Preview
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Mark R. Nivinskus, Bar No. 195335
NIVINSKUS LAW GROUP, A LAW CORPORATION
134 W. Wilshire Ave.
Fullerton, CA 92832
Telephone: (714) 533—8110
Fax Number: (714) 533—8828 E-FILED
9/2/2020 7:42 PM
Attorneys for Plaintiff I
NO_: 18000285 SupenorCounofCaMonfla
our File
Bar No_; 195335 Coumyomesno
By:J.Mafimez,Depuw
SUPERIOR COURT OF CALIFORNIA, FRESNO COUNTY
FRESNO JUDICIAL DISTRICT JUDICIAL DISTRICT
11 UNITED FINANCIAL CASUALTY CASE No. ?gcedOOS/Bla
COMPANY
12 Plaintiff, DECLARATION PURSUANT
TO CODE OF CIVIL
13 vs. PROCEDURE SECTION 585(d)
AND EVIDENCE CODE SECTION
l4 GABRIELA CRUZ 1550
Defendants,
15 (Declaration of Facts)
16
l7
18
The undersigned declares:
19
The facts stated herein are within my personal knowledge
20
true of my own knowledge and if sworn as a witness, I could
and
21
competently testify thereto.
22
am the Custodian of Records for the plaintiff herein. The
I
23
attached exhibits are true copies of the original records
24
contained in plaintiff's claim file, as business records are
25
in Evidence Code §1271. The records were prepared in the
defined
26
regular course of business, and they were prepared at or near
27
of the act, condition or event reflected therein. The
the time
28
I
y
v z
documents attached hereto were preserved as a part of the
records of the business of plaintiff, as defined in Evidence
Code §1270, in the regular course of its business. The
photostatic copies of the documents in plaintiffs claims file
are admissible pursuant to Evidence Code §1550(2) and are
admissible as the writing itself:
The records contain the following facts regarding the
accident alleged in the complaint filed by plaintiff:
1. Date of Accident: December l8, 2016
Location of Accident: SR-4l at Ashlan Ave., Fresno, CA
10 2.
11 93726
12 3. Driver of Insured‘s vehicle: Derilyn Weber
13 4. Owner of Insured's vehicle: Derilyn Weber
14 5. Owner of defendant's vehicle: Gabriela Cruz
15 6. Driver of defendant's vehicle: Gabriela Cruz
l6 7. Defendant's vehicle: 2002 GMC
l7 8. How the Accident OCCurred: The defendant's vehicle
18 struck the rear of the plaintiff's insured's vehicle
l9 which was lawfully stopped in traffic.
20 9. How the defendant was Negligent: The defendant was
21 driving at an excessive and unsafe rate of speed and
22 was inattentive.
23
24 At the time of the accident alleged in plaintiff's
there was a policy of automobile insurance in force
25 complaint,
was issued by plaintiff to Derilyn Weber. The payments
26 which
herein were required by the terms and conditions of
27 enumerated
28 the policy and are supported by the attached exhibits.
2
r
. .
Plaintiff paid for its insured‘s property damage as
follows:
Property damage and towing $2,606.90 Date Paid: January 08,
2017
Total property damage = $2,606.90
Total paid = $2,606.90
Pursuant to the terms and conditions of the insurance
policy, plaintiff is subrogated to the rights of its insured.
10
Therefore plaintiff is entitled to recover from the defendant
11
the sum of $2,606.90.
12
I declare under the penalty of perjury under the laws of
13
the State of California that the foregoing is true and correct.
14 “T4“
Executed V&bwiUfl\\€>QN' 20 \C1
W)
on , ,
15
l6
at MK .
Owgtate)
.
17
l8
l9
WWMWUJ»
(signature. of Declarant)
Mynesha Perkins-Clarke
20
Declarant (Please print or type)
21
22
23
24
25
26
27
28
. .
‘ . .
. Date:
Estimate
ID:
Estimate Version:
1
AM
2/ 9/2017 09:18
16-2066701 -01
.
Supplement:1(F F) 2/ AM
9/2017 09:16:39
.
FRESNO ALL PART TYPE
Profile ID:
United Financial Casualty Company
*i’************************* DAMAGE APPRAISAL*************************
Damage AssessedBy: Yazminda Berna! 559.240.5080 Claim Rep:MEGAN BARACK
(440) 910-1742
Supplemented By:Jugshir Sidhu 209-409-4337
Classification:
Please contact Yazminda Bernal at 559-240—5080 or
YBERNAL1@PROGRESSTVE.COM for any supplement request or questions
regarding this appraisal.
*
Product TypeAuto
*
12/1 8/201 6
Date of Loss;
"
Deductible:WAIVED
“
Claim Number: 16-206670 1 -O1
Insured:DERILYN WEBER
Owner: DERILYN WEBER
91 1072
Mitchell Service:
2012 Nissan Maxima 3.5 S
Description:
Body Style:4D Sed 3.5L
Drive Train: 6 CyI
Inj AT FWD
VIN: 1N4AA5AP4CC820908 License:6YTE705 CA
Mileage:72,280
OEM/ALT: A Search Code:FRESNO1
Coior: white
Options: CD CHANGER, PASSENGER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWERWINDOW
POWER STEERING, REAR WINDOW DEFOGGER, AIR CONDITION, CRUISE CONTROL
TILT STEERING COLUMN, AM/FM STEREO, DRIVER AIRBAG4 REAR (DUAL-ZONE) AC
POW ER PASSENGER SEAT, FRONT SIDE AIRBAG WITH HEAD PROTECTION
ANTl-LOCK BRAKE SYS., TRACTlON CONTROL, ALUM/ALLOY WHEELS
TIRE lNFLATION/PRESSURE MONITOR, ANTI-THEFT SYSTEM, AUXILIARY INPUT
BLUETOOTH WIRELESS CONNECTIVITY, LEATHER STEERING WHEEL, CD PLAYER
POWER ADJUSTABLE EXTERIOR MIRROR, SUNROOF/MOONROOF, AUTO AIR CONDITION
TRIP COMPUTER, FIRST ROW BUCKET SEAT
REAR HEATING, VENTILATION & AIR CONDITIONING, CLOTH SEAT, SIDE AIRBAGS
AUTOMATIC HEADLIGHTS, SECOND ROW SIDE AIRBAG WITH HEAD PROTECTION
INTERIOR AUTOMATIC DAY/NIGHT OR ELECTROCHROMATIC MIRROR, MP3 PLAYER
DRIVER SEAT WITH POWER LUMBAR SUPPORT, ELECTRONIC STABILITY CONTROL
KEYLESS ENTRY SYSTEM, REAR BENCH SEAT, STEERING WHEEL AUDIO CONTROLS
Line Entry Labor Line Item Pan Type/ Dollar Labor
Item Number Type Operation Description Part Number Amount Units
Luggage Lid
1 101703 BDY REMOVE/INSTALL Luggage Panel
Lid Finish 0.4 #
BDY REMOVE/INSTALL Luggage Trim Panel
Frt 0.3
2
BDY REMOVE/INSTALL Rear Luggage Trim Panel 0.2
3
Existing 1.0*
4 101386 BDY REPAIR LuggageLid Panel
5 REF REFINISH/REPAIR Luggage Pane!
Lid C 1.7"
6 MODIFIED REFINISH WITH FULL CLEAR COAT
7 101 398 BDY REMOVE/REPLACE Luggage Lid Adhesive Emblem 84890-9NOOA 46.36 0.2
This estimate has been re-calculated with a modified profile
ESTIMATE RECALL NUMBER: 16—2066701-01
01/06/2017 14:24:56
OEM:
Mitchell Data Version: DEC_16_V
MAPP:DEC_1 s_v0205 Copyright (C) 1994 -2016
Mitchell International Page 1 of 5
Software Version: .212
7.1 Rights Reserved
All
Date: AM
2/ 9/2017 09:18
Estimate
ID: 16-2066701 -O1
Estimate Version:
1
Supplement: 1(F F) AM
2/ 9/2017 09:16:39
FRESNO ALL PART TYPE
Profile ID:
8 Adhesive, one time use only
9 101399 BDY REMOVE/REPLACE LuggageLidAdhesive Nameplate 84894-9NO0A 55.45 0.2
10 Adhesive, one time use only
Rear Body
S1 11 101509 BDY REPAIR Rear Body Panel Existing 2.0*#
12 Body Repair
Paintless
S1 13 101 527 BDY REMOVE/INSTALL Rear Body Trim Panel Existing 0.2 r
RearLamas
14 101568 BDY REMOVE/INSTALL R License Lamp Assembly Existing 0.2#r
15 101569 BDY REMOVE/INSTALL L License Lamp Assembly Existing 0.2#r
Rear Bumger
16 BDY OVERHAUL Rear Bumper Cover Assy 1.3#
REMOVE/REPLACE
u AIM ‘
INC #
17 101 568 BDY Rear Bumper Cover 445.00
18 BDY REMOVE/INSTALL R Rear Combination Lamp 0.4#
19 BDY REMOVE/INSTALL Lamp
L Rear Combination 0.4#
20 REF REFINISH Rear Bumper Cover 2.8#
21 Keystone. quote #101 664997
*
S1 22 101 601 BDY REMOVE/REPLACE Rear Bumper Energy Absorber Recycled 0.00 INC
23 LKQ assembly
Included with
*
S1 24 101 602 BDY REMOVE/REPLACE Rear Bumper Reinforcement Bar Recycled 392.00 0.4 #r
S1 25 BDY REMOVE/INSTALL Rear Bumper Cover INC #
26 LKQ Spk/w Tiede Q#6188945
27 Bar/foam and
Inc. and
left right stays
S1 28 REF REFINISH/REPAIR Rear Bumper Reinforcement Bar O.8*
S1 29 Line Markup %25.00 98.00
*
S1 30 101603 BDY REMOVE/REPLACE R Rear Bumper Stay Recycled 0.00 0.3#
31 Included with LKQ assembly
S1 32 REF REFINISHIREPAIR R Rear Bumper Stay 03*
*
S1 33 101604 BDY REMOVE/REPLACE L Rear Bumper Stay Recycled 0.00 0.3#
34 Included with LKQ assembly
S1 35 REF REFINISHIREPAIR L Rear Bumper Stay 03*
Additional Costs
8:Materials
*
36 936012 ADD'LCOST Hazardous Waste Disposal 4.00
Additional Ogerations
37 REF ADD'LOPR Three Stage 2.7
38 VEHICLE PAINT CODE: 0X3
&
Additional CostsMaterials
*
39 ADD‘LCOST Paint/Materials 301.00
Snecial/Manual Entry
S1 40 900500 BDY *
REPAIR TIEDOWN Existing O.5*
*
S1 41 900500 BDY REPAIR PULLS AS NEEDED-Rear Body Panel Existing 1.0*
* -
Judgment Item
# -Labor Note Applies
C - Included in Clear Coat / Three Stage Calc
r - CEG R&R Time Used For This Labor Operation
Recycler Information Section:
Keystone - Fresno
3131 S. North Point Drive
Fresno CA 93725
800-339-5033:
17 Bumper Cover, Rear VNA 445.00
PartNumber: Nl1 1002640 /AM
PROGR Program
Description:LKQ Quote #2 101664997 Pa
Recycled
Disclaimer: pan pricing may represent either actual pricing
which the recycler is willing to sell the part for in its
(the price at
condition) or undamaged pricing (the price at which the recycler
existing
would sell the part if it was in undamaged condition).
If you are unsure, please contact the automotive recycler.
This estimate has been re-calculated with a modified
profile.
ESTIMATE RECALL NUMBER: 16-2066701—01
01/06/2017 14:24:56
OEM:
Mitchell Data Version: DEC_1 6_V
MAPP: DEC_1 6_V0205 Copyright (C) 1994 - 2016 Mitchell International Page 2 of5
Software Version: 7.1 .212 AII Rights Reserved
'
. I '
. Date:
Estimate
ID:
AM
2/ 9/201 7 09:18
16-2066701-01
Estimate Version:
1
Supplement: 1(F F)2/ AM
9/2017 09:16:39
FRESNO ALL PART TYPE
Profile ID:
"All manufacturers requirements regarding seat belt and supplemental
restraint system replacement must be adhered to. If additional parts
or operations are necessary to properly accomplish this, please
contact the estimating claims rep"
Estimate Totals
Add'l
Labor Sublet
I. Labor Subtotals Units Rate Amount Amount Totals II. Summary
Part Replacement Amount
Body 9.5 64.00 0.00 0,00 608.00 Taxable Parts 938.81
Refinish 8.6 64.00 0.00 0.00 550.40 Parts Adjustments 98.00
Sales Tax @ 7.975% 82.69
Non-Taxable Labor 1,158.40
Replacement Parts Amount
Total 1,1 1 9.50
LaborSummary 18.1 1,158.40
III.Additional Costs Amount IV, Adjustments Amount
Taxable Costs 301 .00 Insurance Deductible WAIVED
Sales Tax @ 7.975% 24WOO
Customer Responsibility 0.00
Non—Taxable Costs 4,00
Addmonal Costs
Total 329.00
Paint Material Method: Rates
Rate = 35.00
Snit
I. Total Labor: 58.40
1,1
ll. Replacement Parts:
Total 19,50
1,1
|||. Total Additional Costs: -
329.00
GrossTotal: 2,606.90
IV. Total Adjustments: 0.00
Net Total: 2,606.90
Less Original Net Total: 1,634.52
Net Supplement Amount: 972.38
S1:Jugshir Sidhu 209-409-4337 972.38
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 0F YOUR VEHICLE.
Point(s) of Impact
6 Rear Center (P)
PROGRESSIVE
A|t.Location:
CALIBER COLL-FRESNO
Inspection Site:
Address: 6899 N Milbum Ave
Fresno, CA 93722
(559) 41 7.4447
This estimate has been re—calculated with a modified
profile.
ESTIMATE RECALL NUMBER: 01/06/201714:24:5616—2066701 -01
OEM:
Mitchell Data Version: DEC_1 6_V
MAPP:DEC_16__V0205 Copyright (C) 1994 - 2016 Mitchell International Page 3 of 5
Software Version: 7.1 .212 All Rights Reserved
.
‘
\
x
. | -
. Date:
Estimate
ID: 16-2066701-01
Estimate Version:
1
AM
2/ 9/2017 09:18
Supplement:1 (F F) AM
2/ 9/2017 09:16:39
FRESNO ALL PART TYPE
Profile ID:
Shop agrees to perform the specified repairs at the price indicated.
Repair Facility Authorized Signature
THIS APPRAISAL 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. WE WARRANT THE PARTS
ARE AT LEAST EQUAL TO THE ORIGINAL MANUFACTURER PARTS IN TERMS OF
KIND, QUALITY, SAFETY, FIT, AND PERFORMANCE.
************* IMPORTANT INFORMATION: READ CAREFULLY *************
The customer has the right to select the repair shop. Pursuant to CA
Code of Regulations sec 2695.8(9) Progressive does not require you to
have your vehicle repaired at a specific repair shop. The customer
has the right to select a repair shop of their choice. This is a
damage appraisal only based on damage visible or certain at the time
it was written. Per Business & Professions Code section 9884.9 the
customer, not Progressive, must give authorization for the repairs
before they can begin. This appraisal is not an authorization for
repairs. If frame or unibody repair is included on this appraisal, the
amount shown includes time or allowance for measuring before, during
and after those repairs. To ensure proper and prompt payment for
additional damage discovered during the course of repairs, contact
Progressive for supplement procedures. Progressive honors the
prevailing labor market rate in your area for your property. If you
choose a shop that charges in excess of prevailing labor market rates,
you will be responsible for the difference.
Lifetime guarantee for sheetmetal and plastic parts.
The replacement parts written on this appraisal are intended to return
your vehicle to its pre—loss condition with proper installation.
After repair, if any sheet metal or plastic body part included in this
appraisal fails to return your vehicle to its prerloss condition
(assuming proper installation), in terms of form, fit, finish,
durability or functionality, Progressive will arrange and pay for the
repLacement of the part, to the extent not covered by a manufacturer's
or other warranty. This service will be performed at no cost to you
(including associated repair and rental car costs). To obtain service
under this Guarantee, call Progressive at 15800-274—4641. This
Guarantee applies as long as you own or lease the vehicle. This
Guarantee is not transferable and terminates if you sell or otherwise
transfer your vehicle.
THIS GUARANTEE DOES NOT COVER NORMAL WEAR AND TEAR OR DAMAGE CAUSED
BY IMPROPER MAINTENANCE, NEGLECT, ABUSE OR SUBSEQUENT ACCIDENT. THIS
GUARANTEE IS LIMITED TO ARRANGING FOR THE SELECTION OF REPAIR PARTS
THAT WILL RETURN YOUR VEHICLE TO ITS PRE-LOSS CONDITION. ACCORDINGLY,
PROGRESSIVE WILL NOT BF LIABLE FOR ANY INDIRECT, INCIDENTAL OR
CONSEQUENTIAL DAMAGES THAT RESULT FROM THE INSTALLATION OR USE OF
THESE PARTS.
Type Terms and Abbreviations
NEW and OEM or part number displayed — These refer to a new, original
equipment manufacturer part.
NON—OEM and A/M and Qual REPL — These refer to an after—market part,
which is a new, non—original equipment manufacturer part.
This estimate has been re—calculated with a modified
profile.
ESTIMATE RECALL NUMBER: 16-2066701—01
01/06/2017 14:24:56
OEM:
Mitchell Data Version: DEC_16_V
MAPP:DEC_16_V0205 Copyright (C) 1994 - 2016
Mitchell International Page 4 of 5
Software Version: .212
7.1 AllRights Reserved
‘
'
'
. . Date:
Estimate
ID:
2/9/201709:18AM
16-2066701-01
Estimate Version:
1
Supplement:1 (F F) AM
2/ 9/2017 09:16:39
FRESNO ALL PART TYPE
Profile ID:
USED/RECYCLED and LKQ ~ These refer to a used OEM part.
REMANUFACTURED and RECOND. and RECORE — These refer to used/recycled
OEM parts that have been refurbished.
Progressive's Lifetime Guarantee does not cover repairs you request
the shop to make that are not related to this accident, including but
not exclusive to unrelated prior damage and pre—existing damage.
"For your protection California law requires the following to appear
on this form: Any person who knowingly presents false or fraudulent
Claim for the payment of a loss is guilty of a crime and may be
subject to fines and confinement in state prison."
This estimate has been re—calculated with a modified
profile.
ESTIMATE RECALL NUMBER: 16—2066701—01
01/06/2017 14:24:56
OEM:
Mitchell Data Version: DEC_1 6__V
MAPP:DEC_1 6__V0205 Copyright (C) 1994 — 2016 Mitchell International Page 5 of 5
Software Version: 7.1 .212 All Rights Reserved
‘ Date: AM
2/ 9/201 7 09:18
_ ‘
Estimate
ID: 16—2066701—01
’
‘
Estimate Version:
1
Supplement: 1(F F)2/ AM
9/2017 09:16:39
Profile
ID: FRESNO ALL PART TYPE
United Fmancual Casualty Company
Supplement Delta Report
Comparison of Estimate 16-2066701-01 Supplement 0 and Supplement
1
Damage AssessedBy: Yazminda Bernal 559.240.5080
Supplemented By:Jugshir Sidhu 209-409-4337
Insured:DERILYN WEBER
Owner: DERILYN WEBER
2012 Nissan Maxima 3.5 S
Vehicle Description:
*
12/18/2016
Date of Loss:
Line Labor Line Item Dollar Labor CEG
Item Type Operation Description Type
Part Amount Units Unit
Changed Entries
*
22 ADD‘L COST Paint/Materials 252.00 0.0 T
39< ADD‘L COST Paint/Materials *<
301 .00 0.0 T
Added Entries
S1 11 BDY REPAIR Rear Body Panel Existing 2.0‘ 9.8
12 Body Repair
Paintless 0.0
S1 13 BDY REMOVE/INSTALL Rear Body Trim Panel Existing 0.2 0.2
*
S1 22 BDY REMOVE/REPLACE Rear Bumper Energy Absorber Recycled 0.00 INC 1.3T
23 Included with LKQ assembly 0.0
*
S1 24 BDY REMOVE/REPLACE Rear Bumper Reinforcement Bar Recycled 392.00 0.4 0.4T
$1 25 BDY REMOVE/INSTALL Rear Bumper Cover INC 1.0
26 LKQ Spk/w Tiede Q#6188945 0.0
27 Bar/foam and
Inc. and
left right stays 0.0
S1 28 REF REFINISH/REPAIR Rear Bumper Reinforcement Bar O.8*
S1 29 Markup %25.00
Line 98.00 0.0
*
S’s30 BDY REMOVE/REPLACE R Rear Bumper Stay Recycled 0.00 0.3 0.3T
31 Included with LKQ assembly 0.0
S1 32 REF REFINISH/REPAIR R Rear Bumper Stay O.3*
*
S1 33 BDY REMOVE/REPLACE LRear Bumper Stay Recycled 0.00 0.3 0.3T
34 LKQ
Included with assembly 0.0
S1 35 REF REFINISH/REPA
Preview
y u Mark R. Nivinskus, Bar No. 195335 NIVINSKUS LAW GROUP, A LAW CORPORATION 134 W. Wilshire Ave. Fullerton, CA 92832 Telephone: (714) 533—8110 Fax Number: (714) 533—8828 E-FILED 9/2/2020 7:42 PM Attorneys for Plaintiff I NO_: 18000285 SupenorCounofCaMonfla our File Bar No_; 195335 Coumyomesno By:J.Mafimez,Depuw SUPERIOR COURT OF CALIFORNIA, FRESNO COUNTY FRESNO JUDICIAL DISTRICT JUDICIAL DISTRICT 11 UNITED FINANCIAL CASUALTY CASE No. ?gcedOOS/Bla COMPANY 12 Plaintiff, DECLARATION PURSUANT TO CODE OF CIVIL 13 vs. PROCEDURE SECTION 585(d) AND EVIDENCE CODE SECTION l4 GABRIELA CRUZ 1550 Defendants, 15 (Declaration of Facts) 16 l7 18 The undersigned declares: 19 The facts stated herein are within my personal knowledge 20 true of my own knowledge and if sworn as a witness, I could and 21 competently testify thereto. 22 am the Custodian of Records for the plaintiff herein. The I 23 attached exhibits are true copies of the original records 24 contained in plaintiff's claim file, as business records are 25 in Evidence Code §1271. The records were prepared in the defined 26 regular course of business, and they were prepared at or near 27 of the act, condition or event reflected therein. The the time 28 I y v z documents attached hereto were preserved as a part of the records of the business of plaintiff, as defined in Evidence Code §1270, in the regular course of its business. The photostatic copies of the documents in plaintiffs claims file are admissible pursuant to Evidence Code §1550(2) and are admissible as the writing itself: The records contain the following facts regarding the accident alleged in the complaint filed by plaintiff: 1. Date of Accident: December l8, 2016 Location of Accident: SR-4l at Ashlan Ave., Fresno, CA 10 2. 11 93726 12 3. Driver of Insured‘s vehicle: Derilyn Weber 13 4. Owner of Insured's vehicle: Derilyn Weber 14 5. Owner of defendant's vehicle: Gabriela Cruz 15 6. Driver of defendant's vehicle: Gabriela Cruz l6 7. Defendant's vehicle: 2002 GMC l7 8. How the Accident OCCurred: The defendant's vehicle 18 struck the rear of the plaintiff's insured's vehicle l9 which was lawfully stopped in traffic. 20 9. How the defendant was Negligent: The defendant was 21 driving at an excessive and unsafe rate of speed and 22 was inattentive. 23 24 At the time of the accident alleged in plaintiff's there was a policy of automobile insurance in force 25 complaint, was issued by plaintiff to Derilyn Weber. The payments 26 which herein were required by the terms and conditions of 27 enumerated 28 the policy and are supported by the attached exhibits. 2 r . . Plaintiff paid for its insured‘s property damage as follows: Property damage and towing $2,606.90 Date Paid: January 08, 2017 Total property damage = $2,606.90 Total paid = $2,606.90 Pursuant to the terms and conditions of the insurance policy, plaintiff is subrogated to the rights of its insured. 10 Therefore plaintiff is entitled to recover from the defendant 11 the sum of $2,606.90. 12 I declare under the penalty of perjury under the laws of 13 the State of California that the foregoing is true and correct. 14 “T4“ Executed V&bwiUfl\\€>QN' 20 \C1 W) on , , 15 l6 at MK . Owgtate) . 17 l8 l9 WWMWUJ» (signature. of Declarant) Mynesha Perkins-Clarke 20 Declarant (Please print or type) 21 22 23 24 25 26 27 28 . . ‘ . . . Date: Estimate ID: Estimate Version: 1 AM 2/ 9/2017 09:18 16-2066701 -01 . Supplement:1(F F) 2/ AM 9/2017 09:16:39 . FRESNO ALL PART TYPE Profile ID: United Financial Casualty Company *i’************************* DAMAGE APPRAISAL************************* Damage AssessedBy: Yazminda Berna! 559.240.5080 Claim Rep:MEGAN BARACK (440) 910-1742 Supplemented By:Jugshir Sidhu 209-409-4337 Classification: Please contact Yazminda Bernal at 559-240—5080 or YBERNAL1@PROGRESSTVE.COM for any supplement request or questions regarding this appraisal. * Product TypeAuto * 12/1 8/201 6 Date of Loss; " Deductible:WAIVED “ Claim Number: 16-206670 1 -O1 Insured:DERILYN WEBER Owner: DERILYN WEBER 91 1072 Mitchell Service: 2012 Nissan Maxima 3.5 S Description: Body Style:4D Sed 3.5L Drive Train: 6 CyI Inj AT FWD VIN: 1N4AA5AP4CC820908 License:6YTE705 CA Mileage:72,280 OEM/ALT: A Search Code:FRESNO1 Coior: white Options: CD CHANGER, PASSENGER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWERWINDOW POWER STEERING, REAR WINDOW DEFOGGER, AIR CONDITION, CRUISE CONTROL TILT STEERING COLUMN, AM/FM STEREO, DRIVER AIRBAG4 REAR (DUAL-ZONE) AC POW ER PASSENGER SEAT, FRONT SIDE AIRBAG WITH HEAD PROTECTION ANTl-LOCK BRAKE SYS., TRACTlON CONTROL, ALUM/ALLOY WHEELS TIRE lNFLATION/PRESSURE MONITOR, ANTI-THEFT SYSTEM, AUXILIARY INPUT BLUETOOTH WIRELESS CONNECTIVITY, LEATHER STEERING WHEEL, CD PLAYER POWER ADJUSTABLE EXTERIOR MIRROR, SUNROOF/MOONROOF, AUTO AIR CONDITION TRIP COMPUTER, FIRST ROW BUCKET SEAT REAR HEATING, VENTILATION & AIR CONDITIONING, CLOTH SEAT, SIDE AIRBAGS AUTOMATIC HEADLIGHTS, SECOND ROW SIDE AIRBAG WITH HEAD PROTECTION INTERIOR AUTOMATIC DAY/NIGHT OR ELECTROCHROMATIC MIRROR, MP3 PLAYER DRIVER SEAT WITH POWER LUMBAR SUPPORT, ELECTRONIC STABILITY CONTROL KEYLESS ENTRY SYSTEM, REAR BENCH SEAT, STEERING WHEEL AUDIO CONTROLS Line Entry Labor Line Item Pan Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units Luggage Lid 1 101703 BDY REMOVE/INSTALL Luggage Panel Lid Finish 0.4 # BDY REMOVE/INSTALL Luggage Trim Panel Frt 0.3 2 BDY REMOVE/INSTALL Rear Luggage Trim Panel 0.2 3 Existing 1.0* 4 101386 BDY REPAIR LuggageLid Panel 5 REF REFINISH/REPAIR Luggage Pane! Lid C 1.7" 6 MODIFIED REFINISH WITH FULL CLEAR COAT 7 101 398 BDY REMOVE/REPLACE Luggage Lid Adhesive Emblem 84890-9NOOA 46.36 0.2 This estimate has been re-calculated with a modified profile ESTIMATE RECALL NUMBER: 16—2066701-01 01/06/2017 14:24:56 OEM: Mitchell Data Version: DEC_16_V MAPP:DEC_1 s_v0205 Copyright (C) 1994 -2016 Mitchell International Page 1 of 5 Software Version: .212 7.1 Rights Reserved All Date: AM 2/ 9/2017 09:18 Estimate ID: 16-2066701 -O1 Estimate Version: 1 Supplement: 1(F F) AM 2/ 9/2017 09:16:39 FRESNO ALL PART TYPE Profile ID: 8 Adhesive, one time use only 9 101399 BDY REMOVE/REPLACE LuggageLidAdhesive Nameplate 84894-9NO0A 55.45 0.2 10 Adhesive, one time use only Rear Body S1 11 101509 BDY REPAIR Rear Body Panel Existing 2.0*# 12 Body Repair Paintless S1 13 101 527 BDY REMOVE/INSTALL Rear Body Trim Panel Existing 0.2 r RearLamas 14 101568 BDY REMOVE/INSTALL R License Lamp Assembly Existing 0.2#r 15 101569 BDY REMOVE/INSTALL L License Lamp Assembly Existing 0.2#r Rear Bumger 16 BDY OVERHAUL Rear Bumper Cover Assy 1.3# REMOVE/REPLACE u AIM ‘ INC # 17 101 568 BDY Rear Bumper Cover 445.00 18 BDY REMOVE/INSTALL R Rear Combination Lamp 0.4# 19 BDY REMOVE/INSTALL Lamp L Rear Combination 0.4# 20 REF REFINISH Rear Bumper Cover 2.8# 21 Keystone. quote #101 664997 * S1 22 101 601 BDY REMOVE/REPLACE Rear Bumper Energy Absorber Recycled 0.00 INC 23 LKQ assembly Included with * S1 24 101 602 BDY REMOVE/REPLACE Rear Bumper Reinforcement Bar Recycled 392.00 0.4 #r S1 25 BDY REMOVE/INSTALL Rear Bumper Cover INC # 26 LKQ Spk/w Tiede Q#6188945 27 Bar/foam and Inc. and left right stays S1 28 REF REFINISH/REPAIR Rear Bumper Reinforcement Bar O.8* S1 29 Line Markup %25.00 98.00 * S1 30 101603 BDY REMOVE/REPLACE R Rear Bumper Stay Recycled 0.00 0.3# 31 Included with LKQ assembly S1 32 REF REFINISHIREPAIR R Rear Bumper Stay 03* * S1 33 101604 BDY REMOVE/REPLACE L Rear Bumper Stay Recycled 0.00 0.3# 34 Included with LKQ assembly S1 35 REF REFINISHIREPAIR L Rear Bumper Stay 03* Additional Costs 8:Materials * 36 936012 ADD'LCOST Hazardous Waste Disposal 4.00 Additional Ogerations 37 REF ADD'LOPR Three Stage 2.7 38 VEHICLE PAINT CODE: 0X3 & Additional CostsMaterials * 39 ADD‘LCOST Paint/Materials 301.00 Snecial/Manual Entry S1 40 900500 BDY * REPAIR TIEDOWN Existing O.5* * S1 41 900500 BDY REPAIR PULLS AS NEEDED-Rear Body Panel Existing 1.0* * - Judgment Item # -Labor Note Applies C - Included in Clear Coat / Three Stage Calc r - CEG R&R Time Used For This Labor Operation Recycler Information Section: Keystone - Fresno 3131 S. North Point Drive Fresno CA 93725 800-339-5033: 17 Bumper Cover, Rear VNA 445.00 PartNumber: Nl1 1002640 /AM PROGR Program Description:LKQ Quote #2 101664997 Pa Recycled Disclaimer: pan pricing may represent either actual pricing which the recycler is willing to sell the part for in its (the price at condition) or undamaged pricing (the price at which the recycler existing would sell the part if it was in undamaged condition). If you are unsure, please contact the automotive recycler. This estimate has been re-calculated with a modified profile. ESTIMATE RECALL NUMBER: 16-2066701—01 01/06/2017 14:24:56 OEM: Mitchell Data Version: DEC_1 6_V MAPP: DEC_1 6_V0205 Copyright (C) 1994 - 2016 Mitchell International Page 2 of5 Software Version: 7.1 .212 AII Rights Reserved ' . I ' . Date: Estimate ID: AM 2/ 9/201 7 09:18 16-2066701-01 Estimate Version: 1 Supplement: 1(F F)2/ AM 9/2017 09:16:39 FRESNO ALL PART TYPE Profile ID: "All manufacturers requirements regarding seat belt and supplemental restraint system replacement must be adhered to. If additional parts or operations are necessary to properly accomplish this, please contact the estimating claims rep" Estimate Totals Add'l Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Summary Part Replacement Amount Body 9.5 64.00 0.00 0,00 608.00 Taxable Parts 938.81 Refinish 8.6 64.00 0.00 0.00 550.40 Parts Adjustments 98.00 Sales Tax @ 7.975% 82.69 Non-Taxable Labor 1,158.40 Replacement Parts Amount Total 1,1 1 9.50 LaborSummary 18.1 1,158.40 III.Additional Costs Amount IV, Adjustments Amount Taxable Costs 301 .00 Insurance Deductible WAIVED Sales Tax @ 7.975% 24WOO Customer Responsibility 0.00 Non—Taxable Costs 4,00 Addmonal Costs Total 329.00 Paint Material Method: Rates Rate = 35.00 Snit I. Total Labor: 58.40 1,1 ll. Replacement Parts: Total 19,50 1,1 |||. Total Additional Costs: - 329.00 GrossTotal: 2,606.90 IV. Total Adjustments: 0.00 Net Total: 2,606.90 Less Original Net Total: 1,634.52 Net Supplement Amount: 972.38 S1:Jugshir Sidhu 209-409-4337 972.38 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 0F YOUR VEHICLE. Point(s) of Impact 6 Rear Center (P) PROGRESSIVE A|t.Location: CALIBER COLL-FRESNO Inspection Site: Address: 6899 N Milbum Ave Fresno, CA 93722 (559) 41 7.4447 This estimate has been re—calculated with a modified profile. ESTIMATE RECALL NUMBER: 01/06/201714:24:5616—2066701 -01 OEM: Mitchell Data Version: DEC_1 6_V MAPP:DEC_16__V0205 Copyright (C) 1994 - 2016 Mitchell International Page 3 of 5 Software Version: 7.1 .212 All Rights Reserved . ‘ \ x . | - . Date: Estimate ID: 16-2066701-01 Estimate Version: 1 AM 2/ 9/2017 09:18 Supplement:1 (F F) AM 2/ 9/2017 09:16:39 FRESNO ALL PART TYPE Profile ID: Shop agrees to perform the specified repairs at the price indicated. Repair Facility Authorized Signature THIS APPRAISAL 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. WE WARRANT THE PARTS ARE AT LEAST EQUAL TO THE ORIGINAL MANUFACTURER PARTS IN TERMS OF KIND, QUALITY, SAFETY, FIT, AND PERFORMANCE. ************* IMPORTANT INFORMATION: READ CAREFULLY ************* The customer has the right to select the repair shop. Pursuant to CA Code of Regulations sec 2695.8(9) Progressive does not require you to have your vehicle repaired at a specific repair shop. The customer has the right to select a repair shop of their choice. This is a damage appraisal only based on damage visible or certain at the time it was written. Per Business & Professions Code section 9884.9 the customer, not Progressive, must give authorization for the repairs before they can begin. This appraisal is not an authorization for repairs. If frame or unibody repair is included on this appraisal, the amount shown includes time or allowance for measuring before, during and after those repairs. To ensure proper and prompt payment for additional damage discovered during the course of repairs, contact Progressive for supplement procedures. Progressive honors the prevailing labor market rate in your area for your property. If you choose a shop that charges in excess of prevailing labor market rates, you will be responsible for the difference. Lifetime guarantee for sheetmetal and plastic parts. The replacement parts written on this appraisal are intended to return your vehicle to its pre—loss condition with proper installation. After repair, if any sheet metal or plastic body part included in this appraisal fails to return your vehicle to its prerloss condition (assuming proper installation), in terms of form, fit, finish, durability or functionality, Progressive will arrange and pay for the repLacement of the part, to the extent not covered by a manufacturer's or other warranty. This service will be performed at no cost to you (including associated repair and rental car costs). To obtain service under this Guarantee, call Progressive at 15800-274—4641. This Guarantee applies as long as you own or lease the vehicle. This Guarantee is not transferable and terminates if you sell or otherwise transfer your vehicle. THIS GUARANTEE DOES NOT COVER NORMAL WEAR AND TEAR OR DAMAGE CAUSED BY IMPROPER MAINTENANCE, NEGLECT, ABUSE OR SUBSEQUENT ACCIDENT. THIS GUARANTEE IS LIMITED TO ARRANGING FOR THE SELECTION OF REPAIR PARTS THAT WILL RETURN YOUR VEHICLE TO ITS PRE-LOSS CONDITION. ACCORDINGLY, PROGRESSIVE WILL NOT BF LIABLE FOR ANY INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE INSTALLATION OR USE OF THESE PARTS. Type Terms and Abbreviations NEW and OEM or part number displayed — These refer to a new, original equipment manufacturer part. NON—OEM and A/M and Qual REPL — These refer to an after—market part, which is a new, non—original equipment manufacturer part. This estimate has been re—calculated with a modified profile. ESTIMATE RECALL NUMBER: 16-2066701—01 01/06/2017 14:24:56 OEM: Mitchell Data Version: DEC_16_V MAPP:DEC_16_V0205 Copyright (C) 1994 - 2016 Mitchell International Page 4 of 5 Software Version: .212 7.1 AllRights Reserved ‘ ' ' . . Date: Estimate ID: 2/9/201709:18AM 16-2066701-01 Estimate Version: 1 Supplement:1 (F F) AM 2/ 9/2017 09:16:39 FRESNO ALL PART TYPE Profile ID: USED/RECYCLED and LKQ ~ These refer to a used OEM part. REMANUFACTURED and RECOND. and RECORE — These refer to used/recycled OEM parts that have been refurbished. Progressive's Lifetime Guarantee does not cover repairs you request the shop to make that are not related to this accident, including but not exclusive to unrelated prior damage and pre—existing damage. "For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent Claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison." This estimate has been re—calculated with a modified profile. ESTIMATE RECALL NUMBER: 16—2066701—01 01/06/2017 14:24:56 OEM: Mitchell Data Version: DEC_1 6__V MAPP:DEC_1 6__V0205 Copyright (C) 1994 — 2016 Mitchell International Page 5 of 5 Software Version: 7.1 .212 All Rights Reserved ‘ Date: AM 2/ 9/201 7 09:18 _ ‘ Estimate ID: 16—2066701—01 ’ ‘ Estimate Version: 1 Supplement: 1(F F)2/ AM 9/2017 09:16:39 Profile ID: FRESNO ALL PART TYPE United Fmancual Casualty Company Supplement Delta Report Comparison of Estimate 16-2066701-01 Supplement 0 and Supplement 1 Damage AssessedBy: Yazminda Bernal 559.240.5080 Supplemented By:Jugshir Sidhu 209-409-4337 Insured:DERILYN WEBER Owner: DERILYN WEBER 2012 Nissan Maxima 3.5 S Vehicle Description: * 12/18/2016 Date of Loss: Line Labor Line Item Dollar Labor CEG Item Type Operation Description Type Part Amount Units Unit Changed Entries * 22 ADD‘L COST Paint/Materials 252.00 0.0 T 39< ADD‘L COST Paint/Materials *< 301 .00 0.0 T Added Entries S1 11 BDY REPAIR Rear Body Panel Existing 2.0‘ 9.8 12 Body Repair Paintless 0.0 S1 13 BDY REMOVE/INSTALL Rear Body Trim Panel Existing 0.2 0.2 * S1 22 BDY REMOVE/REPLACE Rear Bumper Energy Absorber Recycled 0.00 INC 1.3T 23 Included with LKQ assembly 0.0 * S1 24 BDY REMOVE/REPLACE Rear Bumper Reinforcement Bar Recycled 392.00 0.4 0.4T $1 25 BDY REMOVE/INSTALL Rear Bumper Cover INC 1.0 26 LKQ Spk/w Tiede Q#6188945 0.0 27 Bar/foam and Inc. and left right stays 0.0 S1 28 REF REFINISH/REPAIR Rear Bumper Reinforcement Bar O.8* S1 29 Markup %25.00 Line 98.00 0.0 * S’s30 BDY REMOVE/REPLACE R Rear Bumper Stay Recycled 0.00 0.3 0.3T 31 Included with LKQ assembly 0.0 S1 32 REF REFINISH/REPAIR R Rear Bumper Stay O.3* * S1 33 BDY REMOVE/REPLACE LRear Bumper Stay Recycled 0.00 0.3 0.3T 34 LKQ Included with assembly 0.0 S1 35 REF REFINISH/REPA