TYSONS CORNER COLLISION CENTER

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1 Written By: Phil Racey Adjuster: Aaron Christman, (888) Business Insured: INSURED, STATE FARM Policy #: Claim #: Type of Loss: LIAB-Liability Date of Loss: 7/22/2011 6:30:00 PM Days to Repair: 0 Point of Impact: 06 Rear Owner: Inspection Location: Insurance Company: HO, TAN STATE FARM INSURANCE COMPANIES 8799 POHICK CREEK VIEW 8604 LEESBURG PIKE State Farm SPRINGFIELD, VA VIENNA, VA State Farm Blvd (703) Evening Repair Facility Charlottesville, VA (703) Business (888) Business VEHICLE Year: 2004 Body Style: 3D H/B VIN: WMWRE33474PD75915 Mileage In: Make: MINI Engine: 4-1.6L-SC License: XCY3317 Mileage Out: Model: COOPER S Production Date: 9/2003 State: VA Vehicle Out: Color: Int: Condition: Job #: 4 Wheel Disc Brakes CD Player Front Side Impact Air Bags Power Steering 6 Speed Transmission Clear Coat Paint Intermittent Wipers Power Windows Air Conditioning Cloth Seats Keyless Entry Rear Window Wiper Aluminum/Alloy Wheels Digital Clock Passenger Air Bag Spoiler AM Radio Driver Air Bag Power Brakes Stereo Anti-Lock Brakes (4) Dual Mirrors Power Locks Tilt Wheel Bucket Seats FM Radio Power Mirrors Traction Control 8/9/2011 2:07:59 PM Page 1

2 Line Operation Description Qty Extended Price $ 1 REAR BUMPER N 2 ** Repl Qual Repl Parts Bumper cover w/o aero pkg w/o sensor Labor Paint Add for Clear Coat # Refn Tape out and paint stripes on rear cover QUARTER PANEL 6 * Rpr LT Quarter panel Add for Clear Coat * R&I Filler pocket S model R&I LT Wheel opng mldg PILLARS, ROCKER & FLOOR 11 * R&I LT Rocker molding w/aero pkg REAR LAMPS 13 R&I LT Tail lamp assy # Rpr Align decklid # S01 Repl epc # S01 Repl car cover # S01 Repl flex SUBTOTALS NOTES Line 2: Billed at cost will adjust when part is received. Additional time may be needed based on condition of the fiberglass part when we receive it. 8/9/2011 2:07:59 PM Page 2

3 ESTIMATE TOTALS Category Basis Rate Cost $ Parts Body Labor 5.3 $ /hr Paint Labor 8.3 $ /hr Paint Supplies 8.3 $ /hr Subtotal 1, Sales Tax $ % Grand Total 1, CUSTOMER PAY 0.00 INSURANCE PAY 1, /9/2011 2:07:59 PM Page 3

4 SUPPLEMENT SUMMARY Line Operation Description Qty Extended Price $ Added Items 15 # S01 Repl epc # S01 Repl car cover # S01 Repl flex Labor Paint SUBTOTALS TOTALS SUMMARY Category Basis Rate Cost $ Parts Subtotal Sales Tax $ % 0.53 Additional Supplement Taxes Total Supplement Amount NET COST OF SUPPLEMENT CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate 1, Phil Racey Supplement S Phil Racey Job Total: $ 1, INSURANCE PAY: $ 1, /9/2011 2:07:59 PM Page 4

5 LOANER VEHICLES ARE NOT PROVIDED FOR REPAIRS PERFORMED BY AT ANY TIME. THIS IS AN ESTIMATE TO REPAIR ONLY - THIS ESTIMATE IS BASED ON VISUAL AND SUSPECTED DAMAGE - AN EXACT REPAIR AMOUNT IS NOT POSSIBLE TO CALCULATE WITHOUT ALL DAMAGED AND COVERING PARTS REMOVED UPON DISASSEMBLY FOR REPAIR. PART PRICES ARE NOT EXACT AND UNDER NO CIRCUMSTANCES CAN WE, THE SUPPLYING AGENT GUARANTEE THE AVAILIBILITY OF PARTS, PART PRICING, OR DIFFERENCES IN PART SELECTION DUE TO VEHICLE OPTION VARIATIONS, MARKET CONDITIONS, AND CURRENCY FLUCTUATIONS. THE MANUFACTURER OF YOUR PORSCHE, AUDI, MERCEDES-BENZ, ASTON MARTIN, AND SMART VEHICLE REQUIRE SPECIFIC REPAIR PROCESSES AND TECHNIQUES TO PROPERLY AND SAFELY RETURN YOUR VEHICLE TO PRE-LOSS CONDITION. CARRIES THE REQUISITE CERTIFICATIONS TO PERFORM REPAIRS TO THESE VEHICLES AND ONGOING TRAINING TO ENSURE YOUR VEHICLE IS PROPERLY REPAIRED. PROVIDES A LIFETIME WARRANTY TO THE ORIGINAL VEHICLE OWNER FOR WORKMANSHIP ON RELATED REPAIRS PERFORMED. PARTS CARRY THE MANUFACTURERS WARRANTY IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE IMPRISONMENT, FINES AND DENIAL OF INSURANCE BENEFITS. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF AUTOMOBILE PARTS NOT MADE BY THE ORIGINAL MANUFACTURER. PARTS USED IN THE REPAIR OF YOUR VEHICLE BY OTHER THAN THE ORIGINAL MANUFACTURER ARE REQUIRED TO BE AT LEAST EQUAL IN LIKE, KIND AND QUALITY IN TERMS OF FIT, QUALITY AND PERFORMANCE TO THE ORIGINAL MANUFACTURER PARTS THEY ARE REPLACING. 8/9/2011 2:07:59 PM Page 5

6 Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide ERE1970, CCC Data Date 8/1/2011, and the parts selected 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 information provided by MOTOR 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 AM, Qual Repl Parts or Comp Repl Parts which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qual Recy Parts, 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 2010 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 Pathways estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. CCC Pathways - A product of CCC Information Services Inc. 8/9/2011 2:07:59 PM Page 6

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