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) 926-4977

Claim #: 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. SPRINGFIELD, MA 01105 Repair Facility (413) 732-8702 Business

Email: bvreeland@hanover.com Phone: (413) 977-4951

BALISE COLLISION REPAIR CENTER 292 MAIN ST. SPRINGFIELD, MA 01105 (413) 732-8702 Business (413) 747-0509 Fax 55-0811490

VEHICLE Year:

2012

Color:

GRAY Int: gray

License:

953DL3

Make:

HOND

Body Style:

4D SED

State:

MA

Odometer:

Model:

CIVIC LX

Engine:

4-1.8L-FI

VIN:

2HGFB2E57CH556344

Condition:

TRANSMISSION

Production Date:

Console/Storage

AM Radio

Cloth Seats Bucket Seats

5 Speed Transmission

CONVENIENCE

FM Radio

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

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Page 1

Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

Line 1

Oper

Repl

4

Labor

Bumper cover w/o Si US built

1.4 04715TR3A90ZZ

1

303.38

Incl.

Repl

LT Spacer US built

71598TR0A01

1

12.27

0.1

R&I

LT Tail lamp assy

33550TR0A01

Incl.

0.8

TRUNK LID

9

R&I

R&I trunk lid

68500TR0A90ZZ

Blnd

Trunk lid LX, EX, EX-L

68500TR0A90ZZ

11

R&I

License molding US built, w/o DX cool mist

74890TR3A01ZF

R&I

License plate

13

Repl

Nameplate "CIVIC"

14

R&I

Trunk lid trim

84620TR3A01ZA

#

LT Quarter panel

04646TR0A90ZZ

1.2 0.3 0.1

75722TR0A01

1

26.73

0.2 0.3

QUARTER PANEL

16

Repl

17

Add for Clear Coat

18

Deduct for Rear Bumper R&I

19

R&I

20 21

1

735.12

17.5

1.2 63910TR0A00ZZ

Blnd

Fuel door

63910TR0A00ZZ

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

24

Repl

LT Inner panel US built (HSS)

64700TR3415ZZ

1

25

Incl.

0.2

10.70 570.70 s

0.2 6.5

Add for Clear Coat R&I

LT Upper qtr trim US built beige

84180TR0A01ZC

Incl.

27

R&I

RT Upper qtr trim US built beige

84130TR0A01ZC

0.3

Rpr

Fabricate 1/4 sleeves

Repl

LT Gutter extn US built

# S01

30

S01

Add for Clear Coat

31

S01

Deduct for Overlap

2.0 63720TR3305ZZ

1

40.13

2.5

0.2 -1.0

R&I

LT Roof molding

74316TR0A01

0.4

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

38

1.0

ROOF

33 34

1.5 0.3

26

29

3.1

-1.0

Fuel door

32

3.0 1.2

10

28

Paint

REAR LAMPS

7

15

Extended Price $

Add for Clear Coat

5

12

Qty

O/H rear bumper

3

8

Part Number

REAR BUMPER

2

6

Description

BACK GLASS

Incl.

REAR BODY & FLOOR

39

9/17/2012 10:18:43 AM

R&I

Pkg tray trim DX, LX, EX, HF beige

84505TR0A01ZC

107572

Incl.

Page 2

Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY 40 41 42

*

43

*

S01

R&I

LT Trunk side trim US built DX, LX, EX, HF

R&I R&I Rpr

84651TR3A01ZA

Incl.

Rear panel trim

84640TR0A01ZA

Incl.

Spare cover US built

84521TR3A00ZA

Incl.

Rear body panel

66100TR0A00ZZ

1.5

0.5

NOTE: spot repair spot refinish LT side of panel 44

Overlap Major Adj. Panel

45

-0.4

Add for Clear Coat

46

*

S01

Rpr

47

REAR SUSPENSION

48

Repl

Rear floor pan US built

0.1 04655TR3A00ZZ

1.5

0.5

NOTE: spot repair spot refinish LT side of floor panel

49

Align four wheels

1

m

O/H rr susp lt

1.6

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.

42200TR0901

1

101.05 m

67550TR0A90ZZ

1

628.07

53

Deduct for Overlap

54 55

Repl

LT Hub & bearing sedan

Incl.

Incl.

REAR DOOR

56

Repl

LT Door shell

57

Overlap Major Adj. Panel

58

Add for Clear Coat

59

Add for power units

4.0

0.5 0.2

60

R&I

LT Door w'strip US built

72850TR3A01

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

64

R&I

LT Moveable glass Honda US built

73450TR3A00

65

*

66 67

0.5

1

3.80

0.3 Incl.

R&I

LT Run channel

72775TR0A01

Incl.

R&I

LT Fixed glass Honda, w/o Si US built

73455TR3L00

Incl.

R&I

LT Weatherstrip US built

73491TR3A01

Incl.

68

*

R&I

LT Handle, outside painted

72181TR0A11ZH

Incl.

69

*

Refn

LT Handle, outside painted

72181TR0A11ZH

70

Overlap Minor Panel

71

Add for Clear Coat

72

2.9 -0.4

0.5 -0.2 0.1

FRONT DOOR

73

Blnd

LT Outer panel

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

9/17/2012 10:18:43 AM

67151TR0305ZZ

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Page 3

Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY 79

SEATS & TRACKS

80

S01

81

WHEELS

82

*

83

Repl

Seat cushion pad clip

82138TR0003

2

3.24

Repl

LT/Rear Wheel, steel 15"

42700TR0A02

1

78.60 m

Repl

LT/Rear Wheel cover 15" US built

44733TR0A00

1

20.88

Refn

TINT AND TEST

84

TIRES

85

#

86

#

87

#

DETAIL MASK

1

88

#

ADD FOR FLEX

1

12.00 T

89

#

RUSTPROOFING

1

10.00 T

90

#

DENIB AND POLISH

1

91

#

Blnd

92

#

Repl

93

#

94

#

95

#

96

COVER CAR FOR OVERSPRAY

1

3.00 X

0.3

0.2 0.5 0.6 0.2 2.5

BLEND WELD ZONES

0.5

SEAM SEAL

1

RESET ELECTRONICS

1

0.3

SETUP AND MEASURE

1

2.0

#

DIAGNOSE SUSPENSION

1

0.5

97

#

REPAIR CLAMP DAMAGE

1

0.5

98

#

PULL UNIBODY

1

4.0 F

99

#

D&R BATTERY

1

0.2

100

#

RESEAL VAPOR BARRIOR

1

101

#

PANEL BONDING KIT

1

102

#

BALANCE WHEEL

1

103

#

S01

Repl

Paint/materials

1

396.00

104

*

S01

Repl

FIRE 195/65R15 AFFINITY TOURING S4 89S

1

101.15

Refn

T

0.5

ANTI CORROSION PRIMER

0.3

FI07602

1.25

0.5

0.2

39.56 T 0.2 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

9/17/2012 10:18:43 AM

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3,770.48

57.5

19.8

Page 4

Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

ESTIMATE TOTALS Category

Basis

Rate

Parts Body Labor

53.5 hrs

@

$ 36.00 /hr

Paint Labor

19.8 hrs

@

$ 36.00 /hr

712.80

Frame Labor

4.0 hrs

@

$ 40.00 /hr

160.00

Miscellaneous

1,926.00

312.46

Subtotal

6,569.28

Sales Tax

$ 3,767.48

Total Cost of Repairs

@

6.2500 %

235.47 6,804.75

Deductible

500.00

Total Adjustments

500.00

Net Cost of Repairs

9/17/2012 10:18:43 AM

Cost $ 3,458.02

6,304.75

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Page 5

Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

SUPPLEMENT SUMMARY Line

Oper

Description

Part Number

Qty

Extended Price $

Labor

Paint

Changed Items 39

*

43

*

Rpr S01

Rpr

Rear body panel

66100TR0A00ZZ

-3.0

-1.0

Rear body panel

66100TR0A00ZZ

1.5

0.5

NOTE: spot repair spot refinish LT side of panel 42

*

46

*

Rpr S01

Rpr

Rear floor pan US built

04655TR3A00ZZ

-2.0

-0.5

Rear floor pan US built

04655TR3A00ZZ

1.5

0.5

NOTE: spot repair spot refinish LT side of floor panel 98

#

103

#

S01

Repl

Paint/materials

1

-382.00

Repl

Paint/materials

1

396.00

Repl

FIRE P195/65R15 AFFINITY TOURING S4

FI01808

1

-117.99

-0.3

Repl

LT Gutter extn US built

63720TR3305ZZ

1

40.13

2.5

Deleted Items 80

*

Added Items 29

S01

30

S01

Add for Clear Coat

31

S01

Deduct for Overlap

79

0.2 -1.0

SEATS & TRACKS

80 104

1.0

*

S01

Repl

Seat cushion pad clip

S01

Repl

FIRE 195/65R15 AFFINITY TOURING S4 89S

82138TR0003

2

3.24

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

9/17/2012 10:18:43 AM

107572

288.43

-0.5

0.7

Page 6

Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

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

Supplement S01

313.66

Workfile Total:

$

6,804.75

TOTAL ADJUSTMENTS:

$

500.00

NET COST OF REPAIRS:

$

6,304.75

Ted Lolos BRIAN VREELAND

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.

9/17/2012 10:18:43 AM

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Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

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.

9/17/2012 10:18:43 AM

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Claim #:

14-00-929703-1-1

Workfile ID:

0e1a89c0

Supplement of Record 1 with Summary 2012 HOND CIVIC LX 4D SED 4-1.8L-FI GRAY

TIRE PARTS SUPPLIERS Line

Description

Supplier

104

FIRE 195/65R15 AFFINITY TOURING S4 89S

Town Fair Tire Co

Price

1127 Riverdale Street, W. Springfield MA 01089-0

9/17/2012 10:18:43 AM

$ 101.15 (413) 787-0701

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