civic repair sept and oct 2012

CITIZENS INSURANCE CO OF AMERICA

THE HANOVER INSURANCE GROUP

For Supplements Call 413-977-4951

PO BOX 15052, WORCESTER, MA 01615

Phone: (800) 628-0250

Fax: (508) 926-4977Claim #:

Workfile ID:

14-00-929703-1-1

0e1a89c0

Supplement of Record 1 with Summary

Written By: BRIAN VREELAND, License Number: 013123, 9/17/2012 10:18:18 AM

Adjuster: PROCTOR, SARAH, (800) 628-0250 Business

Insured: David Ewen Policy #: APN3755616 Claim #: 14-00-929703-1-1

Type of Loss: Collision Date of Loss: 09/11/2012 12:00 AM Days to Repair: 15

Point of Impact: 07 Left Rear Deductible: 500.00

Owner: Inspection Location: Appraiser Information: Repair Facility:

David Ewen

88 APPLETON ST

SPRINGFIELD, MA 01108

(413) 237-0809 Evening

BALISE COLLISION REPAIR

CENTER

292 MAIN ST.


Repair Facility

(413) 732-8702 Business

Email:

[email protected]

Phone: (413) 977-4951

BALISE COLLISION REPAIR CENTER

292 MAIN ST.


(413) 732-8702 Business

(413) 747-0509 Fax

55-0811490

VEHICLE

Year: 2012 Color: GRAY Int: gray License: 953DL3 Production Date:

Make: HOND Body Style: 4D SED State: MA Odometer: 5876

Model: CIVIC LX Engine: 4-1.8L-FI VIN: 2HGFB2E57CH556344 Condition:

TRANSMISSION Console/Storage AM Radio Cloth Seats

5 Speed Transmission CONVENIENCE FM Radio Bucket Seats

Overdrive Air Conditioning Stereo Recline/Lounge Seats

POWER Rear Defogger Search/Seek WHEELS

Power Steering Tilt Wheel CD Player Full Wheel Covers

Power Brakes Cruise Control Auxiliary Audio Connection PAINT

Power Windows Telescopic Wheel SAFETY Clear Coat Paint

Power Locks Intermittent Wipers Anti-Lock Brakes (4) Metallic Paint

Power Mirrors Keyless Entry Driver Air Bag OTHER

Power Trunk/Tailgate Alarm Passenger Air Bag Traction Control

DECOR Steering Wheel Controls Head/Curtain Air Bags Stability Control

Tinted Glass Message Center Front Side Impact Air Bags

Dual Mirrors RADIO SEATS

9/17/2012 10:18:43 AM 107572

Claim #: 14-00-929703-1-1

Workfile ID: 0e1a89c0


2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

Line Oper Description Part Number Qty Extended

Price $

Labor Paint

1 REAR BUMPER

2 O/H rear bumper 1.4

3 Repl Bumper cover w/o Si US built 04715TR3A90ZZ 1 303.38 Incl. 3.0

4 Add for Clear Coat 1.2

5 Repl LT Spacer US built 71598TR0A01 1 12.27 0.1

6 REAR LAMPS

7 R&I LT Tail lamp assy 33550TR0A01 Incl.

8 TRUNK LID

9 R&I R&I trunk lid 68500TR0A90ZZ 0.8

10 Blnd Trunk lid LX, EX, EX-L 68500TR0A90ZZ 1.2

11 R&I License molding US built, w/o DX

cool mist

74890TR3A01ZF 0.3

12 # R&I License plate 0.1

13 Repl Nameplate "CIVIC" 75722TR0A01 1 26.73 0.2

14 R&I Trunk lid trim 84620TR3A01ZA 0.3

15 QUARTER PANEL

16 Repl LT Quarter panel 04646TR0A90ZZ 1 735.12 17.5 3.1


18 Deduct for Rear Bumper R&I -1.0

19 R&I Fuel door 63910TR0A00ZZ Incl.

20 Blnd Fuel door 63910TR0A00ZZ 0.2

21 Repl LT Air outlet vent 75450TR0A00 1 17.70 Incl.

22 Repl LT Splash shield 74591TR0A00 1 3.82 0.2

23 Repl LT Stone guard US built 74485SNAA00 1 10.70 0.2

24 Repl LT Inner panel US built (HSS) 64700TR3415ZZ 1 570.70 s 6.5 1.5


26 R&I LT Upper qtr trim US built beige 84180TR0A01ZC Incl.

27 R&I RT Upper qtr trim US built beige 84130TR0A01ZC 0.3

28 # Rpr Fabricate 1/4 sleeves 2.0

29 S01 Repl LT Gutter extn US built 63720TR3305ZZ 1 40.13 2.5 1.0

30 S01 Add for Clear Coat 0.2

31 S01 Deduct for Overlap -1.0

32 ROOF

33 R&I LT Roof molding 74316TR0A01 0.4

34 BACK GLASS

35 R&I Back glass Honda, US built w/o

navigation

73211TR3A01 Incl.

36 Repl Dam 73525SYY000 1 7.32

37 Repl Lower seal 73227TR0A00 1 8.65 Incl.

38 REAR BODY & FLOOR

39 R&I Pkg tray trim DX, LX, EX, HF

beige

84505TR0A01ZC Incl.

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Claim #: 14-00-929703-1-1




40 R&I LT Trunk side trim US built DX,

LX, EX, HF

84651TR3A01ZA Incl.

41 R&I Rear panel trim 84640TR0A01ZA Incl.

42 * R&I Spare cover US built 84521TR3A00ZA Incl.

43 * S01 Rpr Rear body panel 66100TR0A00ZZ 1.5 0.5

NOTE: spot repair spot refinish LT side of panel

44 Overlap Major Adj. Panel -0.4


46 * S01 Rpr Rear floor pan US built 04655TR3A00ZZ 1.5 0.5

NOTE: spot repair spot refinish LT side of floor panel

47 REAR SUSPENSION

48 Repl Align four wheels 1 m 1.6

49 O/H rr susp lt m 2.9

50 Repl LT Trailing arm w/o Si 52371TR0A03 1 187.32 m Incl.

51 Repl LT Upper cntrl arm 52510TR0A01 1 67.52 m Incl.

52 Repl LT Knuckle sedan, US built DX,

LX, HF

52215TR3A00 1 132.62 m Incl.

53 Deduct for Overlap Incl.

54 Repl LT Hub & bearing sedan 42200TR0901 1 101.05 m Incl.

55 REAR DOOR

56 Repl LT Door shell 67550TR0A90ZZ 1 628.07 4.0 2.9

57 Overlap Major Adj. Panel -0.4


59 Add for power units 0.2

60 R&I LT Door w'strip US built 72850TR3A01 0.5

61 R&I LT Water shield 72861TR0A00 0.1

62 R&I LT Belt molding 72950TR0A01 Incl.

63 Repl LT Black out tape US built 67865TR3A01 1 3.80 0.3

64 R&I LT Moveable glass Honda US built 73450TR3A00 Incl.

65 * R&I LT Run channel 72775TR0A01 Incl.

66 R&I LT Fixed glass Honda, w/o Si US

built

73455TR3L00 Incl.

67 R&I LT Weatherstrip US built 73491TR3A01 Incl.

68 * R&I LT Handle, outside painted 72181TR0A11ZH Incl.

69 * Refn LT Handle, outside painted 72181TR0A11ZH 0.5

70 Overlap Minor Panel -0.2


72 FRONT DOOR

73 Blnd LT Outer panel 67151TR0305ZZ 1.0

74 R&I LT Water shield 72361TR0A01 0.1

75 R&I LT Belt molding 72450TR0A01 0.3

76 R&I LT R&I mirror 76258TR3A01 0.4

77 R&I LT Handle, outside painted

alabaster slv

72181TR0A11ZC 0.4

78 R&I LT R&I trim panel 83550TR0A11ZB 0.4

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Claim #: 14-00-929703-1-1




79 SEATS & TRACKS

80 S01 Repl Seat cushion pad clip 82138TR0003 2 3.24

81 WHEELS

82 * Repl LT/Rear Wheel, steel 15" 42700TR0A02 1 78.60 m 0.3

83 Repl LT/Rear Wheel cover 15" US built 44733TR0A00 1 20.88

84 TIRES

85 # COVER CAR FOR OVERSPRAY 1 3.00 X 0.2

86 # Refn TINT AND TEST 0.5

87 # DETAIL MASK 1 0.6

88 # ADD FOR FLEX 1 12.00 T

89 # RUSTPROOFING 1 10.00 T 0.2

90 # DENIB AND POLISH 1 2.5

91 # Blnd BLEND WELD ZONES 0.5

92 # Repl SEAM SEAL 1 T 0.5

93 # RESET ELECTRONICS 1 0.3

94 # Refn ANTI CORROSION PRIMER 0.3

95 # SETUP AND MEASURE 1 2.0

96 # DIAGNOSE SUSPENSION 1 0.5

97 # REPAIR CLAMP DAMAGE 1 0.5 0.5

98 # PULL UNIBODY 1 4.0 F

99 # D&R BATTERY 1 0.2

100 # RESEAL VAPOR BARRIOR 1 1.25 0.2

101 # PANEL BONDING KIT 1 39.56 T

102 # BALANCE WHEEL 1 0.2

103 # S01 Repl Paint/materials 1 396.00

104 * S01 Repl FIRE 195/65R15 AFFINITY

TOURING S4 89S

FI07602 1 101.15 0.3

NOTE: Town fair Tire Co 1127 Riverdale st Wspringfield MA (413)787-0701

105 # S01 Additional P/M per mitchell

$643.90 less $396.00 allowed

1 247.90 T

NOTE: Code NH737M 12.9hrs refinish 2.9hrs blend =643.90 less 396.00 allowed = 247.90

SUBTOTALS 3,770.48 57.5 19.8

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Claim #: 14-00-929703-1-1




ESTIMATE TOTALS

Category Basis Rate Cost $

Parts 3,458.02

Body Labor 53.5 hrs @ $ 36.00 /hr 1,926.00

Paint Labor 19.8 hrs @ $ 36.00 /hr 712.80

Frame Labor 4.0 hrs @ $ 40.00 /hr 160.00

Miscellaneous 312.46

Subtotal 6,569.28

Sales Tax $ 3,767.48 @ 6.2500 % 235.47

Total Cost of Repairs 6,804.75

Deductible 500.00

Total Adjustments 500.00

Net Cost of Repairs 6,304.75

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Claim #: 14-00-929703-1-1




SUPPLEMENT SUMMARY

Line Oper Description Part Number Qty Extended

Price $

Labor Paint

Changed Items

39 * Rpr Rear body panel 66100TR0A00ZZ -3.0 -1.0

43 * S01 Rpr Rear body panel 66100TR0A00ZZ 1.5 0.5

NOTE: spot repair spot refinish LT side of panel

42 * Rpr Rear floor pan US built 04655TR3A00ZZ -2.0 -0.5

46 * S01 Rpr Rear floor pan US built 04655TR3A00ZZ 1.5 0.5

NOTE: spot repair spot refinish LT side of floor panel

98 # Repl Paint/materials 1 -382.00

103 # S01 Repl Paint/materials 1 396.00

Deleted Items

80 * Repl FIRE P195/65R15 AFFINITY

TOURING S4

FI01808 1 -117.99 -0.3

Added Items

29 S01 Repl LT Gutter extn US built 63720TR3305ZZ 1 40.13 2.5 1.0

30 S01 Add for Clear Coat 0.2

31 S01 Deduct for Overlap -1.0

79 SEATS & TRACKS

80 S01 Repl Seat cushion pad clip 82138TR0003 2 3.24

104 * S01 Repl FIRE 195/65R15 AFFINITY

TOURING S4 89S

FI07602 1 101.15 0.3

NOTE: Town fair Tire Co 1127 Riverdale st Wspringfield MA (413)787-0701

105 # S01 Additional P/M per mitchell

$643.90 less $396.00 allowed

1 247.90 T

NOTE: Code NH737M 12.9hrs refinish 2.9hrs blend =643.90 less 396.00 allowed = 247.90

SUBTOTALS 288.43 -0.5 0.7

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Claim #: 14-00-929703-1-1




TOTALS SUMMARY

Category Basis Rate Cost $

Parts 40.53

Body Labor -0.5 hrs @ $ 36.00 /hr -18.00

Paint Labor 0.7 hrs @ $ 36.00 /hr 25.20

Paint Supplies 0.7 hrs @ $ 20.00 /hr 14.00

Additional Supplement Materials/Supplies -14.00

Miscellaneous 247.90

Subtotal 295.63

Sales Tax $ 288.43 @ 6.2500 % 18.03

Total Supplement Amount 313.66

NET COST OF SUPPLEMENT 313.66

CUMULATIVE EFFECTS OF SUPPLEMENT(S)

Estimate 6,491.09 Ted Lolos

Supplement S01 313.66 BRIAN VREELAND

Workfile Total: $ 6,804.75

TOTAL ADJUSTMENTS: $ 500.00

NET COST OF REPAIRS: $ 6,304.75

BRIAN VREELAND

MA LIC #013123

PER MASSACHUSETTS REG. TITLE 212 CHAPTER 2.02(5), "THIS ESTIMATE HAS BEEN PREPARED AND SWORN TO

UNDER THE PENALTIES OF PERJURY."

Estimate calculated using a preset user threshold amount for the paint and material cost.

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Claim #: 14-00-929703-1-1




Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide

ARG4449, CCC Data Date 8/17/2012, 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.

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 2012 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 complete 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.

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.

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Claim #: 14-00-929703-1-1




TIRE PARTS SUPPLIERS

Line Description Supplier Price

104 FIRE 195/65R15 AFFINITY TOURING S4 89S Town Fair Tire Co $ 101.15

1127 Riverdale Street, W. Springfield MA 01089-0 (413) 787-0701

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civic repair sept and oct 2012

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