,CA 94520-6767 Telephone: (510)671-2708 Fax Phone: (SIO)SSS-7939 ESTIMATE RECALL NUMBER: 091191200809:51:19 4377 Mitchell Data Version: OEM AUG_08—V UltraMate is a Trademark of Mitchell International Copyright(C)1994-2008 Mitchell International Page 3 of 4 UltraMate Version: 6.5.020 All Rights Reserved Date: 10/03/08 04:05 P M Estimate ID: 4377 E stim ate Version: 1 Supplement 1 (F) 09/24/08 10:11:50 AM FINAL Profile ID: CSAA DRN Body Shop: MIKE ROSE'S AUTO ISODY,INC Address: 2260 VIA DE MERCADOS CONCORD,CA 94520 Telephone: (510)689-1739 Fax Phone: (510)689-0991 THIS ESTIMATE HAS BEEN BASED 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. Company Code: Drop Off Date and Time: 09/17/08 Repair D ates: Promise Date: 09/29/08 Start Date: 09/23/08 Vehicle Pick Up Date and Time: 09/24/08 Completion Date: 09/24/08 Is Vehicle Driveable(YIN)?: N ESTIMATE RECALL NUMBER: 09119/200809:51:19 4377 Mitchell Data Version: OEM: AUG_OB_V UltraMate is aTrademark of Mitchell International Copyright(C)1994-2008 Mitchell International Page 4 of 4 UltraMate Version: 6.5.020 All Rights Reserved N \INK O� Q N a o M a y 0 N P a m ' G N T 6'CD O 6 N d