ESubro Hub Demand Package

(1)

All Evidence

ESubro Hub Demand Package

GEICO GENERAL INS CO

OHIO MUTUAL INS GROUP 2021019098

Issued 0.00

8732164250000001

Demander:

Responder:

Status :

7672.41

Original Damages : Response Amt (R) : ^0.00 Demand Amt (D): ^7672.41 Total Payment Amt :

Demand Summary

This package includes the following:

Demand Detail Negotiation Detail

Evidence Detail Activity Log

Claim #(D):

Claim #(R):

$

$ Overall Demand Amt: $ Doc Sharing : ^NO

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 1 of 56

(2)

Demand Summary

Demander:

Responder:

Claim #(D):

Claim #(R):

Original Damages: ^$7672.41 Total Demand Amt. (D): ^$

GEICO GENERAL INS CO OHIO MUTUAL INS GROUP

8732164250000001 2021019098

Demander Company Information Responder Company Information

Company Name:

Claim Number:

Line of Insurance:

Insured Name:

Driver Name:

Vehicle Make/Model:

Vehicle Year:

Demander Vehicle Information Responder Vehicle Information

Driver Name:

Vehicle Make/Model:

Vehicle Year:

Company Name:

Claim Number:

Line of Insurance:

Insured Name:

8732164250000001 GEICO GENERAL INS CO

JESSE SARGENT

SUBARU WRX 2019

2021019098

OHIO MUTUAL INS GROUP

RAYMOUND MARTIN Personal

Personal

SATN ION 2 2004

Demand Detail

Bailment: No

Lic Plate State/Num: VT HMK701 Lic Plate State/Num:

Policy Number:

Internal Reference: Internal Reference:

Policy Number:

Loss Information

Loss Date: 10/23/2021 Vehicle City:

Loss Location: Vehicle State: VT

Loss Facts:

Non-Fault - Claimant Rear-Ended Policyholder

Demander Rep. Information Responder Rep. Information

Address:

Rep. Name:

Address:

Rep. Name:

PRU TECH ADAM JANSEN

3350 Buschwood Park Dr

Tampa, FL 33618

1725 Hopley Ave PO Box 111 Bucyrus, OH 44820

Rep. Phone: 800-459-4038 Rep. Phone: 1-800-686-3011 ext. 0866

Remittance Information

(3)

Demand Negotiation Detail

Auto Damages:

Rental Towing Other Deductible

Salvage Amt

Original Damages

Auto Damages:

Rental Towing Other Deductible

Salvage Amt

Demander Offer 11/08/2021 18:28 EST

6972.41

0.00 200.00 0.00 500.00

Total Loss: N

Total: 7672.41

100.00 %

6972.41

0.00 0.00 0.00 500.00

7672.41

Please consider additional damages.

Negotiation Message:

Edited Damages

Coll Comp(OTC) Coll Comp(OTC)

Resp Liability Resp Liability 100.00 %

Current Offer 7472.41

Total Demand

Payments Rcvd 0.00 Prior Payments

Rental Towing Other Deductible

Salvage Amt

Resp Liability %

Current Offer

Responder Offer Auto Damages:

Coll Comp(OTC)

Current Payment

Total: 7472.41 Total:

Auto Damages:

Rental Towing Other Deductible

Salvage Amt

Original Damages

Auto Damages:

Rental Towing Other Deductible

Salvage Amt

Demander Offer 11/05/2021 05:49 EDT

6972.41

0.00 0.00 0.00 500.00

Total Loss: N

Total: 7472.41

100.00 %

6972.41

0.00 0.00 0.00 500.00

7472.41

Please Review for Payment.

Negotiation Message:

Issued

Coll Comp(OTC) Coll Comp(OTC)

Resp Liability Resp Liability 100.00 %

Current Offer 7472.41

Total Demand

Payments Rcvd 0.00 Prior Payments

Rental Towing Other Deductible

Salvage Amt

Resp Liability %

Current Offer

Responder Offer Auto Damages:

Coll Comp(OTC)

Current Payment

Total: 7472.41 Total:

Date Added Added By Event Type Event Description

Activity Log

11/10/2021 17:17 EST SYSTEM PROFILE Notification Email Sent Notification Email Sent to ADAM JANSEN (R) at [email address on file] due to the "Assign Internal Ownership (R)" event.

11/10/2021 17:17 EST STACY BOWERS (R) Assign Internal Ownership

(R) Ownership assigned to ADAM JANSEN.

11/10/2021 17:17 EST STACY BOWERS (R) Responder Owner Changed Ownership changed on Responder to ADAM JANSEN.

11/09/2021 05:55 EST GEICO DATA INTEGRATION (D)

Document is now available for review

Document Available on E-Subro: TOW INVOICE (Dispatch #G1263521298) $200.00 11/08/2021

11/09/2021 05:55 EST GEICO DATA INTEGRATION (D)

Evidence Added by

Demander Evidence Added: Tow and/or Storage Bill

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 3 of 56

(4)

Date Added Added By Event Type Event Description

Activity Log

11/08/2021 18:28 EST GEICO DATA INTEGRATION (D)

Document is now available for review

Document Available on E-Subro: Payment for $200.00 created on 11/08/2021, Check 228541129

11/08/2021 18:28 EST GEICO DATA

INTEGRATION (D) Original Damages Edited Message: Please consider additional damages.

11/08/2021 18:28 EST GEICO DATA INTEGRATION (D)

Evidence Added by

Demander Evidence Added: Proof of Payment

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Document is now available for review

Document Available on E-Subro:

EST_PHOTOS_$6972.41_11/02/2021-15:48:30

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Document is now available for review

Document Available on E-Subro:

EST_ESTIMATE_$6972.41_11/02/2021-15:38:06

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Document is now available for review

Document Available on E-Subro: Payment for $6,972.41 created on 11/04/2021, Check 228462599

11/05/2021 05:49 EDT GEICO DATA

INTEGRATION (D) Demand Issued Demand issued by GEICO CORPORATE GROUP. The Demand was assigned to Ohio Mutual Insurance Routing Unit at OHIO MUTUAL INS GROUP via automated routing rules. Message: Please Review for Payment.

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Evidence Added by

Demander Evidence Added: Estimate

11/05/2021 05:49 EDT GEICO DATA

INTEGRATION (D) Demand Created Demand created by GEICO CORPORATE GROUP

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Evidence Added by

Demander Evidence Added: Proof of Payment

11/05/2021 05:49 EDT GEICO DATA

INTEGRATION (D) Demand Initiated Demand initiated by GEICO CORPORATE GROUP

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Evidence Added by

Demander Evidence Added: Photograph(s)

Date Added Added By Document Type / Description Method

Demand Evidence List

For Damages

11/09/2021 05:55 EST GEICO DATA INTEGRATION (D)

Dint

Tow and/or Storage Bill Orig : $7,472.41

11/08/2021 18:28 EST GEICO DATA INTEGRATION (D)

Dint

Proof of Payment Orig : $7,472.41

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Dint

Photograph(s) Orig : $7,472.41

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Dint

Estimate Orig : $7,472.41

11/05/2021 05:49 EDT GEICO DATA INTEGRATION (D)

Dint

Proof of Payment Orig : $7,472.41

(5)

Claim Information

Claim Number 8732164250000001

Insured Name Jesse A Sargent

Dispatch Information

Dispatch Number G1263521298

Dispatch Date 10/25/2021

Date Paid 11/08/2021

Vehicle Information

Vehicle Owner's Name Jesse A Sargent

Vehicle Year, Make and Model 2019 SUBARU WRX

Vehicle Category Auto

License Plate State Vermont

License Plate Number HMK701

VIN JF1VA1A61K9823116

Vehicle Color Gray

Vehicle Location Information

Type of Location Residence

Location Name driveway

Address 108 OVERLOOK LN

City NEWPORT

State Vermont

ZIP 05855-8793

Cross Street/Landmark

Destination Location Information

Vehicle Destination Inspection Location

Destination Name Newport Auto Works-XF

Address 472 UNION ST

City NEWPORT

State Vermont

ZIP 05855-5466

Provider Information

Provider Name Ellis And Mosher Inc

Provider Dispatch Address 133 COVENTRY ST, NEWPORT, VT, 05855- 2149

Provider Billing Address 133 COVENTRY ST, NEWPORT, VT, 05855- 2149

Total Fees Amount $0.00

Pending Amount $0.00

Credit Amount $0.00

Queued Amount $0.00

Paid Amount $200.00

Tax Amount $0.00

Total Invoice Amount $200.00

Primary Services Payment Information

Provided Service Rate # of Days/Timeframe Total Amount

Tow Service $200.00 $200.00

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 5 of 56

(6)

Pay To The Order Of Ellis And Mosher Inc

Financials

Gross Amount $200.00

Net Amount $200.00

Backup Withholding $0.00

Payment Identification

Issued Date 11/08/2021

Mail To Name Ellis And Mosher Inc

Mail To Address

Memo ERS - Collision

PO# G1263521298

Payment Type System Check

Check Number 228541129

Related Documents

Document Name

Reserve Line Allocation

Exposure Reserve Line Cost Type Amount

Jesse A Sargent - Collision (2019 SUBARU) Collision Loss $200.00

(7)

Version : E01 Image FileName : PHOTO2 Image Label : Photo 04

Insured : Sargent, Jesse

Policy Number : 6073397389 Claimant : Sargent, Jesse

Year : 2019

Make : Subaru

Model : WRX Manual

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Appraiser : NEWPORT AUTO WORKS, INC.

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 7 of 56

(8)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(9)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 9 of 56

(10)

Version : E01 Image FileName : PHOTO4

Image Label : type of aftermarket exhaust

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(11)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 11 of 56

(12)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(13)

Version : E01 Image FileName : PHOTO18 Image Label : quarter

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 13 of 56

(14)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(15)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 15 of 56

(16)

Image Label : Midpipe bent hitting floor shield

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(17)

Version : E01 Image FileName : PHOTO10 Image Label : VIN Number

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 17 of 56

(18)

Image Label : Rear

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(19)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 19 of 56

(20)

Image Label : Rear sway bar hitting crossmember

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(21)

Image Label : Exhaust pulling on hanger

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 21 of 56

(22)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(23)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 23 of 56

(24)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(25)

Version : E01 Image FileName : PHOTO17 Image Label : Quarter

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 25 of 56

(26)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(27)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 27 of 56

(28)

Version : E01 Image FileName : PHOTO3 Image Label : Left Front

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(29)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 29 of 56

(30)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(31)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 31 of 56

(32)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(33)

Version : E01 Image FileName : PHOTO29 Image Label : Right Rear

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 33 of 56

(34)

Version : E01 Image FileName : PHOTO28 Image Label : Odometer

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(35)

Version : E01 Image FileName : PHOTO27 Image Label : Right Front

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 35 of 56

(36)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(37)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 37 of 56

(38)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(39)

Version : E01 Image FileName : PHOTO36 Image Label : License Plate

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 39 of 56

(40)

Version : E01 Image FileName : PHOTO32 Image Label : Left Rear

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(41)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 41 of 56

(42)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(43)

Image Label : Sway bar mount bent on crossmembe r

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 43 of 56

(44)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

(45)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/01/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 45 of 56

(46)

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

(47)

Image Label : Exhaust pipe dentedfrom hitting s uspensi

Year : 2019

VIN : JF1VA1A61K9823116

Loss Date : 10/23/2021

Photo Added Date : 11/02/2021

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 47 of 56

(48)

NEWPORT AUTO WORKS, INC.

PartsShare:

Federal ID:

State ID:

License Number:

030363092 450-111114301-01 64458

472 UNION ST, NEWPORT, VT 05855 Phone: (802) 334-2255

FAX: (802) 334-0206

Estimate of Record

Customer: Sargent, Jesse Job Number:

Written By: Thomas Gray, 11/2/2021 3:36:58 PM Adjuster: ACMU, (800) 841-3000 Business

Insured: Sargent, Jesse Policy #: 6073397389 Claim #: 8732164250000001-01

Type of Loss: Collision Date of Loss: 10/23/2021 2:30 PM Days to Repair: 18 Point of Impact: 06 Rear

Owner: Inspection Location: Insurance Company:

Sargent, Jesse Newport Auto Works-XF GEICO

108 Overlook Ln 472 UNION ST 13

Newport, VT 05855 NEWPORT, VT 05855 GEICO Insurance VT

(802) 624-3348 Cell Other 300 Crosspoint Parkway

(802) 334-2255 Day Getzville, NY 14068

(800) 841-3000 Business

VEHICLE

2019 SUBA WRX Manual 4D SED 4-2.0L Turbocharged Gasoline Gasoline Direct Injection black

VIN: JF1VA1A61K9823116 Interior Color: Mileage In: 43,865 Vehicle Out:

License: HMK701 Exterior Color: black Mileage Out:

State: VT Production Date: 1/2019 Condition: Excellent Job #:

TRANSMISSION STEERING WHEEL TOUCH CONTROLS

CD PLAYER DUAL MIRRORS

6 SPEED TRANSMISSION CONSOLE/STORAGE AUXILIARY AUDIO CONNECTION TINTED GLASS

4 WHEEL DRIVE INSTRUMENT PANEL SATELLITE RADIO SEATS

DRIVER CONVENIENCE TRACTION CONTROL SAFETY CLOTH SEATS

KEYLESS ENTRY STABILITY CONTROL DRIVERS SIDE AIR BAG BUCKET SEATS

MESSAGE CENTER ALARM PASSENGER AIR BAG RECLINING/LOUNGE SEATS

POWER WINDOWS AIR CONDITIONING FRONT SIDE IMPACT AIR BAGS REAR END

POWER LOCKS CLIMATE CONTROL HEAD/CURTAIN AIR BAGS BACKUP CAMERA

POWER MIRRORS REAR DEFOGGER PAINT REAR SPOILER

HEATED MIRRORS HANDS FREE DEVICE CLEARCOAT PAINT WHEELS

POWER TRUNK/LIFTGATE RADIO FRONT END 4-WHEEL DISC BRAKES

CRUISE CONTROL AM RADIO POWER STEERING ALUMINUM/ALLOY WHEELS

INTERMITTENT WIPERS FM RADIO POWER BRAKES

TILT WHEEL STEREO ANTI-LOCK BRAKES (4)

TELESCOPIC WHEEL SEARCH/SEEK GLASS & MIRRORS

6v5wdt 6v5wdt

(49)

Customer: Sargent, Jesse Job Number:

Line Oper Description Part Number Qty Extended

Price $

Labor Paint

1 EXHAUST SYSTEM

2 R&I R&I exhaust assy rearward of manifolds

m 1.8 M

3 QUARTER PANEL

4 * Rpr RT Quarter panel 2.0 1.5

Note: Lower portion bent dented partial paint

5 Add for Clear Coat 0.6

6 REAR BODY & FLOOR

7 Repl Rear body panel 52401VA0119P 1 184.43 Incl. 1.8

8 Overlap Major Adj. Panel -0.4

10 Add for Inside 0.9

11 Repl Rear floor pan 52129VA0009P 1 312.02 s 18.5 1.2

12 R&I LT Trunk side trim Incl.

13 Repl RT Trunk side trim 94511FJ011 1 118.75 Incl.

14 R&I Spare housing w/o Type RA 0.1

15 R&I Jack carrier 0.1

16 * Rpr LT Rear sill 0.5 0.3

Note: repair from welding

18 * Rpr RT Rear sill 0.5 0.3

Note: repair from welding

20 TRUNK LID

21 * Rpr Trunk lid w/spoiler WRX 4.5 2.3

22 Overlap Major Adj. Panel -0.4

24 R&I R&I trunk lid 0.6

25 R&I Spoiler paint to match 0.3

26 Repl Nameplate "SUBARU AWD" 93079FJ050 1 63.90 0.2

27 Repl Nameplate "WRX" 93079VA030 1 29.53 0.2

28 Repl Emblem 91174SA170 1 63.90 0.1

29 R&I Trunk lid trim paint to match w/o keyless

0.3

30 Repl Weatherstrip WRX 57532FJ001 1 52.20 Incl.

31 REAR LAMPS

32 ** Repl A/M NSF RT Tail lamp 84912VA020 1 218.54 0.4

33 R&I LT Tail lamp 0.4

34 REAR SUSPENSION

35 Repl Susp crossmember 20152VA000 1 425.59 m 6.0 M

36 WHEELS

37 R&I LT/Rear R&I wheel m 0.1 M

38 R&I RT/Rear R&I wheel m 0.1 M

11/2/2021 3:37:00 PM 064458 Page 2

Claim #: 2021019098 (Demand 191535484) (Generated Nov 10, 2021 05:17 PM EST) Page 49 of 56

(50)

Customer: Sargent, Jesse Job Number:

39 REAR BUMPER

40 O/H rear bumper 1.2

41 ** Repl A/M Bumper cover w/Eyesight pkg

57702VA040 1 236.92 Incl. 2.8

43 * Repl Impact bar 57711FJ0919P 1 225.95 0.4 0.5

Note: Refinished from factory

44 Refn Tow eye cap 0.2

46 Repl RT Upper bracket 57707VA111 1 10.82 0.1

47 Repl RT Center bracket 57707VA071 1 16.85 0.1

48 * Repl Cover 57731VA120 1 8.22 0.1 0.0

49 MISCELLANEOUS OPERATIONS

50 # Repl Borla S type cat back system 1 1,496.99 1.5 M

51 # CHO - OPERATION - COLOR

MATCH

1 0.3

52 # CHO - REFINISH - COVER CAR 1 0.2

53 # MATERIAL - SEAM SEALER 1 69.99

54 # MATERIALS - FLEX ADDITIVE 1 10.00

55 # MATERIAL - CORROSION

PROTECTION

1 10.00 0.2

56 # SET UP & MEASURE - INDICATOR

OF POSSIBLE STRUCTURAL DMG

1 2.0 F

57 # UNIBODY PULL - STANDARD &

CORRECT CONDITION

1 2.0 F

58 # Subl SUBLET - SUSPENSION

ALIGNMENT

1 69.95 X

59 # Rpr D&R Battery 0.2

60 # Repl Firestone Winterforce 2 225 50 17

1 214.90

61 # Subl Tire studding 1 18.00 X

62 # Subl Dismount mount and balance 1 18.00 X

63 # Subl 4 Wheel Alignment 1 89.99 X

64 # Rpr Pre repair scan 0.5

65 # Rpr Post repair scan 0.5

66 # Subl Hazardous waste removal 1 2.50

SUBTOTALS 3,967.94 45.8 13.9

NOTES

Prior Damage Notes:

Front bumper cover torn

(51)

Customer: Sargent, Jesse Job Number:

ESTIMATE TOTALS

Category Basis Rate Cost $

Parts 3,772.00

Body Labor 32.3 hrs @ $ 48.00 /hr 1,550.40

Paint Labor 13.9 hrs @ $ 48.00 /hr 667.20

Mechanical Labor 9.5 hrs @ $ 48.00 /hr 456.00

Frame Labor 4.0 hrs @ $ 48.00 /hr 192.00

Paint Supplies 13.9 hrs @ $ 28.00 /hr 389.20

Miscellaneous 195.94

Subtotal 7,222.74

Sales Tax $ 4,161.20 @ 6.0000 % 249.67

Grand Total 7,472.41

Deductible 500.00

CUSTOMER PAY 500.00

INSURANCE PAY 6,972.41

This is not an authorization to repair.

All GEICO customers have the right to have their vehicle repaired in the shop of their choice.

No Supplement will be honored unless authorized by GEICO.

NOTICE: Vehicles constructed of special metals may require the use of specialized welding and bonding equipment.

Proper measuring and structural repair systems are required on today's vehicle to accurately accomplish vehicle repairs. Make sure your shop has the proper equipment to repair your vehicle.

ALTERNATE PARTS DISCLAIMER:

IF A QUALITY REPLACEMENT PART (A/M, LKQ, RECOND OR OPT OEM) APPEARS ON THIS ESTIMATE, IT INDICATES THAT THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. GUARANTEES, IF ANY, APPLICABLE TO THESE REPLACEMENT CRASH PARTS ARE PROVIDED BY THE PART MANUFACTURER OR DISTRIBUTOR RATHER THAN BY THE MANUFACTURER OF YOUR VEHICLE.

***IN ADDITION TO ANY SUCH GUARANTEES, GEICO PROVIDES THE FOLLOWING:

OWNER LIMITED GUARANTEE WE GUARANTEE THAT ALL QUALITY REPLACEMENT BODY PARTS (PARTS NOT MANUFACTURED BY THE MANUFACTURER) IDENTIFIED ON YOUR ESTIMATE, ARE FREE OF DEFECTS IN MATERIAL AND WORKMANSHIP AND MEET GENERALLY ACCEPTED INDUSTRY STANDARDS. THIS PARTS AND LABOR GUARANTEE WILL BE IN EFFECT FOR AS LONG AS YOU OWN THE VEHICLE DESCRIBED IN THE ESTIMATE.

THIS GUARANTEE COVERS THE COST OF THE PART, LABOR TO INSTALL, AND INCIDENTALS SUCH AS PAINT AND MATERIALS AND IS SPECIFICALLY LIMITED TO THOSE ITEMS. THIS GUARANTEE DOES NOT COVER LOSS OR DAMAGE THAT IS UNRELATED TO DEFECTS IN THE QUALITY REPLACEMENT PARTS. THIS IS NOT TRANSFERABLE.

IF ANY QUALITY REPLACEMENT PARTS ARE DEFECTIVE IN EITHER MATERIAL OR WORKMANSHIP, CONTACT YOUR LOCAL GEICO REPRESENTATIVE.

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Customer: Sargent, Jesse Job Number:

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 ARL7594, CCC Data Date 11/01/2021, and potentially other third party sources of data; and (b) the parts presented are OEM-parts. OEM parts are manufactured by or for the vehicle's Original Equipment Manufacturer (OEM) according to OEM's specifications for U.S. distribution. OEM parts are available at OE/Vehicle dealerships or the specified supplier. 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 with discounted pricing. 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 2022 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.

CCC ONE Estimating - A product of CCC Intelligent 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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Customer: Sargent, Jesse Job Number:

If you disagree with this settlement offer or have questions or concerns about the valuation or settlement offer, you may contact the Consumer Services Section of the Vermont Insurance Division by mail to 89 Main Street, Montpelier, VT 05620-3101 or you can call toll-free at (800) 964-1784.

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Customer: Sargent, Jesse Job Number:

PARTS SUPPLIER LIST

Line Supplier Description Price

32 1001 Best Autolite Dist. #SU2819106N $ 218.54

NE Sales Center A/M NSF RT Tail lamp

Lindenhurst NY 11757 Quote: 1049582028

(866) 567-3500 Expires: 11/09/21

41 Empire Auto Parts #S8018 $ 236.92

61 Robert Treat Paine Drive A/M Bumper cover w/Eyesight pkg

Taunton MA 02780 Quote: 28299755

(888) 366-5155 Expires: 11/03/21

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Customer: Sargent, Jesse Job Number:

ALTERNATE PARTS USAGE

VIN: JF1VA1A61K9823116 Interior Color: Mileage In: 43,865 Vehicle Out:

License: HMK701 Exterior Color: black Mileage Out:

State: VT Production Date: 1/2019 Condition: Excellent Job #:

Alternate Part Type Selection Method # Of Times Notified Of Available Parts

# Of Parts Selected

Aftermarket Manually List 2 2

Optional OEM Manually List 0 0

Reconditioned Manually List 0 0

Recycled N/A 0 0

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Pay To The Order Of Newport Auto Works

Financials

Gross Amount $6,972.41

Net Amount $6,972.41

Backup Withholding $0.00

Payment Identification

Issued Date 11/04/2021

Mail To Name Newport Auto Works

Mail To Address 472 Union St, Newport, VT, 05855-5466

Memo Collision Coverage

Payment Type System Check

Check Number 228462599

Related Documents Document Name

Reserve Line Allocation

Exposure Reserve Line Cost Type Amount

Jesse A Sargent - Collision (2019 SUBARU) Collision Loss $6,972.41

ESubro Hub Demand Package

All Evidence