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Claim 762 - Farmers-F.Terrazas
CITY OF PALM DESERT CITY CLERK DEPARTMENT STAFF REPORT REQUEST: CLAIM AGAINST THE CITY (#762) BY FARMERS INSURANCE / FELIPE TERRAZAS IN THE AMOUNT OF $12,400.56 SUBMITTED BY: Rachelle Klassen, City Clerk DATE: October 22, 2015 CONTENTS: • Staff Report • Recommendations of Claims Adjusters and Staff • Claim No. 762 Recommendation By Minute Motion, reject the Claim and direct the City Clerk to so notify the Claimant. Background Based on a review of the subject Claim and the recommendation of the Claims Adjuster, Risk Manager, City Attorney, and staff, it is recommended that the Claim be rejected. Discussion of this item should be held in Closed Session pursuant to Government Code Section 54956.9(b), potential litigation. Submitted by: RACHELLE D. KLASSEN- IIMC CITY CLERK rd k Attachment (as noted) roved: HN M. WOHLMUTH Y MANAGER CARL WARREN & COMPANY Claims Management and Solutions September 24, 2015 TO: City of Palm Desert ATTENTION: Rachelle Klassen RE: Claim Claimant Member Date Rec'd by Mbr Date of Event CW File Number Farmers Insurance vs. Palm Desert Farmers Insurance as subrogee for Felipe Terrazes Palm Desert 9/23/ 15 8/13/15 1917046 TVQ Please allow this correspondence to acknowledge receipt of the captioned claim. Please take the following action: 0 CLAIM REJECTION: Send a standard rejection letter to the claimant. Please include a Proof of Mailing with your rejection notice to the claimant. An exemplar copy of a Proof of Mailing is attached. Please provide us with a copy of the Notice of Rejection and copy of the Proof of Mailing. If you have any questions feel free to contact the assigned adjuster or the undersigned claims specialist. Very Truly Yours, CARL WARREN & CO. TIL4� M. VarOw,,, Timothy M. Varon Claims Specialist AN EMPLOYEE -OWNED COMPANY 770 S Placentia Avenue i Placentia CA 92870 P O Box 25130 i Santa Ana CA 92799-5180 www carlwarren com i Tel 714-572-5200 1 800-572-6900 i Fax 866-254-4423 CA License No 2607296 _4" CARL WARREN & CONIM Y Clams Management and So!ut;ons September 24, 2015 Farmers Insurance Attn: Stacy I.e P.O. Box 268992 Oklahoma City, OK 73126-8992 RE: Claim Claimant Member Date Rec'd by Mbr Date of Event Your File Number CW File Number Farmers Insurance vs. Palm Desert Farmers Insurance as subrogee for Felipe Terrazes City of Palm Desert 9/23/15 8/13/15 099 SUB 3004140522-1 1917046 TVQ Please be advised the above -referenced claim was referred to our office for investigation. We are the liability Claims administrators for the City of Palm Desert. This matter is being handled under the file number provided above and is being investigated by our Claims Adjuster Timothy Varon. Upon completion of the investigation, we will contact you concerning our determination of liability. Very Truly Yours, CARL WARREN & CO. Ti,4� M. Va ro*v Timothy M. Varon Claims Specialist 657-622-4287 An Employee -Owned Company 770 S. Placentia Avenue I Placentia, CA 92870 Tel: 800-572-6900 1 Direct: 714-572-5200 1 Fax: 866-254-4423 o n; CA License No: 2607296 Klassen, Rachelle From: Greenwood, Mark Sent: Friday, September 25, 2015 1:21 PM To: Klassen, Rachelle Subject: Claim No. 762 Rachelle, It is recommended that Claim No. 762 be denied as fault for the collision has not been placed with the City. Mark Greenwood, P.E. Director of Public Works City of Palm Desert a I I y Of P 0 [ M 7 3 - 5 1 o FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346-061I info@cityofpalmdesert.org TO: CJPIA (c/o CARL WARREN & CO.), CITY MANAGER4CITY ATTORNEY-j DIRECTOR OF BUILDING & SAFETY, DIRECTOR OF PUBLIC WORKS, RISK MANAGER FROM: CITY CLERK DATE: SEPTEMBER 23, 2015 SUBJECT: CITY CLAIM NO. 762 / CARL WARREN & COMPANY FILE NO. 1917046 TVQ - CLAIM AGAINST THE CITY BY FARMERS INSURANCE/ FELIPE TERRAZAS IN THE AMOUNT OF $12,400.56 The attached Claim No. 762 is being transmitted to you for the following: ❑ Information only. or Review and recommendaRidn to the Claims Review Committee for any action required by the City of Palm Desert. We would appreciate your report, if requested, by October 23, 2015, for timely response to the Claimant. RACHELLE D. KLASSEN, MMC CITY CLERK Attachment (as noted) ff ii s'1:!D :x 5FW iC-1 CITY OF PALM DESERT t�hFARMERS en,zm INSURANCE 09/ 18/2015 City Clerk, City Of Palm Desert 73-510 Fred Waring Drive Palm Desert, CA 92260 Re: Our Insured: Our Claim #: Date of Loss: Your Insured: Your Claim #: Deductible Amount: Loss of Use Amount Rental Amount: Total Amount Owed Mr. Felipe Terrazas 099 SUB 3004140522-1 08/13/2015 City Of Palm Desert Unknown $500.00 $0.00 $0.00 $12,400.56 Dear City Clerk, City Of Palm Desert: ASSIGNED CMM N0. Toll Free: (800) 435-7764 Email: myclaimgfarmersinsurance.com National Document Center P.O. Box 268992 Oklahoma City, OK 73126-8992 Fax: (877) 217-1389 Our investigation has established that the above loss was caused by your negligence or someone employed by you. It has been determined that you are responsible for all or part of the material damage, bodily injury, property damage, medical, and/or related expense payments paid on our insured's behalf. The current amount we have paid on our insured's behalf may increase or decrease due to additional bodily injury, property damage, medical and/or other related expense payments. The amount for which we are seeking reimbursement for property damage is $12,400.56. You have the right to dispute any or all of our claim. If you do not dispute it within seven (7) days of receiving this letter, Farmers Insurance Exchange will assume that it is valid. Be advised that no partial payment, which is less than the full amount, will be considered in any way an acceptance of benefits, a novation or an accord and satisfaction of this claim without the express written release of our claim executed by an individual who identifies himself/herself as a member of our subrogation department. "Therefore, our legal rights to enforce collection on the remaining amount of the claim shall not be waived or estopped due to a partial payment by you. If you need additional support for our claim or require further information, please contact me. Please send payment to: National Document Center PO Box 268992 Oklahoma City, Ok 73126 Sincerely, Stacy Le Auto Subrogation Representative Farmers Insurance Exchange 909-801-3306 stacy.le@farmersinsurance.com CITY OF PALM DESERT R` C; E 1 Y E U ASSIGNED CLAIM NO. CLAIM AGAINST THE CITY OF PALM DESJVJ CLERK'S OFFICE �M DESERT. CA (For Damage(s) to Person(s) or Personal Property 2115 SEP 23 PM 2: 24 Received by: via: U.S. Mail �Sl_ Interoffice Mail Over -the -Counter A CLAIM MUST BE FILED WITH THE CITY CLERK OF THE CITY OF PALM DESERT WITHIN SIX MONTHS AFTER WHICH THE INCIDENT OR EVENT OCCURRED. BE SURE YOUR CLAIM IS AGAINST THE CITY OF PALM DESERT, NOT ANOTHER PUBLIC ENTITY. WHERE SPACE IS INSUFFICIENT, PLEASE USE ADDITIONAL PAPER AND IDENTIFY INFORMATION BY PARAGRAPH NUMBER. COMPLETED CLAIMS MUST BE MAILED OR DELIVERED TO THE CITY CLERK, CITY OF PALM DESERT, 73-510 FRED WARING DRIVE, PALM DESERT, CA 92260. TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Palm Desert, California: The undersigned respectfully submit(s) the following claim and information relative to damage(s) to person(s) and/or personal property: 1. CLAIMANT INFORMATION: NAME r11y-1'1'm allo iR-J(ru I ti 1ws ADDRESS JLn, (� c �_t OITYN SOCIAL SEC O. /- /- PHONE N6.A/ TE BIRTH: LICENSE NO. 2. Name, telephone number and post office address to which claimant desires notices to be sent, if other than above: •-I 3. Occurrence or event from which the claim arises: a. DATE: 5 b. TIME: c. PLACE (exact and specific lnratinn d. How, and under what circumstances did damage or injury occur? Specify the particular occurrence, event, act or ommission you claim caused the injury or damage. (Use additional paper if necessary.) i'j'Gj-eS I ERLjJS -WX1 A 1691'am. Epp e. What particular action by the City, or }ts employees,• caused the .al injury? G1111A1/fl --gyp Shy.? f1f Page 1 of 2 L or 4. Give a general description of the indebtedness, obligation, injury, damage, or loss incurred so far as it may be known at the time of presentation of the claim. there were no injuries, state "no injuries": Qt���T� X ixililcl, G'� -� :OW 2 - U V A 5. Give the name(s) of the City employee(s) causing the damage or injury: L) Z7A m1 6. NaM d address of any other person(s) injured: � ; 7. Nam; land address of the owner of any damaged property: 8. Damages claimed: a. Amount claimed as of this date: $ Z 0 b. Estimated amount of future costs: $ c. Total amount claimed: $ d. Basis for computation of amounts claimed include copies of all , bills, invoices, estimates, etc.): D, + 9. Names and addresses of all witnesses, hospitals, doctors, etc.: 10. Any additional information, including police reports, which might be helpful in considering this claim:, WARNING:IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! PENAL CODE 72; INSURANCE CODE 556.1). I have read the matters and statements made in the above claim, and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief as to such matters I believe the same to be true. 1 certify under penalty of perjury that the foregoing is TRUE AND CORRECT. 4 Signed thisRE day f 20 �, at on s ,Gar SIGNATUN SIGNATURE OF CLAIMANT Office of the City Clerk, Palm Desert, California DOC. NO. �_ DATE FILED -i---15 �— Page 2 of 2 S/fE Oi VLIFOIb/A TRAFFIC COLLISION REPORT PAGE 1 OF 6 SPECit�CCNC[::O'6 RUwdER •aid R,Jf ' ` .A,L_ L-C REI�'L :NUUFFq vwaEp FELON'F T152250103 0 n Palm Desert Desert Nu. -R 1R1 {RUN L 11, -TR Cr —1 Gv Oc VEER IGV: u\Av R.—C, 0 — Riverside 36Q3 36 Thursday �I Es ❑"D LCLL.SCN LCCIAREU LN w0 Gi YENf i1wE 1'"1 '4— Of i,CERiD FRED WARING DR 811312015 1508 3300 5267 � wRFFL-1T KORW�Krf LPS LJC'HOwA1F5 PFrLTCC/FMrST f EEr of _.:�:Lx <aAc;-uv Espinoza 5267 V q uA"/.lEA5FC11CN\NO. 1: AIC rN:Y+E: G on FEET G SAN PABLO AVE ❑rt1 ' AR. CR:Kg5UliN5E .VJwOtR 5[A:E a-H Sari SaAEiv =•, L,F Y_N •R RASE:w D!L ICLLON LKENSE'NUR+a S:a:E 2002 TOYOTA TACONIA SILVER CA 11 CA M C - . . - - >.IKA ryilE (Fq Si_ w•C<lF. lAST� FELIPE CALDERON TERRAZES O K21r,+Q J SwEaSL:.H FELIPE CALDERON TERRAZES iAiAN ' RFF1 uingFl{ a•: •.ias AcrwFa. r� ...�........�„ -rr., fiA�:.fP CA REa ,—� L5r1n L.N (,i r,r.C_E Cu LaDE a S Cf ''� CFF.CCR L IXY.VER _j Ot RENIES TOWING(7601340.7560 ace. �� aF. ru,N Fits �eR:[� L5 Pi°"L"rE O1�` �_ L_L .lt Y_:EC:S VCNE A-P+NENT `/]gEfER :C r.waRa:IK JI wC,E [JI: �r KAr.uN N.u9EH 511 E5N92N1220E77e2 r ' O"r.5iR�6E rENKIE OA"A:£ L l VE•a C:_'rri! — .R i�r.U:E ;]r.L•.CR w:SWaNCE CAq R:CR FARMERS INSURANCE GROUP P �w —_ 22 LN s:gEsi LR+K•N[av SPED E FRED WARING DR 45 E-•Eu.:u E••.: u_ w.x_�cxcaw _iNst •uw:;ER s:a;_ FORD F-150 WEi1TE i 2 CA C M C 2002 CA G,leR .AyE if YSi 4pJLE US'; Y3 LIZZADRO NMN DIAZ RSNv[E r SAwEa1DR.Eq CITY OF PALM DESERT I STREET AD DRESS ?-1 C19v�51 El— 1:: •.E25 A_^^..^.I[E55 J SANE AS LRivER 73510 FRED WARING DRIVE, PALM DESERT 92260 '"HtEL —KLf i—i PALM DESERT CA YUCAI A rmv;RIFONU 323- 3 �1 F=KEA L] ORi:tR J Cr N[R YUCAIPA T06Y;NG 1888) 323-T725 ecY 5ER —4 c:5 n Pqq_ at_iU1 AL Oi[EC:S rG.E MPtgENi REF ER'O'fA+RA:'VE L k..,:.: Lf �.r.F,C,"C\•A:uEEq 21FiAF 17EE52i•-625= C:.!la „0.,._wr,� 0.'E:rE55cUC+:E 22 CC5^.RIeE VlN,CyE Oww A::E ° CALIFORNIA JOINT POWERS INS NA C-.a Cc �•: 51RCEr CH w:.N:.Av S'EE•. _ DLi N SAN PABLO AVE 40 ---- _ aaq: CP,KP-S L'�:•ti NLLOEN 'arC 15> A::: C,:� 5,3F1v E._�' - w,t L• \St Nt.Jc`.H- 3 -":L.IICC .q... .... LH'.22 "NE c,RiT_wl_C.E '.Ai:l v.-R�.nl'E '� Sa•.re a1'.R ♦TR ° STAEET ACGAES! "'� 7r5fait v2ia OTrtR E� +rA r�aN F•Ei r.f.:+ WEGH- f-� vO,ta FaCf. OUST i _ —aCrtR rc.�wRAD\f �wAti uWD LF G. 1HtE[LH �.LrFi:av SaEEO -- — -- OO: (µ-ESPINOZA, ALISHA 5267 `_i'•-s['A r" • STATE OF CALIFgUiA TRAFFIC COLLISION CODING PAGE 2 OF a or 81131Z015 e 1508 3300 � 5267 T152250103 ow,rFn�DOns CITY Of PALM DESERT 7 6610 FRED WAR04G DRIVE. PALA DESERT 82260 m w DHLtq ONE WAY TRAFFIC SKIN SEATING POSITION 1 2 3 7-DRIVBt 4 6 6 T fTNYAOONIMAR •• ML DOM TRK OR VAN S•POSRION IDDIIOVIII 7 B OTHER ac2a Mm SAFETY EQUIPMENT A-NDI�NVDNCU LAIN BA80@YED LDrICBILYCLE.NA_: .. 8.101KNOMBN W AN BAS NOT DEPLOYED ORNVER PASSIDAM C-LAP�TUM N-OTl®t wM0 LNO D-WQTNOTLS ►•NOTRBgWEp B•SHOLL=ot NAIMBBSUSED ��� N-rEP Y•YBS F- SIIDIRDOt H1MVESS NOT USaID O-0I VDOCLB IMED �„ O- LAP I SHOULDIR HAIBQJB IN® It- N VONRB NOT USED S-NOT EJECTE) J-LAP SHOULD13tWE HARKINGNOT UM S- N VONB DCLB WE UNDONQM 1-FULLY BJEC7ED K- PASSIM RtlTRABITNOT IN® BV T-NVEMCLE RO►BtUM 2- PARTIALLY EJWTED U •NCN VEIBCLB 3-UIDN ONOM INATTENTION CODES A - COLL PRIORI HANDHELD B-CSL PIIDIM NANCBN@ C-RADIO I CD EOUeYDNi a.�q F-aATOW O•C/Cd101 N•PDnOMAI HYC®Q "POO aM K-rnlee ITWS MARS® BDON VBN,7H AIM FULL OPIRD BY AN ASEISNR r) SIIOIRD HIE DD'L/IS® N TWA NAIDATN[ PRIMARY Cp1lSpN FACTOR LISTNABMfRCFPAI ATFAULT TRAFFIC CONTROL DEVK= 11213 SPECIAL INFORMATION 1 2 3 MOVEME T' PRECEDING �X A VCSICNIONYOLATED dye 21453A NO CONTROLS RAICTIOR 0 NASARDOUS MATERIAL STOPPED caNTTeoLsNOTRRICTpNNG COL PHONEHA/OHELDNUN ♦ ♦ 8PROCEEDNGSTRAIGHT B OTHER IMPROPER ORMNG: CONTROLS OWED CELL pgKE HAMOFM N I= RAN OFF ROAD D NO CONTROLS PREgE MACTOR ♦ ♦ CELL PHHONB NOT N U39 KAMM RiOHNT TIM OTHER THAN OIBYEt TWIC OF COLLISION SCHOOL Bus RBATED E MAKING LEFT TURN WN HEAD-ON TG FT MOTORTRUCK COMBO MAIOHG U TURN Evalml B SIDESWIPE tt FT TRA ER COMBO o BACKING REAR END I IN SLOWINo/STO►Pm 2TTE -. ♦ D BROADSIDE it PASSING OTHER VEHICLE ♦ A CLEAR E HIT OBJECT IJ CHANGING LANES 8 CLAIAY IF OVE TIJAt1E0 IK PARNWGMINLEWER C RAINING YEICl.E PEDESTRIAN L ENTERING TRAFFIC D SNOWING OTKIEIt M III OTHERIN OTHER SAPE TURNING FOG f VISIBILITYVISIBILITYFf• MOTOR VEHICLE INVOLVED)NA MTN N N G INTO OPPONG IANE F O TH@P: NC114OLL1S10FL O 0 PARKED G VMND B PEDESTRIAN 1 2 ] OTHER ASSOCIATED FACTOR PIAR♦ 1 TO 2 P MERGING LKNfTRNO C OTV EMR MOTOR VEHICLE TRAVEl1N G WRONG WAY DAYLIGHT SECTION A VC SECTION VIOLATION:* OHp O MOTOR VEH ON OTHER ROADWAY OTHER:' 8 DUSK -DAWN E PARKED MOTOR VEHICLE C DARK -STREET UGHTTS IF TRAIN ANIMAL: 8 VC SECTION VIOLATION: Cmd C VC SECTION VIOLATION: Ca>a E VISION OBSCUREME I D DARK • NO STREET LIGHTS E DARK- STREET LIGHTS NOT FUNCTIONING 1 2 3 SO LDRUO 7 2 ROADWAYSINFACE ♦ A �. 1 Fl)ED OBJECT: ♦ ♦ HAD NOT BEEN DRINKING B WET B HBO- UNDER NFLLIEICE C SNOWY -ICY J OTHER OBJECT' F RIATTENTION': O STOP i GO TRAFFIC C HBO-NOTUNDERINFLU.- D SLIPPERY (MUDDY.OILY.ETC.) D HID NK' CO ROADWAY COI ITEMS) pNARK 170 2 RENS) PEDESTRIANS ACTION H ENTERING I LEAVING RAMP E I IR DRUG WELL NO PEDESTRIAN INVOLVED 1 PREVIOUS COltJD011F PAIR EW Plll DIPAIRMENT-PHYSICAL'HOLES` DEEP RUTS CROSSING BN CROSSWALK RTINTERSECTION J WNFAMIWAR WITH ROAD O IMPAAIRMENT NOT KCNOYYNB LOOSE KATERAL ON RDWY K DEFECTIVE VENT. EOl1IP:NOTAPPLICABLBC Cud OBSTRUCTION ON ROADWAY CROSSEgN CROSSWALK NOT I SLEEPY I FATIGUEDD PAIR ZON1ETNTERSECTION E REDUCED ROADWAY WIDTH D CROS�IG-HOT N CROSSWALK L UNINVOLVED VEHICLE F FLOODED E NNDE ROAD- CLUS SHOULDER N OTHER': OTHER NOT N ROAD ♦ N NONE APPARENT [*IN NOUNI15l1AL CONDRION9 APPROACWLEAVING SCHOOL BUS 10 RUNAWAY VEHICLE See AflecMd Sketch uac� STATE OF CJLL*OFJ" INJURED / WITNESSES / PASSENGERS PAGE q OF 8/13/2015 1508 3300 o 5267 T152250103 EXTENT OF INJURY M ONq INJURED WAS Px' ONE) I l*, MAT am ..,.� over �.a. waver at.ODan..T vwf�aw d'.o1 o"'m I'll pall, ., oTlml X 91 59 IO 411119 i0a rvTM MN MUEM A F I Q .M ❑ 0101010 TELLPHO i ow+a�oran 11111, TO C)M dno.eaaewlmTs® •0 122 1 (M ,.Cal BMDM REM TERRAZES I ❑ ❑ — ❑ ❑ ❑ ❑ 1 2 M 6 0 Tnn/ule ryaaaan n K T.IIBI10 �..cnr d naeTr awE aotsco ❑ El ❑ ❑ ❑ ❑ I DO.a / T[1F1T101E IwI+RFO aan T11.,lPOarEO sY 1.IQN ro w.wE va:rw d wlexl oaOE Tomes ❑ ❑10 lo❑❑❑ hWl100aI T OKvI BY TM lO Ot%IaaE oM1EO �Y dvoxomwaoT ❑ ❑ ❑ ❑ I O a I ADDIER Tp)�r,C1E Tl1MF0tl Y1 fWAN0564YED ITT TU TO MaM,Ea va:tul d naml twrt aoislEn ❑ ❑ ❑ IMA/ED Oaln EOF MiM i0 wa0*1 new d naDrt wa aom® PM* afuLL ESPINOZA, Mr--VA rana[a 517 lq Mr Y b17312015 MNa W. Y RM Sk-IE--c+4 IP &Z Pig4llRiy. 6-071 ON 042 eaFOOLiO Pa DW P N, rcc� aw��a wpm C9t'32ots�2rPTti2�ao3 ALL MEAKMMMAMAPPROt UATEAND WrIgWAIUM ANgUiTMOW.e- I 20, 4 to' Ir li• /I, t 15 ShA) PABL0 AV I ai /3 ti M . L F&cig 6jARIA)6 AX ►A V_ 2 M- 0 ��a�.str,n ��'zco, o8,�zniS ss. OW p 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL PAGE 5 OF 6 DATE OF INCIDENT TIME RCIC NUMBER OFFICER I.D. NUMBER 08-13-2015 1508 3300 5267 T15 225 0103 NOTIFICATION: I was dispatched to a call of an unknown injury collision at 1509 hours. I responded from Highway I I I and Monterey Avenue and arrived on scene at 1511 hours. All times and speeds were estimated. Measurements were obtained using a Pro -laser III laser device. STATEMENTS: Party #1 (Terrazes) stated he was driving V-1 (Toyota) in the #1 eastbound lane on Fred Waring Drive approximately 45 MPH approaching San Pablo Avenue. P-I stated the signal for eastbound traffic on Fred Waring Drive was green as he entered the intersection of San Pablo Avenue. P-1 stated as he entered the intersection at San Pablo Avenue he saw V-2 (Ford) enter the intersection from northbound San Pablo Avenue. P-I stated he attempted to avoid the collision by steering to the left, however, was unable to avoid colliding into V-2 (Ford) and struck V-2's (Ford) front end. P-1 stated the impact caused his vehicle to lose control and continue eastbound through the intersection striking the center median and overturned. P-1 said he sustained no injuries as a result of this collision and declined medical attention at the scene. Party #2 (Diaz) stated he was driving V-2 (Ford) in the northbound lane on San Pablo Avenue approaching Fred Waring Drive. P-2 said he was preparing to stop for the northbound red signal and as he approached the limit line at approximately 5 MPH, the northbound signal changed to green and he proceeded into the intersection. P-2 stated as he was approximately halfway through the intersection when V-1 (Toyota) collided into the front of his vehicle which caused V-I (Toyota) to lose control and strike the sign of the center median and overturn. P-2 said he sustained no injuries as a result of this collision and declined medical attention at the scene_ Witness #1 (Muela) stated she was stopped in the northbound left turn lane on San Pablo Avenue at Fred Waring Drive. W-I stated while waiting to turn on westbound Fred Waring Drive she saw V-2 (Ford) proceed northbound on San Pablo Avenue and collide into V-1 (Toyota) towards the middle of the intersection. W-1 stated V-2 (Ford) was traveling eastbound on Fred Waring Drive at an unknown speed and V-2 (Ford) had entered the intersection from northbound San Pablo Avenue at a very slow speed. W-1 stated after V-2 (Ford) struck V-1 (Toyota), V-1 (Toyota) lost control and overturned on the center median. W-1 stated the collision happened very fast and did not know which vehicle had the red light. SUMMARY: Party #1 (Terrazes) was driving V-1 (Toyota) in the #1 eastbound lane on Fred Waring Drive approaching San Pablo Avenue at approximately 45 MPH. P-2 (Diaz) was driving V-2 (Ford) in the northbound lane on San Pablo Avenue approaching Fred Waring Drive approximately 5-15 MPH slowing for a red light. As P-1 was driving eastbound on Fred Waring Drive he collided with P-2 in the middle of the intersection on Fred Waring Drive and San Pablo Avenue. After colliding with V-2 (Ford), V-1 (Toyota) lost control striking the center median on the east side of the intersection which caused the vehicle to overturn. As a result of this collision, V-1 (Toyota) sustained major damage to the front end and entire passenger's side of PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE Espinoza 5267 08-13-2015 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 STATE OF CALIFORMA NARRATIVEISUPPLEMENTAL PAGE 6 OF 6 DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 08-13-2015 1508 3300 5267 T15 225 0103 the vehicle due to rolling over onto the passenger's side. V-1 (Toyota) was towed by Yuccipa Towing, located at 74741 Joni in the city of Palm Desert. V-2 (Ford) sustained major front end damage to include front bumper and hood. V-2 (Ford) was towed by Renie's Towing, located at 42200 Beacon Hill in the city of Palm Desert. AREAS OF IMPACTS (AOI) AOI #1 V-1 vs V-2 24' north of the south curb prolongation of Fred Waring Drive 25' west of the east curb prolongation of San Pablo Avenue AOI #2 V-1 vs center median (traffic sign) 40' north of the south curb prolongation of Fred Waring Drive 24' east of the east curb prolongation of San Pedro Avenue The areas of impact were determined by statements and matching damage. CAUSE: The cause of this collision is a violation of 21453(a) VC- Red Signal which states: A driver facing a steady circular red signal alone shall stop at a marked limit line, but if none, before entering the crosswalk on the near side of the intersection or, if none, then before entering the intersection, and shall remain stopped until an indication to proceed is shown. Due to conflicting driver statements and lack of independent witnesses, fault cannot be determined in this collision. RECOMMENDATIONS: None. PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE Espinoza 5267 08-13-2015 INCIDENT REPORT I `— DATE PREPARED: 08/13f2015 RIVERSIDE COUNTY SHERIFFCA0330000 ® INITIAL ❑ SUPPLEMENTAL 1 FILE NL6r0ER .2 DATEMMEREPORTED J. DATFI ME ASSIGNED - A.DATEf"E DIV. START 5 DATE' 7E INV TERM 6 AULIT ARR 7 JOV ARR T15 225 0103 081315/1508 081315/1509 0813J5/I511 081315/1635 0 0 I OFhE!SES, CODE SECFION CREME COLNTS 9 EDP CODE Non -Criminal Non -Injury Traffic Collision 01 18J7-N 10 OFtENSLS• CODE SECTION (A:d cr Gee c :o) CRNE cow, 5 I1. EDP CODE 1: OFFEN'5E5-CODE SLRION 1,1141 11,1,111 CR:ME COUNTS 13 EDP CODE I: LOCATION OF OCCUItRISCE I5. REP DIST I 16, OCCIRRED ON', DA'LITINIE 17 OR OMYCEN DAFLTL\IE Fred Waring Drive x San Pablo Avenue, Palm Desert 36Q3 1081315 1508 II BI;St�FSS \.1\IE 19 Sr1FS5 PIiONT: OL' 20 CASE S7:\TL'S,' CLEARANCE None � EXC VICTIM -REPORTING PARTY - WITNESS - OTHERS: ❑ SEE ADDITIONAL PERSONS REPORT OTfi ` VA\IE (ICY, Fast. M'ic'CI<) Dep. Conowa; 2093 S"\ 1 24 RACE I _) DOD rAGE I ?T. HT '_9.',Vr II'_b. _'P.}LAIR' 30.EYES 11.SK1% 3! RESIDENCE ADDRESS On File CITY 71P 33 RES PH(]NF. H RHSINESS AUURF_15 73705 Gerald Ford Drive CITY Palm Desert ZIP 92211 1' BLS PHO.N'E 760-836-1600 36. 1N1'L 311E IL_v, F.n1 S:-_e:cl 136 SEY J10.10E 40 DOB aI ACL _.HT I AJ.\S'T J-f. IMR 1 c5.EY"S +6 47 RhS1Uf.1(E AUURE i1 CITY ZIP - 1I RES iHONE —1 49 Ul;SINESS ADCRESS I CI'r1' _-- lII+ I 10 DLS PH01F I 72 GAtiG DATA GANG NAMI:IS): ❑ Member ❑ Associate ❑ Sclf Admit. []Prior KnoMedge 73. 1A'ITOOSISCARS0,1ARKS/ CLO11tNG DESCRIPTION TATTOOSiSCARS /MARKS ❑ Pace ❑'Neck ❑ R. Arm ❑ L. Arm ❑ Hands ❑ Torso ❑Back ❑ Lees _J VEHICLE: ❑ REFER TO CHP I80 FORM FOR STOLEN, RECOVERED, TO\N ED OR 1>IPOLNDED u 1 11ZL '1. I.If h'1\h: J4 5">TI. t'F �R 1I 1tAAi: �9 1fUUFI I'. O1), 111'LI ,II SI.Nr RC] "TO VALIE ' IL. 5 I G; ('UCDR C01.01- � �_ ]i 1-i.1> _--- 1-'-]-> UTIfLR 1f*N71FIER155 ]' DICpU51TiON U.`\'EI:IC LE rM RIGISTEREDONNCIL 51 ADDitESS CITY S'IAIE ZIP ]I PHONE I I 59 UAM,%GED PROPERTY VALUE ❑ FROPEIRTY RF.POR I A'fl \CITED FOR SI'OLEN, HECOI EKED OR I PROPER11; 15 I I RIIORIINGOIIICER Uit ID REVEtVED1 DATE. TJ ENTEREDa1'DA IF.. ENTERE'J DY'DArk � L Dewy Espinon 5267 ( �. Sherman #154 I I fnPl[C in YR SLT AI'R l'A.NCL!LED I OOI-NCIC ENTERED:I MI,NCIC CANCELED . 907, SWITRS, City of Palm Desert fDm1 A fip r 2 98 g-j -i pq Payment Log Claim Number: Date of Loss: 08/ 13/ 15 Insured's Name: FELIPE TERRAZAS FARMERS I .... A N C e Benefit Type : Check Number Service Service Payee Date I Date Paid Benefit Paid From Date To Date Issued FELIPE TERRAZAS 09/03/15 09/04/2015 $11,900.56 Total Amount $11,900.56 Ie� s FARMERS I N S U H A— F Benefit Type Total 1 $11,900.56 Report Generated for USWSRW41 on 9/16/2015 Page 1 of 1 4 3004140522-1 1 1-IOBLSLX MD Vehicle Data Vehicle Valuation Data Year: 2002 Valuation Amount: $11,984.00 Date Settled:9/3/2015 Make: TOYOTA Considerations: $0.00 Valuation Method: CCC Model: TACOMA Adjustment+l-: ($627.00) Valuation ID: Mileage: Actual Cash Value: $11,357+00 Additional Details: condition -627 VIN:: Sales Tax: $908 56 Inspected VIN:5TESN92N12Z067782 Lic. Transfer Fee: $135.00 License State: CA Other Fees: $0.00 License Number: LINK Deductible: $500+00 Salvage Value: $0.00 Net Total: $11,900.56 Owner Retained: No Adjuster Data Fee Calculation State: CA Veh Inspection CR: Veh Inspection Division: GOLDEN GATE Veh Inspection Date:8119/2015 Repair Est Amount: Settling CR: Settling Division: KC TOTAL LOSS Lien Info Salvage Data Lien: $0 00 Salvage Type: Salvage Pool Residual Debt: $0.00 Salvage Status: Customer Due: $11,900.56 Salvage Vendor: IAA INC Mortgagee Due: $0.00 Addressl: Lien Holder: City: State: Send Date: 9/3/2015 10:59.03 AM Receive Date:9f3/2015 06 13:24 PM Status: Completed Send Counter. 1 Host Message: Reported to NICB: N Leased: Lien: Damaged License Plate: Calculation Date: 8/1312015 Stock #: 15745782 Gross Salvage: Total Advanced Charges:0.00 Total Pre -Paid Charges: $0.00 Total Vendor Charges:0.00 Net Salvage: $0.00 Computerized Vehicle Registration Inquiry Report Vehicle Registration Inquiry Report 76174956 **x Notice: DMV info use subject to DMV Commercial Requester Account agreement Claim No: Date: 08/19/201.5 Requested: Time: 12:05:21 P:d Reason: Insurance Claim User ID: C?8 Loss Date: 08/13/2015 ----------------------------- REGISTERED OWNER INFO ------------------------- NAME: TERRAZAS FELIPE C ADDRESS: ;T CITY: STATE: CA COUNTY: RIVERSIDE ZIP CODE: ------------------------- LEGAL OWNER (LTENHOLDER) INFO ---------------- NAME: ADDRESS: CITY: GA STATE: GA Z I P CODE: --------------------------------- VEiICLE INFO ------------------------------ EXPIRES: 04/30/16 VLF: FN VIN: TYPE: 31:Reg,:lar - Commercial LTCENSE: ENGINE NO: YR MODEL: 2002 WEIGHT: 03267 YR SOLD: 00/00/02 AXLE: 2 * YEAR: FUEL: G BODY TYPE: PK VEH TYPE: 32 EQUIP NO: HULL NO: MAKE.: TOYI SUP PLATE: ----------------------------------------------------------------------------- Date of latest Registration Card Issuance: 05/06/2015 Date of latest Ownership Certificate Issuance: 05/05/2002 --------------------------------- RECORD STATUS----------------------------- 12/17/14 SMOG DUE W30/16 NO MAILING ADDRESS 04/01/2002-ODOMETER: 4 MILES ACTUAL MILEAGE Fee Calculation.Reper±_ Transaction.: Total Loss Settlement Loss Date: 08/13/2015 ELP Status: None Cut-cf-State: No Last Reg. Period: 04/30/2015 Fee based on RIVERSIDE County. ----------------------------------------------------------------------------- x***xxx****x**k***********x******** NOTICE *xxx***x***********************x**** FEE ESTIMATE, based on DMV-supplied data and disregards any title transfer taking place or other specific credits or charges. * k * * x x x * x * x * x * x x * * x * * * * * * x x x * x * * * x * * * * * * * * * * * s * * * * * * * * x * * * x * x * * * x * * * * * * * * * * * x *xxxx**x*x***********************x** NOTICE Calculated weight fees assume operating weight has not changed. ----------------------------------- SETTLEMENT FCR THE PERIOD FROM 04/30/2015 TO 04/30/2016 ---------------------------------------- Registration Fee $ 46 C'H? Fee $ 24 Weight Fee $ 24 Vehicle license Fee with 67.5° Reduction $ 23 Transfer Fee(One Time Fee) $ 15 Air Qsal.ity $ 7 SAFE $ 1 Auto Theft/DUI $ 1 Abandoned Vehicle Abatement $ 1 Fingerprint Fee $ 1 Vehicle License Fee with 63.51 Reduction Used (4 mo.) $ -8 ----------------------------------------- SETTLEMENT TOTAL TO REGISTERED OWNER: $ 135 -------------------------- PREVIOUS REGISTRATION FEES ----------------------- FOR THE PERIOD FROM 04/30/2015 TO 04/30/2016 ---------------------------------------- R.egistration Fee $ 46 CHP Fee $ 24 Weight Fee $ 24 Vehicle License Fee with 67.5% Reduction $ 23 Air Quality $ 7 SAFE $ 1 Auto Theft/DUI $ 1 Abandoned Vehicle Abatement $ 1 Fingerprint Fee $ 1 ---------------------------------------- TOTAL FEES PAID BY REGISTERED OWNER: $ 128 -------------------------------- LICENSE REFUND--------------------- ---------------------------------------- Vehicle License Fee with 67.5% Reduction- $ 23 Vehicle License Fee with 67.5% Reduction Used (4 mo.) $ -8 DMV Administration. Fee $ -19 ---------------------------------------- REFUND: $ 0 TOTAL REFUND TO INSURANCE COMPANY: NONE x Fee Calculations include all changes as of 7/1/3013 ---------------------------- End of DMVIINK PrinrcuC------------------- V.3 ����\ . <� � � � � � \\ � . :� � . . � � � \� � \\\ � � � : .\>y�� \� . � � � � �� � � < . . < � ..����/��: . .. � .�.,� � «_ � � � � yv . � � � »:� w� � � , .. . � � � �� � � ..: ?2 . : w. � © . . � � � yam. .� : \ ����y� �.» . .. � � � � � � . . ���W��« `� /� :x \� \ . . ^^� +� � ' � \ y . ^j\°�� \� \� � � \� \\\�. CCC ONES MARKET VALUATION REPORT CLAIM. - Owner: Felipe Terrazas Report Reference Number: Claim Reference: Adjuster: Waltz, Ben Insured: Felipe Terrazas USW#: Loss Vehicle: 2002 Toyota Tacoma 4X2 Claim Submitted Date: 08/18/2015 Xtracab Prerunner 2 Door Date/Time Last Updated: Original Pickup Truck Policy Number: VIN: Appraiser: Waltz, Benjamin Odometer: Location: Loss Incident Date: 08/13/2015 VALUATION SUMMARY Base Vehicle Value $ 11,984.00 ----... - --- _.. Loss vehicle condition - 627.00 Adjusted Vehicle Value Vehicular Sales Tax License/Fees (if applicable) Total -----.--.-__—__. $ 11,357.00 $ 11,357.00 This CCC ONETI Market Valuation Report was prepared for Farmers Insurance Exchange by CCC Information Services Inc. The CCC ONETm Market Valuation Report reflects CCC's opinion as to the value of the loss vehicle. CCC has been preparing market value reports for the insurance industry since 1981. The Base Vehicle Value is derived from comparable vehicle(s) available or recently sold in the marketplace at the time of valuation, with adjustments made to reflect the loss vehicle configuration. 9 comparable vehicle(s) were utilized in this report. The loss vehicle has been valued in the California region where it was garaged as a older truck with 8% less than average mileage of 163,100. (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 1 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: VEHICLE ALLOWANCES Allowances are factors influencing the value of the loss vehicle when compared to a typical vehicle. The typical vehicle is a vehicle of the same year, make, and model as the loss vehicle, including average mileage, and all standard and predominant equipment. These allowances are displayed for illustrative purposes only. The Base Vehicle Value is calculated from the comparable vehicles with adjustments to reflect the loss vehicle configuration. Vehicle Allowances Package 1: Off Road Package 2: Si-5 Odometer 149,876 Options + 252.00 ---._ ....... - .-- + 202.00 + 559.00 Power Windows Reported + 67.00 Power Locks Reported + 67.00 Power Mirrors ............. —.- ..._._...._.._. Reported -- -- + 48.00 Cruise Control Reported + 67.00 Aluminum/Alloy Wheels Reported + 135.00 Privacy Glass Reported + 67.00 - -- ----------- — Trailer Hitch -- --------._......----- Reported + 67.00 Trailering Package Reported + 67.00 Rear Sliding Window Reported + 67.00 Bedliner Reported + 101.00 VEHICLE HISTORY SUMMARY Experian® AutoCheck® No Title Problem Found Insurance Services Organization/ 1 Record Found National Insurance Crime Bureau National Highway Traffic Safety Administration 3 Recalls (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 2 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference. 2002 TOYOTA TACOMA 4X2 XTRACAB PRERUNNER 2 DOOR PICKUP TRUCK - INDIO, CA 92201 VIN: Below are the components of the loss vehicle, provided to CCC by Farmers Insurance Exchange, included in this valuation. Package 1: Off Road Radio PackageAM Radin Standard Odometer 149,876 Transmission Automatic Transmission Standard Overdrive Standard Power Power Steering Standard Power Brakes Standard Power Windows Reported Power Locks Reported -- . _. _.... _ —_ .._ __ ...... Power Mirrors ... _ __ .._ .......... . Reported Decor/Convenience Air Conditioning Tilt Wheel Standard Reported Cruise Control Reported Intermittent Wipers _ .._........... _._ __ _ Standard Console/Storage Reported Seating Cloth Seats Standard - -- - .._...---.......... - - ---- ....... ......_..__ Bucket Seats ._ __....... ---- _... Reported Reclining/Lounge Seats Reported FM Radio Standard Stereo Standard Search/Seek Standard -- -- -------------- -- CD Player Reported Cassette Standard Wheels Aluminum/Alloy Wheels Reported Safety/Brakes Drivers Side Air Bag Standard Passenger Air Bag Standard Exterior/Paint/Glass Dual Mirrors Standard Privacy Glass Reported Clearcoat Paint Reported Metallic Paint Reported Other -Trucks Rear Step Bumper Standard Trailer Hitch Reported Trailering Package Reported Rear Sliding Window Reported Bedliner Reported California Emissions Reported (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 3 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: Farmers Insurance Exchange uses condition inspection guidelines to rate the condition of key components of the loss vehicle on a three-point scale. A rating of average condition results in a valuation of that component that is consistent with typical vehicles for that year, make and model of vehicle. If a component is rated in exceptional condition, then a positive monetary adjustment is made to reflect the impact of that condition level on the value of the loss vehicle. Similarly, if a component is rated in below average condition, then a negative monetary adjustment is made to reflect the impact of that condition level on the value of the loss vehicle. Inspection Notes, if any, reflect additional observations from the appraiser regarding the loss vehicle's condition. Monetary adjustments are based upon market research consisting of data gathered from dealerships in California. COMPONENT CONDITION VALUE IMPACT Mechanical Average Body/Glass Paint Average Average INSPECTION NOTES: Average- Engine - Average - Belts and hoses show minim al wear. Minimal dirt and grease in engine compartment. Transmission - Average - Fluid slightly discolored. INSPECTION NOTES: Average Sheet Metal - Average - Damage in loss with rol lover loss Trim - Average- Trim damaged in loss with r oolover loss Glass - Average - Glass shattered out in loss INSPECTION NOTES Average - Paint is damaged in loss with rollover loss AVERAGE VEHICLE DESCRIPTION: Engine : Few small leaks to minor seepage. Belts and hoses show minimal wear. Significant to minimal dirt and grease in engine compartment. Transmission : Fluid slightly discolored. None to a few areas of seepage. AVERAGE VEHICLE DESCRIPTION: Sheet Metal : A few to no dents. Numerous to a few dings. No significant surface rust. Trim: Minimal to no damage to components. No broken and/or missing components. Few to no dents. Numerous to a few dings. Glass : Light surface scratches and/or pitting. Few to no chips. AVERAGE VEHICLE DESCRIPTION: Few small deep to minimal surface chips and/or scratches. No significant peeling and/or flaking. Minor swirl marks. Slight to no Fading. (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 4 of 18 CCC 0 E Owner: Felipe Terrazas 1 VEHICLE CONDITION (CONTINUED) Interior Tires Below average Average - $627 INSPECTION NOTES: Total Adjustments: - $627 Average Carpets - Below Average - drivers door trim pa nel heavily worn and soiled , right front door trim pa nel worn and soiled, carpets stained and soiled Dashbo and - Below Average - steering wheel is worn, wear on s hift knob, dash is worn and scratched Headliner - Belo w Average- soiling and stains on headliner Seats - Bel ow Average - large tear in drivers seat , heavy wear an d tear on seats, fading on seats INSPECTION NOTES: Average Left front 6/32nd, Right 7/32nd Left rear dama ged in loss, Right rear 10/32nd Average depth = 7.6132 nd = 7.6111 = 69% tread remaining Claim Reference: AVERAGE VEHICLE DESCRIPTION: Carpets : Lightly soiled to clean and/or stained. A few small to no tears, holes and/ or burn marks. No significant bare spots. Dashboard : Significant to a few small scratches and/or gouges. Components may be damaged and/or cracked. Significant to light wear. Headliner: A few small to no significant holes and/or burn marks. Light to no significant scuffing. Seats : Lightly soiled to clean,faded and/or discolored. A few small to insignificant tears, holes and/or burn marks. None or no significant bare spots. AVERAGE VEHICLE DESCRIPTION: Front Tires : 41% to 90% of new. Example: Typical new car tires are 11132, loss measures at 5132 = 46% (5/11) Rear Tires : 41 % to 90% of new. Example: Typical new car tires are 11/32, loss measures at 5/32 = 46% (5/11) (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 5 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: VINGUARD@ VEHICLE IDENTIFICATION 2002 TOYOTA TACOMA 4X2 XTRACAB PRERUNNER 2 DOOR PICKUP TRUCK - VIN: Vehicles sold in the United States are required to have a manufacturer assigned Vehicle Identification Number (VIN). This number provides certain specifications of the vehicle. Decoding the VIN, using VlNguard®, identifies the vehicle for which vehicle value will be determined. Insurer Description VlNguard® Analysis Year 2002 I 2002 Make Toyota Toyota Model/Trim Tacoma 4X2 Xtracab Prerunner Tacoma 4X2 Xtra Prerunner Model Number SN92N SN92N Body Style 2 Door Pickup Truck I Engine 6-3.4L-FI 6-3.41-Fi Transmission Automatic Transmission Overdrive Restraints Air Bags (Driver+Pass.) Air Bags (Driver+Pass.) Curb Weight 2,950 This vehicle was assembled in U.S.A. VINGUARD@ VEHICLE HISTORY•' • Using the VIN for this vehicle, VlNguard® detected discrepancies or prior history requiring additional research. Please review the information detailed below. VlNguard® Messages: VlNguard has decoded this VIN without any errors. _ ISO Vehicle History: Number of times reported to ISO: 1 ISO's file number: --------- . Activity Reported: Property & Casualty Loss date: 08/13/2015 Insurance company: Farmers Insurance Exchange Phone: Unavailable - _...__ . _.............. ............_.. ._._.. _.............. Claim ref: Point of Impact: - - .. ..__... ----- _....... .. __.. .... --.._ _..__.... (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 6 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: 'i EAPE: /.\►[01_11T•Iyaxy:(O>T/E:I GLE A 6'T[•]:a>•:»1•]:T CCC provides Farmers Insurance Exchange information reported by Experian® regarding the loss vehicle. This data is provided for informational purposes. Unless otherwise noted in this Market Valuation Report, CCC does not adjust the value of the loss vehicle based upon this information. REPORT RUN DATE: 08/18/2015 KEY: `.�i = No Event Found = Event Found O = Information Needed b4 TITLE CHECK O VEHICLE INFORMATION THIS VEHICLE CHECKS OUT. AutoCheck's result for INFORMATION FOUND. AutoCheck found additional this 2002 Toyota Tacoma 4X2 Xtracab Prerunner information on this vehicle. These records will provide more ;how no significant title events. history for this 2002 Toyota Tacoma 4X2 Xtracab When found, events often indicate automotive damage or Prerunner warnings associated with the vehicle. EVENTS CHECKED Kt:bU _IS FOUND EVENTS CHECKED RESULTS FOUND Accident 0 Accident Record(s) Found Abandoned "i No Abandoned Record Found - - - ..... -- _ ...._ . -.- .---......---- ._ . ....... _.. Corrected Title i No Corrected Title Record Found Damaged ! i No Damaged Record Found Driver Education 7,1 No Driver Education Record Found Fire Damage :moNo Fire Damage Record Found _.. .... - ._. _ _...-._.. 7t Duplicate Title 1 No Duplicate Title Record Found Grey Market ' v No Grey Market Record Found Emissions Safety Emissions Safety Inspection Hail Damage ° j No Hail Damage Record Found Inspection Records Found - ......... . ... _...... - Insurance Loss ;:"i No Insurance Loss Record Found Fire Damage Incident -1 No Fire Damage Incident Record Found Junk No Junk Record Found - -- --- - Lease :`4 No Lease Record Found Rebuilt No Rebuilt Record Found Lien O Lien Record(s) Found Salvage "'i No Salvage Record Found -- - .... -- -- Livery Use i No Livery Use Record Found 6i EVENT CHECK Government Use "e No Government Use Record Found THIS VEHICLE CHECKS OUT. AutoCheck's result for - Police Use i No Police Use Record Found this 2002 Toyota Tacoma 4X2 Xtracab Prerunner show no historical events that indicate a significant automotive problem. These problems can indicate past previous car damage, theft, or other significant problems. EVENTS CHECKED RESULTS FOUND NHTSA Crash Test No NHTSA Crash Test Vehicle Vehicle Record Found Frame Damage ""e No Frame Damage Record Found Major Damage Incident '"; No Major Damage Incident Record Found Manufacturer Buyback/ No Manufacturer Buyback/Lemon Lemon ° Record Found Odometer Problem yA No Odometer Problem Record Found Recycled "i No Recycled Record Found _._..... _.._._.__... ...- - -. ......... Salvage Auction ,% No Salvage Auction Record Found Water Damage :"4 No Water Damage Record Found Fleet "' No Fleet Record Found Rental "; No Rental Record Found No Fleet and/or Lease Record Fleet and/or Lease Found No Fleet and/or Rental Record Fleet and/or Rental �i Found Repossessed �'i No Repossessed Record Found Taxi use `pi No Taxi use Record Found Theft °-4 No Theft Record Found (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 7 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference:: EXPERIAN® AUTOCHECK® VEHICLE HISTORY REPORT (CONTINUED) 'i ODOMETER CHECK THIS VEHICLE CHECKS OUT. For this 2002 Toyota Tacoma 4X2 Xtracab Prerunner , no indication of odometer rollback or tampering was found. AutoCheck determines odometer rollbacks by searching for records that indicate odometer readings less than a previously reported value. Other odometer events can report events of tampering, or possible odometer breakage. DATE REPORTED ODOMETER READING 2002-04-01 4 2008-05-02 2010-08-23 2012-06-01 FULL HISTORY REPORT RUN DATE: 08/18/2015 Below are the historical events for this vehicle listed in chronological order. Event Date Event Location Odometer Reading Data Source Event Detail 2002-03-18 CA Independent Source 2002-04-01 CA 4 Motor Vehicle Dept. 2002-04-25 COACHELLA, CA Motor Vehicle Dept. 2002-05-05 COACHELLA, CA Motor Vehicle Dept. 2008-01-03 PALM DESERT, CA Police Report 2008-04-30 INDIO, CA Motor Vehicle Dept. 2008-05-02 CA State Agency 2008-08-20 CA State Agency 2010-08-23 CA 2012-06-01 CA State Agency State Agency VEHICLE MANUFACTURED AND SHIPPED TO DEALER ODOMETER READING FROM DMV REGISTRATION EVENT/RENEWAL TITLE (Lien Reported) ACCIDENT REPORTED REGISTRATION EVENT/RENEWAL PASSED EMISSION INSPECTION ACCIDENT REPORTED, Event Date is date reported to AutoCheck PASSED EMISSION INSPECTION PASSED EMISSION INSPECTION AUTOCHECK TERMS AND CONDITIONS: Experian's Reperts are compiled from multiple sources. It is not always possible for Experian to obtain complete discrepancy information on all vehicles; therefore, there may be other title brands, odometer readings or discrepancies that apply to a vehicle that are not reflected on that vehicle's Report. Experian searches data from additional sources where possible, but all discrepancies may not be reflected on the Repoli. These Reports are based on information supplied to Experian by external sources believed to be reliable, BUT NO RESPONSIBILITY IS ASSUMED BY EXPERIAN OR ITS AGENTS FOR ERRORS, INACCURACIES OR OMISSIONS. THE REPORTS ARE PROVIDED STRICTLY ON AN "AS IS WHERE IS" BASIS, AND EXPERIAN FURTHER EXPRESSLY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE REGARDING THIS REPORT. YOU AGREE TO INDEMNIFY EXPERIAN FOR ANY CLAIMS OR LOSSES, INCLUDING COSTS, EXPENSES AND ATTORNEYS FEES, INCURRED BY EXPERIAN ARISING DIRECTLY OR INDIRECTLY FROM YOUR IMPROPER OR UNAUTHORIZED USE OF AUTOCHECK VEHICLE HISTORY REPORTS. Experian shall not be liable for any delay or failure to provide an accurate report if and to the extent which such delay or failure is caused by events beyond the reasonable control of Experian, including, without limitation, "acts of God", terrorism, or public enemies, labor disputes, equipment malfunctions, material or component shortages. supplier failures, embargoes, rationing, acts of local, state or national governments, or public agencies, utility or communication failures or delays, fire, earthquakes, flood, epidemics, riots and strikes. These terms and the relationship between you and Experian shall be governed by the laws of the State of Illinois (USA) without regard to its conflict of law provisions. You and Experian agree to submit to the personal and exclusive jurisdiction of the courts located within the county of Cook, Illinois. (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 8 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: The National Highway Traffic Safety Administration has issued 3 safety related recall notices that may apply to the above valued vehicle. NHTSA ID: 12V542000 ISSUED: NO. OF VEHICLES: 150,000 Tires:Temporary/emergency spare tire toyota is recalling certain model year 2001 through 2004 Tacoma light trucks manufactured from August 28, 2000, through August 27, 2004, and originally sold, or currently registered, in the following cold climate states with high road salt usage: Connecticut, Delaware, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, new Hampshire, new Jersey, new York, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin, and the District of Columbia. The spare tire in the subject Vehicles is located underneath the rear of the Vehicle and held by a spare tire carrier. A lift plate on the carrier is used to help raise, lower and retain the tire. During its manufacture, the lift plate may not have been sufficienfly coated with anti -corrosion materials. If the plate is insufficiently coated and the Vehicle is operated in cold climate regions where road salts are frequently used, road spray can reach the carrier assembly and corrode the lift plate. Corrosion of the plate could cause it to break, which could result in detachment of the spare tire from the Vehicle. Detachment of the spare tire could result in a road hazard which may increase the risk of a Vehicle crash. A remedy for this defect is currently being developed. Toyota will notify owners when a remedy plan has been finalized. The recall is expected to begin during December 2012. Owners may contact their toyota Dealer or the toyota Customer experience center at 1-800-331-4331. NHTSA ID: 05V225000 ISSUED: NO. OF VEHICLES: 774,856 Suspension: Front: Control arm:Lower ball joint on certain sport utility Vehicles, due to a manufacturing issue in the front suspension lower ball joint, there is a possibility that the surface of the ball of the joint may have been scratched. The ball joint may eventually experience excessive wear and looseness, resulting in increased steering effort. The lower ball joint may separate from the knuckle causing loss of steering control and a crash could occur with prior warning. Dealers will replace the front suspension lower ball joints. The recall is expected to begin on July 15, 2005. Owners should contact toyota at 1-800-331-4331. NHTSA ID: 03V189000 ISSUED: NO. OF VEHICLES: 123,360 Fuel system, gasoline: Delivery: Hoses, lines/piping, and fittings on certain pickup trucks, during side impact testing, a flange at the rear end of the double cab body deformed and interfered with the fuel inlet hose that connects the fuel filler pipe and fuel tank, resulting in damage to the fuel inlet hose. This damage could result in fuel leakage, which could result in a Fire if in the presence of an ignition source. Dealers will install a fuel hose protector on the body flange. Owner notification is expected to begin during July 2003. Owners who take their Vehicles to an authorized Dealer on an agreed upon service date and do not receive the free remedy within a reasonable time should contact toyota at 1-800-331-4331. The following comparable vehicle(s) were used to determine this market value by computing the arithmetic average of the adjusted values of the comparable vehicles. Details on these comparable vehicles are in the Comparable Vehicles section. Type J Comparable Vehicle 1 Dealer Vehicle 12002 Toyota Tacoma 4X2 Xtracab Prerunner 2 Dealer Vehicle 2002 Toyota Tacoma 4X2 Xtracab Prerunner 3 Dealer Vehicle 2002 Toyota Tacoma 4X2 Xtracab Prerunner Price Adjusted Value ---- _ _.---------- _ _ Price $12,990 $12,924 Price $10,990 Price $11,988 $12,477 ---- --------$12,180 4 Dealer Vehicle 2002 Toyota Tacoma 02 Xtracab Prerunner Price $12,980 $12,412 5 Dealer Vehicle 2002 Toyota Tacoma 02 Xtracab Prerunner 6 Dealer Vehicle 2002 Toyota Tacoma 4X2 Xtracab Prerunner 7 Dealer Vehicle 8 Dealer Vehicle 2002 Toyota Tacoma 4X2 Xtracab Prerunner j 2002 Toyota Tacoma 4X2 Xtracab Prerunner Price $9,488 $11,302 Price $7,997 $10,150 Price $11,988 Price $9,995 (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. $12,738 -...$12,786 ..._. Page 9 of 18 GCC 0 E Owner: Felipe Terrazas Claim Reference: 9 Dealer Vehicle 2002 Toyota Tacoma 4X2 Xtracab Prerunner Price $7,900 $10,883 Arithmetic ---- ------ $ 11,984.00 Average (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 10 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: 1 COMPARABLE VEHICLES LOSS VEHICLE - 2002 TOYOTA TACOMA 4X2 XTRACAB PRERUNNER 2 DOOR PICKUP TRUCK — VIN: DEALER VEHICLE DEALER VEHICLE DEALER VEHICLE LOSS VEHICLE COMPARABLE 1 COMPARABLE 2 COMPARABLE 3 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 4X2XTRACAB 4X2XTRACAB 4X2XTRACAB 4X2XTRACAS PRERUNNER PRERUNNER PRERUNNER PRERUNNER 2 DOOR PICKUP TRUCK 2 DOOR PICKUP 2 DOOR PICKUP 2 DOOR PICKUP 6-3.4L-FI 6-3.4L 6-3.4L 6-3.4L Package Package1: Off Road Package Package 2: Sr5 Options Automatic Transmission .. ✓ ✓ ✓ Overdrive ✓ ,� ✓ ✓ Power Steering ✓ ✓ ✓ ✓ Power Brakes ✓ ✓ ✓ ✓ Power Windows ✓ ✓ x x Power Locks ✓ ✓ x x Power Mirrors ✓ X x x Air Conditioning ✓ ✓ ✓ ✓ Tilt Wheel ✓ x x ✓ Cruise Control ✓ ✓ x ✓ Intermittent Wipers ✓ ✓ ✓ ✓ Console/Storage ✓ x x x Cloth Seats ✓ ✓ ✓ ✓ Bucket Seats ✓ x x x Reclining/Lounge Seats ✓ x x x AM Radio ✓ ✓ ✓ ✓ FM Radio ✓ ✓ ✓ ✓ Stereo ✓ ✓ ✓ ✓ Search/Seek ✓ ✓ ✓ ✓ CD Player ✓ x x ✓ Cassette ✓ ✓ ✓ ✓ Styled Steel Wheels x x ✓ ✓ Aluminum/Alloy Wheels ✓ ✓ x x Drivers Side Air Bag ✓ ✓ ✓ ✓ Passenger Air Bag ✓ ✓ ✓ ✓ Anti -Lock Brakes (4) x ✓ ✓ ✓ Dual Mirrors ✓ ✓ ✓ ✓ Privacy Glass ✓ x x x Clearcoat Paint ✓ x x x Metallic Paint ✓ x x x Rear Step Bumper ✓ ✓ ✓ ,� Trailer Hitch ✓ x x x Trailering Package ✓ x x x (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 11 of 18 AddNNCMz=- CCC ONES Owner: Felipe Terrazas Claim Reference: Rear Sliding Window ✓ ✓ x X Bedliner ✓ ✓ X ✓ California Emissions ✓ x x Y Miles _ - _ Price $12, 990 $10, 990 $11,988 Adjustments Package +454 +454 +454 Options +114 +618 +248 Mileage -634 +415 -510 Adjusted Value $12,924 $12,477 $12,180 Dealership Escondido Auto Universal Auto Proz Super Cent Motors Telephone 760-737-9400 626-290-6470 619-440-3000 Stock ID Stock: ' Stock: Stock: VIN Type/Date Pub Date Pub Date Pub Date 7/22/2015 7/30/2015 7/07/2015 Distance from Indio, CA 64 Miles - 97 Miles - 76 Miles - El Escondido, CA Glendora, CA Cajon, CA > Comparable vehicles used in the determination of the Base Vehicle Value are not intended to be replacement vehicles but are reflective of the market value. > Price is the actual sale price as provided by the California Department of Motor Vehicles or other sources or the asking price of an advertised vehicle. > The Adjusted Value represents the price of the comparable vehicle with the adjustments displayed above. Dollar adjustments are based upon market research. > Distances displayed indicate approximate miles between loss and comparable vehicle locations. Distances are based upon a straight line between these locations. > Some comparable vehicles that were recently available may no longer be available. > The Price, Asking Price, Take Price or List Price displayed above (as applicable) may differ from the advertised price where CCC obtains different price information from the seller. (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 12 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: COMPARABLE• DEALER VEHICLE DEALER VEHICLE DEALER VEHICLE LOSS VEHICLE COMPARABLE 4 COMPARABLE 5 COMPARABLE 6 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 4X2 XTRACAB 4X2 XTRACAB 4X2 XTRACAB 4X2 XTRACAB PRERUNNER PRERUNNER PRERUNNER PRERUNNER 2 DOOR PICKUP TRUCK 2 DOOR PICKUP 2 DOOR PICKUP 2 DOOR PICKUP 6-3.4L-FI 6-3.41- 6-3.41- 6-3.41- Package Package 1: Off Road Sr5 Package Package 2: Sr5 Options Automatic Transmission ✓ ✓ ✓ ✓ Overdrive ✓ ✓ ✓ ✓ Power Steering ✓ ✓ ✓ ✓ Power Brakes ✓ ✓ ✓ ✓ Power Windows ✓ x x ✓ Power Locks ✓ x x ✓ Power Mirrors ✓ ✓ x x Air Conditioning ✓ ✓ ✓ ✓ Climate Control x ✓ x x Tilt Wheel ✓ ✓ x ✓ Cruise Control ✓ x x x Intermittent Wipers ✓ ✓ r ✓ Console/Storage ✓ x x x Cloth Seats ✓ ✓ ✓ ✓ Bucket Seats ✓ x x x Reclining/Lounge Seats ✓ x x x AM Radio ✓ ✓ ✓ ✓ FM Radio r ✓ ✓ ✓ Stereo ✓ ✓ ✓ ✓ Search/Seek ✓ ✓ ✓ ✓ CD Player r ✓ x ✓ Cassette ✓ ✓ r ✓ Styled Steel Wheels x ✓ ✓ x Aluminum/Alloy Wheels ✓ x x ✓ Drivers Side Air Bag ✓ ✓ r r Passenger Air Bag ✓ ✓ ✓ ✓ Dual Mirrors ✓ ✓ ✓ ✓ Tinted Glass x x X r Privacy Glass ✓ x x x Clearcoat Paint ✓ x x x Metallic Paint ✓ x x x Rear Step Bumper ✓ ✓ ✓ ✓ Trailer Hitch ✓ x x x Trailering Package ✓ x x x Rear Sliding Window ✓ x x x Bedliner ✓ x x x (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 13 of 18 CCC 0 E Owner: Felipe Terrazas California Emissions Miles Price Adjustments Package Options Mileage Adjusted Value Dealership Telephone Stock ID VIN Type/Date Distance from Indio, CA Claim Reference: ✓ x x x $12,980 $9,488 $7,997 +252 +454 +454 +705 +955 +484 -1,525 +405 +1,215 $12,412 $11,302 $10,150 Crevier Mini Northridge Rock Star Used Toyota Cars of Te 888-314-0557 877-488-2644 951-970-8900 Stock: Stock: Pub Date Pub Date Pub Date 6/28/2015 7/04/2015 5/29/2015 91 Miles - Santa 140 Miles - 57 Miles - Ana, CA Northridge, CA Temecula, CA (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 14 of 18 CCC ONE® • Owner: Felipe Terrazas Claim Reference: DEALER VEHICLE DEALER VEHICLE DEALER VEHICLE LOSS VEHICLE COMPARABLE 7 COMPARABLE 8 COMPARABLE 9 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 2002 TOYOTA TACOMA 4X2 XTRACAB 4X2 XTRACAB 4X2 XTRACAB 02 XTRACAB PRERUNNER PRERUNNER PRERUNNER PRERUNNER 2 DOOR PICKUP TRUCK 2 DOOR PICKUP 2 DOOR PICKUP 2 DOOR PICKUP 6-3.4L-FI 6-3.41- 6-3.41- 6-3.41- Package Package 1: Off Road Package Package 2:Sr5 Options Automatic Transmission ✓ ✓ ✓ ✓ Overdrive ✓ ✓ ✓ ✓ Power Steering ✓ ✓ ✓ ✓ Power Brakes ✓ ✓ ✓ ✓ Power Windows ✓ x x x Power Locks ✓ x x x Power Mirrors r x X z Air Conditioning ✓ ✓ ✓ ✓ Tilt Wheel ✓ x x x Cruise Control ✓ x x x Intermittent Wipers ✓ ✓ ✓ ✓ Console/Storage ✓ x x x Cloth Seats ✓ ✓ ✓ ✓ Bucket Seats ✓ x x x Reclining/Lounge Seats ✓ x x x AM Radio ✓ ✓ ✓ ✓ FM Radio ✓ ✓ ✓ ✓ Stereo ✓ ✓ ✓ ✓ Search/Seek ✓ ✓ ✓ ✓ CD Player ✓ x x x Cassette ✓ ✓ ✓ ✓ Styled Steel Wheels x ✓ r r Aluminum/Alloy Wheels ✓ x x x Drivers Side Air Bag r ✓ ✓ ✓ Passenger Air Bag ✓ ✓ ✓ ✓ Dual Mirrors ✓ ✓ ✓ ✓ Privacy Glass ✓ x x x Clearcoat Paint ✓ x X x Metallic Paint ✓ x x x Rear Step Bumper ✓ ✓ ✓ ✓ Trailer Hitch ✓ x x x Trailering Package ✓ x x X Rear Sliding Window ✓ x x x Bedliner ✓ x x X California Emissions ✓ x X x Miles (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 15 of 18 CCC ONE® r . Owner: Felipe Terrazas Claim Reference: Price Adjustments Package +454 +454 +454 Options +955 +955 +955 Mileage -659 +1,382 +1,574 Adjusted Value $12,738 $12,786 $10,883 Dealership Toyota of Kobigor Auto Blok Charity Hollywood Group Auto Telephone 323-984-9022 323-582-9997 310-326-3604 Stock ID Stock: Stock: VIN Type/Date Pub Date Pub Date Pub Date 6/ 11 /2015 5/29/2015 5/22/2015 Distance from Indio, CA 118 Miles - Los 115 Miles - 119 Miles - Angeles, CA Huntington Lomita, CA Park, CA (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 16 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: Farmers Insurance Exchange has provided CCC the VIN (Vehicle Identification Number) of the loss vehicle and the vehicle owner's zip code, which determine the market(s) that CCC used in the valuation. Using this information, CCC searches its databases to find comparable vehicles in these markets. CCC's database includes dealer and private party advertised vehicle information from numerous resources including AutoTrader.com®. Farmers Insurance Exchange has also provided CCC with the configuration of the loss vehicle, including equipment, odometer, condition, maintenance, etc. CCC also obtains vehicle sales prices from a database of California Department of Motor Vehicles vehicle registration sold transactions. Vehicles located are compared to the loss vehicle, and adjustments are made for differences such as model/trim, equipment, and odometer. Using the adjusted values of the comparable vehicles, CCC calculates the Base Vehicle Value. The Adjusted Vehicle Value is determined by adjusting the Base Vehicle Value to account for the actual condition of the loss vehicle and its other reported attributes, if any, such as refurbishments, after factory equipment, and unrelated prior damage. Please review the information in this Valuation Detail to confirm the reported mileage, condition and to verify there are no missed options, added equipment or refurbishments, or other aspects of the loss vehicle that may impact the value. VALUATION NOTES Any person who knowingly presents a false or fraudulent insurance claim for the payment of a loss may be guilty of a crime and may be subject to fines and confinement in state prison. Regulations concerning vehicle value include California Code of Regulations 10 CA ADC 2695. (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 17 of 18 CCC 0 E Owner: Felipe Terrazas Claim Reference: The loss vehicle has been identified to CCC as a 2002 Toyota Tacoma 4X2 Xtracab Prerunner 2 Door Pickup Truck garaged in the ZIP code 92201 - Indio, CA. Details of the specific markets searched based upon that information follow. THE STATE OF CALIFORNIA is subdivided by CCC into 23 markets. The following 6 markets were used in the preparation of this vehicle Market Valuation Report. DESERT CITIES CA - In this market, CCC maintains a database of 6,563 dealer advertised, and 568 privately advertised vehicles taken from 11 local papers or magazines. RIVERSIDE/SANBERNARDINO - In this market, CCC maintains a database of 33,805 dealer advertised, and 2,726 privately advertised vehicles taken from 36 local papers or magazines. SAN DIEGO CA - In this market, CCC maintains a database of 49,301 dealer advertised, and 4,460 privately advertised vehicles taken from 37 local papers or magazines. Other markets searched - Orange County, L.A. Basin and San Fernando Valley. In these markets, CCC maintains a database of 221,517 vehicles taken from 155 local newspapers or magazines. r From these 6 markets, comparable vehicles were selected based on the year, make, model/trim and body `r `1 style of the loss vehicle. 1 4�r (C) Copyright 2015 CCC Information Services Inc. All Rights Reserved. Page 18 of 18