AUTO CLUB INSURANCE ASSOCIATION Workfile ID: 0763e250 ALL SUPPLEMENTS REQUIRE PRIOR APPROVAL. Supplement of Record 1 with Summary

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1 AUTO CLUB INSURANCE ASSOCIATION Workfile ID: 0763e250 WISCONSIN REGION ALL SUPPLEMENTS REQUIRE PRIOR APPROVAL TO FILE A SUPPLEMENT PLEASE VISIT THE FOLLOWING WEBSITE: For questions or assistance please call (312) Chicago, IL Written By: Jennifer Lord Adjuster: SODEY, TARA Insured: Policy #: AUT WI Claim #: ZPD Type of Loss: Liability Date of Loss: 8/7/ :40 AM Days to Repair: 4 Point of Impact: 06 Rear Owner: Inspection Location: Repair Facility: KROGER, PAMELA KROGER, PAMELA W299 N2591 Duplainville Rd 652 PEWAUKEE RD UNIT F 652 PEWAUKEE RD UNIT F Waukesha, WI PEWAUKEE, WI PEWAUKEE, WI (262) Evening Home (262) Day (262) Evening VEHICLE VIN: 1G4PT5SV5E Production Date: Interior Color: UNK License: 863NRG Odometer: 10,903 Exterior Color: Black Metallic State: WI Condition: Good TRANSMISSION Intermittent Wipers Stereo Lane Departure Warning Automatic Transmission Tilt Wheel Search/Seek SEATS Overdrive Cruise Control CD Player Bucket Seats POWER Rear Defogger Auxiliary Audio Connection Reclining/Lounge Seats Power Steering Keyless Entry Premium Radio Leather Seats Power Brakes Alarm Satellite Radio Heated Seats Power Windows Message Center SAFETY WHEELS Power Locks Steering Wheel Touch Controls Drivers Side Air Bag Aluminum/Alloy Wheels Power Mirrors Telescopic Wheel Passenger Air Bag PAINT Heated Mirrors Climate Control Anti-Lock Brakes (4) Clear Coat Paint Power Driver Seat Remote Starter 4 Wheel Disc Brakes OTHER DECOR Backup Camera w/parking Sensors Front Side Impact Air Bags Fog Lamps Dual Mirrors Home Link Head/Curtain Air Bags Traction Control Console/Storage RADIO Communications System Stability Control 8/24/2016 3:22:57 PM Page 1

2 CONVENIENCE AM Radio Hands Free Device Rear Spoiler Air Conditioning FM Radio Blind Spot Detection 8/24/2016 3:22:57 PM Page 2

3 Line Oper Description Part Number Qty Extended Price $ 1 QUARTER PANEL 2 # S01 Rpr LT Quarter Panel Edge S01 Add for Clear Coat * S01 Rpr LT Lower panel S01 Add for Clear Coat * S01 Rpr LT Tail lamp pocket S01 Overlap Minor Panel S01 Add for Clear Coat S01 Repl LT Pressure valve REAR BODY & FLOOR 11 S01 R&I LT Trunk side trim * S01 Rpr Rear body panel S01 Overlap Minor Panel S01 Add for Clear Coat S01 R&I Rear panel trim REAR LAMPS 17 R&I RT Tail lamp assy R&I LT Tail lamp assy * R&I RT License lamp Incl. 20 * R&I LT License lamp Incl. 21 REAR BUMPER 22 O/H bumper assy ** <> Repl RECOND Bumper cover w/reverse sensor, w/side detection Note: Keystone LABOR: Time is after tail lamp assemblies are removed. Labor Paint Incl S01 Overlap Major Non-Adj. Panel Add for Clear Coat Add for reverse sens R&I Lower cover w/reverse sensor Incl. 28 S01 Repl LT Object sensor S01 Repl LT Corner support ** S01 Repl A/M LT Side support rivet S01 Repl LT Side support MISCELLANEOUS OPERATIONS 33 # S01 Seam Sealer / Caulking Material X 34 # Hazardous Waste SUBTOTALS NOTES Prior Damage Notes: None Visible 8/24/2016 3:22:57 PM Page 3

4 ESTIMATE TOTALS Category Basis Rate Cost $ Parts Parts Discount $ % Body Labor 9.2 $ /hr Paint Labor 5.3 $ /hr Paint Supplies 5.3 $ /hr Miscellaneous Subtotal 1, Sales Tax $ % Total Cost of Repairs 1, Total Adjustments 0.00 Net Cost of Repairs 1, MyPriceLink Estimate ID: /24/2016 3:22:57 PM Page 4

5 SUPPLEMENT SUMMARY Line Oper Description Part Number Qty Extended Price $ Changed Items 8 Add for Clear Coat S01 Add for Clear Coat 0.6 Added Items 1 QUARTER PANEL 2 # S01 Rpr LT Quarter Panel Edge S01 Add for Clear Coat * S01 Rpr LT Lower panel S01 Add for Clear Coat * S01 Rpr LT Tail lamp pocket S01 Overlap Minor Panel S01 Add for Clear Coat S01 Repl LT Pressure valve REAR BODY & FLOOR 11 S01 R&I LT Trunk side trim * S01 Rpr Rear body panel S01 Overlap Minor Panel S01 Add for Clear Coat S01 R&I Rear panel trim S01 Overlap Major Non-Adj. Panel S01 Repl LT Object sensor S01 Repl LT Corner support ** S01 Repl A/M LT Side support rivet S01 Repl LT Side support # S01 Seam Sealer / Caulking Material X Labor Paint SUBTOTALS CHANGES TO ADJUSTMENTS 8/24/2016 3:22:57 PM Page 5

6 TOTALS SUMMARY Category Basis Rate Cost $ Parts Parts Discount $ % Body Labor 6.9 $ /hr Paint Labor 1.1 $ /hr Paint Supplies 1.1 $ /hr Miscellaneous Subtotal Sales Tax $ % Total Supplement Amount NET COST OF SUPPLEMENT MyPriceLink Estimate ID: CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate 1, Valerie Wilson Supplement S Jennifer Lord Workfile Total: $ 1, NET COST OF REPAIRS: $ 1, AUTO CLUB INSURANCE ASSOCIATION, MEMBERSELECT INSURANCE COMPANY OR AUTO CLUB GROUP INSURANCE COMPANY (HEREIN INDIVIDUALLY AND COLLECTIVELY REFERRED TO AS ACIA) GUARANTEES THAT IT WILL REPLACE THE QUALITY REPLACEMENT PARTS (PARTS NOT MANUFACTURED BY THE ORIGINAL EQUIPMENT MANUFACTURER) IDENTIFIED ON THE VEHICLE ESTIMATE ASSOCIATED WITH THIS GUARANTEE IF A DEFECT IS DISCOVERED. ACIA FURTHER GUARANTEES THAT ALL SHEET METAL QUALITY REPLACEMENT PARTS ARE CERTIFIED OR VALIDATED TO BE OF OEM QUALITY. THIS GUARANTEE IS IN EFFECT FOR AS LONG AS YOU OWN THE REPAIR VEHICLE AND IS NOT TRANSFERABLE TO ANOTHER PARTY AT ANY TIME. THIS GUARANTEE COVERS THE COST OF THE PART, LABOR TO INSTALL, PAINT AND MATERIALS IF REQUIRED, AND REASONABLE RENTAL COST OF A SIMILAR TEMPORARY REPLACEMENT VEHICLE DURING THE REPAIRS. THIS GUARANTEE DOES NOT COVER CLAIMS FOR DIMINUTION IN VALUE OR CONSEQUENTIAL DAMAGES. IF A DEFECT IN A QUALITY REPLACEMENT PART IS DISCOVERED, CONTACT YOUR LOCAL ACIA CLAIMS DEPARTMENT IMMEDIATELY AND ACIA WILL REPLACE THE PART WITH A NEW ORIGINAL EQUIPMENT MANUFACTURER PART. IF AN ORIGINAL EQUIPMENT MANUFACTURER PART IS NOT REASONABLY COMMERCIALLY AVAILABLE, ACIA WILL REPLACE THE DEFECTIVE PART WITH ANOTHER QUALITY REPLACEMENT PART. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF AFTERMARKET CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES THAT APPLY TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER, DISTRIBUTOR, OR INSURER OF THESE PARTS. 8/24/2016 3:22:57 PM Page 6

7 MOTOR VEHICLE REPAIR PRACTICES ARE REGULATED BY CHAPTER ATCP 132, WIS. ADM. CODE, ADMINISTERED BY THE BUREAU OF CONSUMER PROTECTION, WISCONSIN DEPT. OF AGRICULTURE, TRADE AND CONSUMER PROTECTION, P.O. BOX 8911, MADISON, WISCONSIN THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE REPLACEMENT PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE REPLACEMENT PARTS RATHER THAN BY THE MANUFACTURER OF YOUR MOTOR VEHICLE. Estimate based on MOTOR CRASH ESTIMATING GUIDE and potentially other third party sources of data. Unless otherwise noted, (a) all items are derived from the Guide DR1AT12, CCC Data Date 8/17/2016, and potentially other third party sources of data; and (b) the parts presented are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk (*) or Double Asterisk (**) indicates that the parts and/or labor data provided by third party sources of data may have been modified or may have come from an alternate data source. Tilde sign (~) items indicate MOTOR Not-Included Labor operations. The symbol (<>) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non-Original Equipment Manufacturer aftermarket parts are described as Non OEM, A/M or NAGS. Used parts are described as LKQ, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign (#) items indicate manual entries. Some 2017 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The CCC ONE estimator has a list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. The following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to be repaired or replaced: SYMBOLS FOLLOWING PART PRICE: m=motor Mechanical component. s=motor Structural component. T=Miscellaneous Taxed charge category. X=Miscellaneous Non-Taxed charge category. SYMBOLS FOLLOWING LABOR: D=Diagnostic labor category. E=Electrical labor category. F=Frame labor category. G=Glass labor category. M=Mechanical labor category. S=Structural labor category. (numbers) 1 through 4=User Defined Labor Categories. OTHER SYMBOLS AND ABBREVIATIONS: Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. Blnd=Blend. BOR=Boron steel. CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel. Incl.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part. O/H=Overhaul. Qty=Quantity. Refn=Refinish. Repl=Replace. R&I=Remove and Install. R&R=Remove and Replace. Rpr=Repair. RT=Right. SAS=Sandwiched Steel. Sect=Section. Subl=Sublet. UHS=Ultra High Strength Steel. N=Note(s) associated with the estimate line. 8/24/2016 3:22:57 PM Page 7

8 CCC ONE Estimating - A product of CCC Information Services Inc. The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR=Bureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number. 8/24/2016 3:22:57 PM Page 8

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