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HomeMy WebLinkAboutClaim 562 - R. PrincipeREQUEST: DATE: C CITY OF PALM DESERT COMMUNITY SERVICES DIVISION CITY CLERK OPERATIONS STAFF REPORT CLAIM AGAINST THE CITY (#562) BY ROBERTA PRINCIPE IN THE AMOUNT OF $19,581 September 14, 2006 CONTENTS: I. Staff Report II. Claim No. 562 Recommendation: By Minute Motion, reject the Claim, in anticipation of its being tendered to the Coachella Valley Water District, 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: CHELLE D. KLASSEN, CMC CITY CLERK Approved: CARLOS L. ORTE CITY MANAGER rd k Attachment (as noted) SHEILA . GILLIGAN, FOR COMMUNITY T. CITY MANAGER ICES/P.I.O. ITY COUNCIL ACTION: APPROVED ;�.... DENIED $ IVED __ OTHER ... . vEs 0 C F TE AYES JQr1 K . >\TOtaS . ABSENT : BSTAIN:.���I P......... VERIFIED BY:._.... Origina). on 7":! with �.ty Clerk`. rit:F.t'F: H:1WPdataIWPDOCSICLAIMSt562-rejectstaf rept.wpd August 15, 2006 TO: City of Palm Desert ATTENTION: � Rachelle Klassen RE: Claimant D/Event Rec'd Y/Office Our File Roberta Principe �7-4-2006 7-26-2006 S 1431684 PMQ We have reviewed the above captioned claim and request that you take the action indicated below: • CLAIM REJECTION: Send a standard rejection letter to the claimant. Please provide us with a copy of the notice sent, as requested above. If you have any questions please contact the undersigned. Very truly yours, cc: CJPIA Attn: Executive Director CARL WARREN & COMPANY �Pete McNulty COP TO '� - ��1� � � . �C�? hCu�Yl DAl'E / �l a /�y2: CARL WARREN & CO. CLAIMS MANAGEMENT•CLAtMS ADJUSTERS 750 The City Drive • Ste 400 • Orange, CA 92868 Mail: P.O. Box 25180 • Santa Ana, Ca 92799-5180 Phone: (714) 740-7999 •(800) 572-6900 • Fax: (714) 740.9412 � d _� 4, � a � '� � ,_ -. � � � �.:: -- Y— r: - � � �� r: �n r: ; a � R � 3 �o vi f`_ �. `y0 G� �� c, n' � m , i. � � ' � ;—rl�; rR�.l_� tii•',�I:I:.G L?r�i�.�r ; PALr,� Deser.��, CALIFOR[�ilA 9�z6o-1578 �rE�:76o �4G—o6t� FtL�:76o 3no—o574 infoC palm-drscr[.oro � TO: CJPIA (c/� CARL WARREN & CO.), CITY MANAGER!t�"�( A�'TC�Y, ACM FOR DEVELOPMENT SERVICES, DIRECTOR OF PUBLIC WORKS, RISK MANAGER FROM: DATE: CITY CLERK JULY 27, 2006 SUBJECT: CLAIM NO. 562 - CLAIM AGAINST THE CITY BY ROBERTA PRINCIPE IN THE AMOUNT OF $19,581 The attached Claim No. 562 is being transmitted to you for the following: ❑ Information only. or �� e.F�����Ad�r��'a�,�to the Cfaims Review Committee for any action `•' required by the City of Palm Desert. We would appreciate your report, if requested, by August 28, 2006, for timely response to the Claimant. ��,<:�� Attached to this report for your reference is an April 27, 2006, Staff Report by Ryan Gayler and the subsequent City Council Meeting Minutes relative to the Coachella Valley Water DistricYs Sewer Line Installation Project in the vicinity of the incident giving rise to the subiect c{aim. < �1 RACHELLE D. KLASSEN, CMC CITY CLERK Attachments (as noted) cc: John Garcia, Engineering Manager Ryan Gayler, Project Administrator I � (� �! Y < ��� M.ffC 0.i tf(�:IIJ 1J�[ CITY OF PALM DESERT � 4'v ���� D ASSIGNED CLAIM NO�� CLAIM AGAIIVST 'fH� CITY OF PALM DESE1�T� Y C L E R�' S 0 F F I C E (For Damage(s) to Person(s) or Personal Proper E}�A L H D E S E R T, C A Received by: via: U.S. Mail Interoffice Mail 2006 JUL 26 PM 4� 46 Over-the-Counter A CLAIM MUST BE FILED WITH THE CITY CLERK OF THE CITY OF PALM DESERT WITHIN SIX MON'THS AFTER WHICH THE INCIDENT OR EVEI�iT OCCURRED. BE SURE YOUR CLAIM LS AGAllVST THE CITY OF PALM DESERT, NOT ANOTHER PUBLIC ENTITY. WHERE SPACE IS INSUFFICIENT, PLEASE USE ADDITIONAL PAPER AND IDENTIFY INFORMATION BY PARAGRAPH NUMBER. COMPLE"I'ED CLAIMS MUST BE MAILED OR DELIVERED 1'O THE CITY CLERK. CITY OF PALM DESERI', 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 reiative to damagets) to person(s) and/or personal property: 1. 2. 3. CLAIMANT INFORMATION: NAME � �i^�� �-- - 1 � � �,1 � �, _ ADDRESS � .e _... .,, .--,., . . ,. . , � �G �. , ., , .. - • 6 :�.J PHONE NO. ('l�i_; S� lir+ i q �r nirc ► n: � . _ ,_ SOCIAL SECURITY 1V0. SDRIVER'S LI�:tNSE NO. - Name, telephone number and post office address to which claimant desires notices to be sent, if other than above• s'�M� /�' �s�V� Occurrence or event from which the clairn arises: a. DATE: � l�'�i.o b. TI E: �'�i'� Y� c. PLACE (exact and specific location)��� s'LC�� J� ��(��((_.. �P�z-�`'! .A�� ' d. How and under what circumstances did damage or injury occur? Specify the particular occurrence, event, act or ommission you claim caused he injury or ciamage. (Use �. additional paper if necessary.) ! ���.� �J I � �. �()� G�i �d�l� �+ -Pf'i 'g�'� �l`! -�t 1/�L1J N�' ��-�Xi x� ht L r N� �-r► - o�- S� 1 Ly �+'t� . C�'s�� �qs U N_ � ii � vJuM�3�� o� VZ�-c - t�+� � R��rfi,'S��� NP�(� c>w � N C� 'i' £ U r�36 . ��� -,-�- %�y � T�, ► ,�.�tii �. 4. ]�Rel� ''r� a, �.,4 S• H F /�nwl� (.1JAs �FR}� 1-��Rt� ��il� e. What particular action by the City, or its employees, caused the alleged damage or injury? �!�� �5 �i^ � ��-� '� 1 N(� I`'�'1/ ��+ t E'r..�' 1 _- �?i � ( �e�^ �!� � N7���� �ild� U J cr� ��►�t� Af.�n ! � NQ lu�N � � 'ii�i �fZ+��,! Co�e.�� ..�� , i'S G cr' .5� l`<uC� � u�tE� rTEt/�N i N E t� W C'a 2.t�F..�12 ."i' �Sr►av� F1-�Y� �hp �=�c--E�R� QI' 1-i�f+� �v7-'�-t-�1�E� Page I of 2 S� �V CGV�-�� SC� "�7t-� �.G�IJ�.� ���� �YQL' �4t2E �l�rtfii Gl� a' (� 0 � t �- 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 preseritation of the claim. If there were no injuries, state "no injuries": _,�� �"�'(�,t-( r`-�11�= � S. 6. 7. Give the name(s) of the City employee(s) causing the damage or injury: �� Name and address of any other person(s) injured: � Name and address of the owner of any damaged property: �i 1�[' 8. Gamages claimed: a. Amount claimed as of this date: ${�i ��/ ��� b. Estimated amount of future costs: $�����,GQ,� _._ c. Total amount claimed: $ I.aO d. Basis for computation of amounts claime include copi�s estimates, etc.): S�. A��c—� �c�vv� 9. 10. Names and addresses of all witnesses, hospitals, doctors, etc.: j�' of all bills, invoices, Any additional information, including police reports, which might be helpful in considering this claim: �` � VfIARNING: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. I certify under penalty of perjury that the foregoing is TRUE AND CORRECT. Signed tFus a� day� •.� U�-� , 20 C)6, at �% �N% . � ` 1� SIGNATURE OF CLAIMAINT ' SIGNATURE OF CLAIMANT Office of the City Clerk, Palm Desert, California DOC. NO. DATE FILED Page 2 of 2 4' i � 1 � l t,j.i 4'�' �a �' � ��} � � — 1 �r � t -� � � 0 � � � \ / D � N N O'� O � � 0 � � � � v � � � -v m III �. �� i; � - �_ �� I 1 � �� W �SG� ��i� �a o —� T � 7] m o � � � ,a �� I Z -p � p �1 II� � ;m Iro � �� rn �D✓ m C� � �� � D � �r I O Z D IN � ��- i :r.; �: .,ti _� r u � � �' o -Ut�l7ft? �` Q N ,'�� s�j r p 1 1 � W D G F A � F � y W + N �' � hi � 1 � � �� � r� O m �, , rn o�g ' o a� � � � � Continuation of 3. d. How and under what circumstances did damage or injury occur?... was not lit with any lights. I was in the right lane as I had just passed through an area of the roadway that was barracaded to one lane and had opened to two lanes shortly before Sheryl Road. As I was passing through the intersection of Cook and Sheryl, which was very dark, I did not see that the SW corner curb juts out about 7' further into Cook St. than the NW corner curb that I just travelled past. I turned the steering wheel to avoid the curb but it was too late and the right front and rear wheel hit the curb. The car spun around to the left but I managed to straighten it out and came to a �top in the middle section of the roadway among a number of barrlcades that were scattered throughout that area. I called AAA roadside service and they sent out a flatbet truck to transport the car to my residence. � The AAA tow truck man said... that part of Cook that was under construction was very hazardous at night because it is so dark out there. . Response to #4. Give a general description of indebtedness... 1. My '94 Honda Civic EX was considered totalled by my insurance company. (AIG estimate attached) 2. AIG has offerred me $4,400.00 if I keep the car and have it repaired on my own. or $5,074.00 if I decide not to keep the car. 3. The body shop verbally informed me on Tuesday 7/25/06 that my car has serious damages including a bent frame and the cost to repair it would be way over the AIG estimate of $4,400.00. They said just for the obvious damage without repairing the frame and the unseen damage under the car repair would start at $5,000.00. I have thus d�cided to take AIG's settlement of $5,074.00. Now I'm faced with trying to replace this car for $5,074.00 which I-feel would be an impossible task. This was not an average car for it's age...it was in great shape. The car has under 80K miles on it and was in excellent over all condition, well maintained throughout the years and loaded... � air conditioning power steering, power brakes, power windows, power door locks, tilt wheel, cruise control, am/fm stereo cassette, dual front air bags, ABS (4-wheel), moon roof, alloy wheels. I had just purchased (6/7/06) 4 new tires at the cost of $426.56 from America's Tire Co. as well as a four wheel allignment in the amount of $79.95. (invoices enclosed) I also had the master brake cylinder replaced on the car on 6/3/06 by Honda of the Desert at the cost of $368.69 (invoice enclosed) I am still paying on these items and consider these as part the loss due to accident. 4. I have had to assume payment of a rental car as of July 21st due to the fact that AIG will no longer pay for it. (invoice enclosed) 5. I am gaing to a chiropractor due to stiffness and pain in my neck occurring after the accident. � .�'r'�`-�`—��' �,r-.�-� i�f� ,� � .� - �'F�—S� � 9� (� C�M +�v�-i IC1� G� � o��--� ��-f����. a ��! (` �7 c��c��rJ C��� ix�� '���.�-� �-��/ad• ac 1�'"'� � �c�?3� G3 rl � y= .i��}�/5 = / I 5 • � � �'� f c� ���(G� ��3k� �1��Ic�� PV ��►.l-+I'��a'J 4- �I�.uI �S -��`'1 �,� � � � � ts- � ; � �. �o . < �� �,.�v�c� � �, 4- I � �L t �'f�l 1"t �.�� �C �--JI � C--1 � P�1�J /�1/�-� " CSE� rr���c.� � � a�. �� ��.a� � A-S �� � f� �.c� �, i � �2 ��� �� ���-�-`� 3 ��s'. � i �3 y �. c�v p �}-. �c� �-� "� s��"'' �sE � � u v v � � ) Cr�-i 6G'�?C� ��o.c� � c � Nt c��.r{ �-�� �`` � �s c� �.t-4t� ��a;� -� � 1 �3, . c�� . . �. Cl+� (� P�/-�c..�� C �� �,`� ��--�. �� � � t G�P�-� -�4 t-� �' � ` �� (���-�- /�-5� � C�M�°��'�� Vr � � cL E ��� � �— � � �SG� u�cL'�t+ �� � ���. f�� x� � � �� �s ��� ,� � .�-�� � �. �v�� � �� � 1 M�r�e f� ��,s� ST�� +� u ��s �N �" ��,�. y�Ar� Ar�ov►.�'� C� � Fv`�,e� � �� � ` � �� _ t, ��ia --- j 0� �o�, � ��Jdc�, � a�� � �. � --___ � � 3 44�c� c� �_---- � � pu,�;- C�-1 � � � �'1 �', � 8 � -�� � I am 65 years of age, retired and living on a fixed income and was not considering purchasing another automobile. This accident will cost me monies that I cannot afford. The stress involved in dealing with the insurance company and the body shop and the delays in getting the answers I needed to make an informed decision have been difficult for me to handle. Now I am faced with the task of replacing my vehicle and the cost involved to do so. 0 AIG Insurance Company Claim No. 0600262496 Claims Adjuster: Oscar Castellon 1-800-560-8398 ext. 36373 Mr. Rogers Auto Body 68704 Perez Rd. Cathedral City, CA 92234 Attn: Vicki Phone: (760) 324-1830 Fax: (760) 324-3512 - ■ . � . . . ..,.:_��i ;�,r..,.�J, ��.�.,; , .. �',.at • • -:i , _ . , �.2 • �'r-.. , � � � �� ���� � � � Dr. Kristen 6ohnet, D.C., L.Ac. Acupuncture & Chiropractrc - r. :� ,? � �-,;., �:J� ,� ,�� <�t�d � �l. ; -�;, I R �!(': .. . ..�o. . �. . .:�i��_ ..... tk:r&.�. . . The Wellness Center � yY� r; -.•-I� ..�'�����i' .rR�i>, . 72-855 Fred Waring Dr., Ste. G20 �� �y`�• • �b �"'..��'�"��i.�::;«,i Paim Desert, CA 92260 r� �;r =' � � F'�"�+�;ti' s` '" I ;�., � �� �,�'-� �,�, �.x _ ; ,�?,i� :;;.� ;:<• �.•.; Telephone: (760) 836-3644 .. ; j,-: , `� ` ' : ' : � Fax:(760)836-t9i4 • -- 1 • . �� i ' ;�:� ^�,.�. < �u .��'�;�� �`; < � � : .�'r'(1 T - -. :Z�: �h . . ':;�'^..,XT.6�}�� � °'� �� ""�'+.�i �'� . _. a .. ` . SiG.}'�9i`. AGEI3CY� � y:�k�ji`�'IS4lJII+iG�CARD; _ i�' ��{�s . r.•,�;�. . , . ' � ,� " ��` ' " . • . " � '. P.;O: ��:: , � �� . ,, :. �... �`�. WILMII�C�dl1',.��s �s850-5510 � YFItS.PQl.lf7( ME�f'$y}� � � ^ CQV�RA.GES REQUIREIZ.�'F1'.LAW -.; - . H4��ON y8068r . � SEE tA1PORTAFIT NOTICE ON FiEVERSE SIOE . 'r-_ ID - CA (7/00) � _ ,."�,. Page � oi 5 . ""�,.'��... - .,. � � 1,/t C �C.. `'f � EstimabQ #'4872717 Print Toq91e Pidu'es {"'"��.,� - �. ,. ....... SGA Appraisal Company West Coast 3W-1� M-F 8-5 PST ESTIMaTE OF REC4RD Inst�t'�dlOwnsr Mfo�rnatl� `��Rnis fo�m•tion inepection i.oqitlon Infamslbn i�ur� RflBERTA � AdJusla Osa�r Gslslbn Location PWNCIPE Addroas �e, R08ERTA Email osrar.pas�ellort�piq.com CAy CATHEpRAL CfiY PRINCtPE AdQ�ess CRy sca� z� Nome Work Cl�tm IMorm�tlo� 11pOnis�r kMOm�tlon / Ci�i�t No 800iQ2406 IrVrttten B� � FiGUEROA, JAVIER Ctainanc Na t Esc. Code «GVERoa Lass Oate 71ir2006 �ce SCA Approispl Cc,mporty West Poli.ry h!o 5�63T57 Coas! 3V1!-Y M-F 8-5 PS7 Loss Typs CoAision �"� 3817 W. 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I�OFiESIVE p� �y 1 OEM 382.87 362.67 IAOULOING 19 RomoveAnatAH P�DOOR TRIM Zp FtertqveJlnitpll R FRT D00li HANDLE 0 6 Body 21 ir P�� �R Ol1TER � BodY 22 Reffnish R Q��R PANEI. Retx�ish 1.9 OIiTSIDE 23 R8R RQUARTERMOUIOfNG 0.3 Body 1 OEM 512.73 $12•73 �a Ramove,'lnstaU R QUARTER GU1SS 1.8 Olaas 25 RB,R R.RE/1R SUSPENSION 3.0 MechaniCal 4NE SiDE -M 26 �S NOT INCLiIDE ALIONIrENT . 27 R3R R REAR SUSP S'�UT •1�A 1 OEM =117.83 :117 85 2� � R UPR REAR SUSP t OEM �.'f4.46 i94.4S CONTROL ARM -AA 29 Rd�R R LWR REAR SUSP 1 OEM s8T.00 S87.D0 CONTROL ARAA -IA 34 I Labor FOUR WHEEL i59.00 �--- /1LIGNMENT s, Mouiur� 9^u+r�ce st2.so � �� sz �dd� .�t � �r+rr a, enuWCE s�z.so TIRE 33 �$g TIRE � AJM �Q$,,QQ 568.00 34 TIRE °,65.00 i3.6d 35 R� TIRE � � �4 �•� �36J� TIRE 9'06.00 53.86 �-. 37 R�R R ftEAR SUSP TRAILING 1 OE�A t292.44 �5247 A4 ARM -M hrrr •��„r�r.�c.� la;ma.c�miw�+b/clie�tsl¢eaeric/EstiqaateFornn.asp�►?dvcid=22906675&estid=... 7/19l2006 Estimate �8 Re�velln II R COAABINPITION l/1MP i� A�SEMBLY 38 Remove/lnstafl REAR BUMPER ASSY 40 �ir REAR BUMPER COVER 41 RCfiniSh RE.�RBUMPER.COVER 42 FiJ1ZARD0US WAS7E DISPQSAI 43 fLEX NDGITNE s4 I�d4t Ops CIFAR COAT 4S Rddi Ops TIN7 COLOR A6 Addl Ops FINISH $AND AND BUFF 47 Addl Ops NWSK FOR OVERSPftI+Y 4g PAIN7AAATERIAIS TY�......... _.-. PaRs Soay AlfeChanical Gtass Bodr Materisls PMinf Paint Matenals Fh¢ Wasbe �Aiye�tlaneous Q� 8ody 0.8 BOdy � �dY ReAnish 2.0 Refinish 2.1 � � �_� �S� 0`2 �g�c 35.00 L.Abo� R�te (nformation 1.�bOr UnitS L/Dor Rate Paint Unib P�int Rste ._......._-...._......_..--•._........... _..._. - -�--..... ••••-•- ..............»....... 22.0 342.00 6.l 565.'JO 9.8 �42.00 0.0 50.00 109 10.9 ,�age s ot � $3.d0 53.OD 53.00 53.00 AdNtion�l......-_...........T.'l..p.e__ .............�. �otsl Parts $1,904 56 Sody 5824.00 nn�►,��i�� $a�6.�o G1sss 575.60 60dy Mahriala 33.00 5457.8� �305.20 53.00 i86.0a i42.00 Paint 528.00 Pelnt Materiats S�.Oo Has Waste 588.00 Misoellane0us E2,209•78' T!x St71.i5 Te�t � 7.�5°10 ...._._.�...�._._..._._..._...... _........._..-.•-......._.._.r..r_.••-.�.....___ ........ ....._..... __....._.__..._.... .�................... •- 7ctat�..... 'E4,349.43 Prevbuc Totat yt,349.�3 7T�i5 Supp 50.00 ....�.......-.._.............. ........................_.._.._......••-•..........-•----...._- -..._....••--•-. .......__.._......�.._........--•..._......-••-.....•--•.,....--.........._.__............ �e� 5100.00 • Td�l B�dament __.57.31-- ..._.......-•---.._.._.____....-._..-•.»--._.._.._.�......_.._._..»-._..__....-.._�..,,.._._._._...... __ ._. ...._.•-•--_........_...r....._._....--._...... Cuatort»r pa7 intur�na Poy s4,242.10 P��j.ype l�qend: 0�1 � or;g�ne� �uipment Manuract�xer ucQ = liloe Kfnd and Quality M"1 = AfLermarket R = Reco�ioned/Rebui�V�.emanuFactuid�Weoaed Thls esti�natQ has bQen preparcd bas�d on tM use ot aRermarket aash parts wppl'ieQ by a source ot+�e� tt�n the manu+acturer a1 your moLor veMde. Tfie ditermarket tresh pdrts used M the pre9aration ot this estimabe aiv warrdnbM by the tn�snufacturer ar dls�;bu�r of w�t► parts rath�r than the manufacturer ot your velrcfe. *:*'T}1I5 EST]MAif IS NOT AN 1►UTF10RI7ATION FOR REP11IR5R'"' p0 nat �¢pair this vefiitJQ und all yuiEeNn�s BSted below arE acknowtrdqed and acaepbed. Fauue to do sa miy rewR in addlao�al cvst to U�e vehicle awne�. This estlmate report ts based on our initlal inspedion and dxs not onver any edditiv�al paris or labor wHch m�y be �equkod aRer the vehkk is k+ the rcpair fadfRy and � ts aom dow+�, rne repatr fadltty must ravt�w and mncur wtth the soope and metl�odaloqy of Ure repair esttmate before beginrting rcpalrs. OccaSionalty addlttonal Qemag(e IS difCovYred aftef the �lehlde is tOm down. lf this heppen5. K fs the repairo�'s ro�sibillty , to no0y AIGs appre�er as soo� as poss�blA artid ta obtain authority do cernplete Me scldfinnal rcpaus needed b resOore the vehlck Oo It,s pre-bss aondldon. Any supplert�rrtal work must be made avapabk I�or InspeUt4n bY J1IGi appre6er and epproved by AIG. Verbal author�adons bY the fietd apprafser are not bind�ng. Supp{emenql repalr requests pr�sented after the oompletion of repairs can be fegal� deNed baseif a► this disdalmer. Faiiure to ohtain pna author'aadon may be +esutt in AIG's being unable ao F�onor supqletne�►ta1 ct►,irges. Any supp4ert�enta� dsatgas must be supported by doamerltation In d�E lurm d involces and recdpts. The deductib�e may or rtk�y not be 1"�sted on the eppraisal. All dedudibles a.'�d bettErt�ent nlust be Colkrte� irom the owner b¢iwe ' releas��g tt►e vehlcle. AH rep0irs must be wmpkied in strld accdMance wlth the manu�eturQrs speciA�tian and reoommendadons. It iS tu�QetStood thet the repa�r Tadil�y lisbed on this estlmata, If one is Nsted, agrees to complete and quarar� ntt repaks �isted o� tt�e esdmebe tar the amount listed on the esttniate. AIG does not warrant or guarantee the worlc of ar►y repa�r facility Or technician and assw�es ra cespo�siWlity o► �iab�i.ry tor the quality ot repairs o► woricmanship ot any repalr faciliry or !�� �----.-..�..:-�-.:..•.�..�.t�P►..r�li�tc/ornc-rica'FstilriateFol't70..aspX?doCid=�22906675&C5tidc... 7/19l2006 Estimate kage � ot � . ulSpikr. '►*"TH1S ESfiMATE IS HOT �N AIJi'HORIUTION FCR REPAIRS'�*� � l po npt repair Utis vehide u�til all guldeine511sted bebw are atknOwled9ed and aCtepbed. Fallure to do so mey r�suk in ddd�tr.�al � oo5t to tile vehicte cmner. I IThls est,�nate report � baseC on our inittal irupectlon and does noc wve� any eddit+onal par� or labar whlch may be required afler the vehick is fn the repalr `adtity anQ ts torn cbwn. The repa�r fad�rty must �eview and concur with the scope and Tethodology of fie repa�r estimatc betorr, beglnn�rg �epaks: OcCasionalTy BdGRronal ddmage IS diseovereq after ftte vehlCle {s tarn down. If thls nappens, �C i5 If1Q �C�lil'CYS rC3p0I19bIIICy �0 f16tNjl AjG's app�aisrr as soon as possib�e and to obtaln authonry do complete the additional repars needed to resoore the vehlde bo �ts pr8-bSF co!idltion, Any supptementat work rmist be ntade availabl¢ ior m�edion by AIG's appraiser and approved by /1IG. VerGal authoru�ons by the fleld appralse► a�e not bindlrg. Suppierr�ntal repair zquests p�oted after the competia� of rcpalrs can De legalTy denl�ad ba9eC on this dl9dairtter. fallure to obtaln priar au�or�mtbn may resuit in AIG's being unable to honor suppiemental charges, Any suRp�rmeenLel charges must be sup{�orted by documentation M Ux form of involces and reoeipts jT�e deducdbk may or may not be I'�sted on rhe appralsal. � IUI deductibfa and beKament must bc � irom the awner before ►eleasmy the vehrde. AU ++epairs must be cornpletrd in sZrid aocordanoe wltn the mxnutacturvrs spedflcanor� and recommendattor►s. tt fs unders�ood t�ai , the tepair fapl�ty listed on this estimate, if one !s ;Isbed, agrees bo compiebe and 9uarantee aM repairs f'sted on the est;ma4a f�r the amount Ifsted vn the estimate. � NG does noc wanant or gva►am+ee the work of any repair facllRy or ted�n ciest and as5umes no respons�bfHty or liabdity for t'x 'i qvality of t+�pairs or workrnanship d eny repeu tacility or InstaNer. NOiICE This estimate has been preyareG Gased on the use of crash parts su,�pUed by a sourtz otfier than the manu��urer of yo�r mator vehiCle. Warrantfes appicable to these repl8oerl�ent parts aro prv�vlded by the manufatturer or d�shibu0or of thest parts tather than ttle fnanu(dCtURr of y0ui wN�kte. Such parts can be identlfied by the ktt�er'A" on tfils at�mate. i( the use at an �ftemiarkat part vokls the exis�in9 warranty on ti�e part being replaoed or on any other part� the aRerrnarket pa�t shal have a vraRarity eawt to a better tt+an the rernalnder of the e�dsting warranty. For �r protection CaliFot'nis Iaw rtqui►ef the foNowinq Co sppear oe this to�m: Asr pen�on who kqvw{nply prestnts a false or hsuduleot dsim for 11+e payn�ent of s bs� Is 9uiltl► d m Ctlme ae4 n+ay be subja.t Co flMs a�td owiftadne�t in rtste prNon. AUTQ iORY REPAiR CCNSUMER 8ilt OF R1aNTS-A CONSUMER IS E�fT?TLED 1"Ot I�.SeMd the suLo body t+�p�ir shop to rep�ir a�lbo bo�r damsqe oower�4 !ry the Ineuranc� oompsnr. Ae in9arsnoe ��Y �Y � n4Wr� the reWirs L� b� don� �t a sp�cifk Ntibo bo�► n�WK sh�►M• L. M Ib�aad, w�ii�n e�tin�sb f�ar auto bod�r t+spaks anef, upo1� GomWttfol� oi �epalrs, e detaibd Invoic�. The estimaty and tt� ievetce mwt indud� �n iamised ifd of p�lts snd I�bOt' ibrly wkh tt+e tobl price fo� t!N work pe►f�xmed. Tf+e esd�net� �nd iavoloe must �lso i0ontiry i�p p�►ts is new, w�d, efbet�nsrlctt, rscoadkloe�q, or *ep�MR. Z. 8e informeq about cvre�ip� for �owieq senricss. U„less t�e inswrsncs comps�ry h�s provided an i�urod wltfi the nanoe of e spedfle towing ooeapa+h prior bo the fnsured s use o�f �naher bowin� co�++pany, tt+� Inru.er mwt Wy aH re�sonabN buwinq chs.g�s ot the towlny compemr usea by th� i�sarea. 3. tte intormed �bout tMt eXteet of Co�erage, if any, for i t^sptacw»�nt ►eittai vehlde whik a dami�ged vehicle ts bdlag repalttd. I4. 8r inforMod whereto rep0lt svop�CtW friltld vr Otha� aoAl{f(aints ind can0�rt►s ebOut �Y�O body t'q17�1'i. L.._..���_..,,.,...,.l.�imo .-�,*,/.uPh��lie�+,t�;veneTic/EstimateForm.aspa?docid=22906675&esud�... 7l19/20{16 , • � � E�tun�ate Pa�e 5 0�� 5 b. Be i�ormed of whe� to rsport wspeded traud or otNe� cempbints and aoncerns about auto boA�r rep�in�. pp►dP1,AI{'ITS WITHIN THE 3URI9DICTLON OF THE IlURlAU OF AUTOMOTNE REPIlxR Complain� conoerning tf�e repair oT a vahk�v by an auto body repair stqp shouid be dlrected to: Toll f� (a00) 9S2-SZ10 plifornpl Deparb�►�nt of Coa�umK Af%Irs du�reau d Aut+omdire iiepair 10240 Sjfltlm8 PirkWsy Socramento, tJ� 95827 The Bureau of Automowe Re�r can atso accepc compla�nts over iCs web s�te at: www.autorepatr.ca.gov ] � � . . ,� . ..._-��:.--� ��-.��..o�./�t;,.,,r�InP.,pri�/RetimatsFortx�..aspx?docid�22906675&estid—... 7�'X912006 Kelley Blue Book Values Page 1 of 2 AUT� 1TETM ,"°�'R►�,-�a"�,� � HO�lEEI L.�:►��� ��N9E� GAE FREE PRICE QUQTE! � �lect Make � � • ��wEws ■ �vtEws ■ YIDEOS • �c1uR�s . �uMs � KELLEY BLUE B�OK VALUES S�R�" ; Find Your Used Car Value � 11 Private Partv Value » 1994 » Honda » Accord EX Couae 2D » Eauiqment and Oations KELLEY BLUE BOOK PRIVATE P/qRTY VALUE California - 07N6I2006 1994 Honda Accord EX Coupe 2D Engine: 4-Cyi. 2.2L VTEC Drive: FWD Transmission: Automatic Mileage: 7e.000 Equipment: Air Conditioning Power Stesring Power Windows Power poor Locks Tilt Wheel Cruise Control AM/FM Stereo Cassette Duat Front Air Bags ABS (4-Wheel) Moon Roof Alloy Wheels Print This PaQe PRIVATE PARTY VALUE ', 1 I✓AutoChe Ak I Get a FREE record summary! �Enier V!N Here �!■a�r �.►�R a.ti� �''r.�� How do I find mv VIN? Ail���.t�Offt c • r Free New Car Duote „ Find a Car Uke This s Auto Finance (�uote � Auto Insurance Quote �► Get a Free VIN Check » Get Another Blue Book� Value Condition: Exceilent "ExcellenY' condition means that the vehicle looks new. is in excellent mechanical condition and needs no reconditioning. This vehicle has never had any paint or body work and is free of rust. The �ehicle has a clean TiNe History and will pass a smog and safety inspection. The engine compartrnent is clean, with no fluid leaks and is free of any wear or visible defects. The vehicle also has complete and ver�able service records. Less than 5% of all used vehicles fall into this category. Private Party Value is what a buyer can expect to pay when b�ying a used car from a p►ivate party. The Private Party Value assumes the vehide is sold "As Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehide's actual condition and bcal market conditions. This value may also be used to derive Fair Market Value for insura�ce and vehicle donation purposes. w�w5��� KEEP'JP �VlTN � � Search by MaF or � Search by Catego a � Search by Price or � Search by Payme or BUILD AND F ADVER� http://www,autosite.com/content/Research/kbb/index.cfin 7/16/2006 5:22 PM ���c (TIRE) AMERICA'S LARGEST TIRE STORE , R�9URTA PRIhICI�'E _ . .. .. , . . .:, PALM UESERT Gt� 9�c5� Financing Avallable Ses store for detalls '�:=Y�: !��-.�q,�...'.r_'l.�0e ��IME;, c:;'fc' F'C�t 1994 N�lVD� GIVI.0 ALL E k' MILEAGE: 77. �41 c���az�r �t 7GRG►UF SF'EC ; : �8�► CODE CC QTY S1ZE DESCRIPTIOf� F E.T. PRICE ��•;�OUFJT � 4.3l►3�: 1VFt{�! 4 F�-18�i6V1R-k4 t3�H B YDK�HAh'!R YK4c� t31�121) .l1Qt ?4.0Q� �9r.�F�1 1JARRAPtTY: MILFAGE- 6d+s �4�� WGRN�MA�lSFiT�/!YlflTEi�'IALo-L7�ETIME RUi;tU �-I�aZA�iD-�=REE REF-'LACEMiEIdT rOMME�lT : Z�JFI_r��' � aN F: �9 R:�5 84�@I7 t�lR!�1 4 CERTIf= lCAT�� FOFt FFEi� r Et='LA�EMEM1f{' .!�� lc� �� 48. Cn�� F311��D !'S NRI� �+ � i Aj'� F�(GG?U I RED EP3V I R��idi'IE'rJ"i �L. F=�E �'l� 1 e?.`�� '0 1Z�� pQ�c24 P��t�l 4 4dA�7E �" I RE D? 5G05�1L FE:E � C'�� �. �0 8. I�l.� �102;.9 NRI� 4 iiV5TALLATIn;v R LIFETTi+ii: .ri�.Ily BA► ;?IvCII�I�� ,����+ 1 i. �b`� 44. Qt!h 8�4m� rdR�^ 4��AL. �IES, RilTf?T z Oh�S � '! Ifir F�E���; I�;G Z r:trL�l�i �U o a�+� .�n� .��� � :Flf*ihiEhi t : ;��'�'� i IfdT�'IEht i : 4?i�-�7-�t� •� � : .;� F'M �t`� tic � o S�-t ��v� I � N� (�. �"� C�' `��� � a �� a� �� .:. , � -- � ,:��� w . . . .. ,y � r n_. . _'��,�. �� � , . WORK ORDER ❑ Air Check LF RF ❑ Return Tires ❑ Change Snows LR RR ❑ Repair ❑ Rotation a❑ Rebalance ❑ Wheel Lock Key Installed / Pretorque � Torqued by: Ft. Lbs. Bay Coordinator• Comments• �LI�TOTAL � TAX: T��7Y'u_: �!;��<< �-1#: �_��'�GY?":`i UF.B.:7: TtNUER�f� : �N� �a �9�7K KRMDAI RLl GA7H�PRAL GITY G� 9��4J4 G'H�t�IE : 760-770-K�57c 5��h TIM rJEiNAS7 tJURK DF;DER# X . •. � �;•��; Custoriiej Signature Cardholder acknowiedges receipt of gootls and/or services in tne amount of Ihe Tota1 ahown hereon ana agrees to pe�torm the obligat�ons set lorth in the Cardholtler s egreement with the Issuer. americastire.com 4�3. a7 �1, �: L:�c J? .y_�F.„ `_��. 4�F.. F��. +r:F.,, �(: STATE OR LOCAL TAXES AND, WHERE REQUIRED OR CHARGED. ENVIRONMENTAL OR DISPOSAL FEES ARE EXTRA. DUPLICATE 1 PAGE 1 • s ROBERTA PRINCIPE HONDA OF THE DESERT 68-025 KY4E ROAD CATHEDRAL CI7Y, CA 92234 i760) 328-8981 SERVICE ADVISOR JOSE MALDQNADO EPA # CA00007334632 ; ...:..:. . ... .::. '.;: : ..::::�. :.:.:,::....... .. :. - - - - a���x��wta .,:.::.; ;':::_: : n ; � . : .:. :. : . .:..:: _ ;:.:;:::: ..<:. :.::: z ;:: T ; : F;, �ib;'': `.; : ; ' ;"�n:a' :;;'iKtVOtG�'tiR, :: ` . .. � _ .....:.� K.::,:.;;:� : :.:: Ymttt�rr:..: ; i3ATE.ti�A..UY:.; .. Si4C�.tqO� ..::. ::::..: VEHtCt��F?EN;ffFIGA.T.1EN�i....;.:..:.: G1t5T;:#�4�::: :: ..AG�iq� ,::`. ....A� .. ........ :.... .P�sEo<>;.::z :: . ._. . . ... . J2JUN06 03JUN06 � 012534 T4075 03JLTN06 154655 , , . .. . .. .: . . . : . .. ... : . . ... ;.: :: :: . .::>: ::::.. . ,: �, ..::: :;::;> :.: . . ; ; ;:;;:.:.::.::_; .:::::....::.::;::,. ;:.. .:, .. . .:::.. . ; .:.-:: ;:.:,; :. .:: . . ....... : K ; RR` -.: . :;. :.MAKEbIdlQ�L:::._.;::<::., '.:;. :.;>;:;:::�iE.�H . F;��i.';.;;i:`.::`i::':'::::; .: :.':.?';:??'1:ii;tL1'fEi:::;:::i '.: ;.BY::;i•.; >::.;::.::z8"S<..i: i:.::: ,, . TIM� tH , . .: . : .TlME REAo . . . YE . : � . : : .. . .: .. . . ... .. �. ... _:.. _. 13:11 12:27 94 HONDA CIVIC ) 09JAN01 71 712 ;.:.:..::, ,... :.. _. ..:. . ... ..: .....�. . .... .. , ,.; ,- .. ::.:.: . . : ::.. :.: . :.: . .: . : _ ...::..-.;:.:..:;.: ;.;;: > .: t�r�s Ha::::: :: :..<.......: :. ....; ::,,::.. ::.: ;:. ;.;. .. .. .. � ;,;:.,..: ;;::.,.:. ...: : � ;:;.:; :.:.;:. HffLEAGEAi .: ... .: . . . ... . . .. :. ..... .:;; ., . . .. . :: . ... . <.. :., :::<;; ; -: _ , . . . .. .. ... .. ... ... ...... . ... . . . . . . . . . _. . 77173 . .... . . . .,. . . . . ..., .,, »uc � � �.: � � �ae.: . . : riouny � . . ::�:toixaaT . :�.:.:... � ta:rt»�a .;:�: . ... � :� mrnc �. � . .:.: � �:. . :,.�..... . ��::. ��-�c� � ,� CUSTOMER STATES BRAKE PEDAL IS GOING TO THE FLOORS, CUSTOMER STATES STARTER AFTER SERVICE 34 FOUND MASTER CYLINDER BY PASSING, REPLACID BRAKE MA.STER CYLINDER 506 C 1.50 135.00 135.00 1 46100—SR3-913 4929352-46100 W—MASTER CYLINDER 230.00 23a.00 230.00 1 08798-9008 4423802-58740 W—FLUID, ** BRAKE (DOT 3) 4.00 4.00 4.00 ������ 3 INTERNAL RENTAL IRETTT INTERNAL RE'NTAL 999 C 0.04 0.00 0.00 3UBL TOYOTA RF'�NTAL C �** PREFERRED CUSTOMER DISCOUN'!' 01 PREFERRED CUSTOMER DISCOI7NT 999 C 0.00 CUSTOMER SATISFACTION IS QUR #1 PRIORITY IF FOR ANY REASON YOU ARE N07 COMPLETELY SATISFIED, PLEASE CONTACT OUR SERVICE MANAGER. OUR SERVICE DEPARTMENT IS OEDICATEO TO YOUR COMPLETE SATISFACTION. WE CARE! DISCLAIMER OF WARRANTIES � The seller hereby expressly disclaims alf warranties � either express or implied, including any implied warranty of inerchantability or fitness for a particular purpose and neither assumes nor authorizes any other � person to assume for it any liability in connection with � the sale of said products. � pES�fiM7i<�V:. .': :. . s �::': . _:TOTALS' LABOR AMOUNT � PARTS AMOUNT � GAS,OIL. LUBE � SUBLET AMOUNT j MISC. CHARGES � TOTAL CHARGES � LESS INS./ ADJ. � SALES TAX ORIGINAL ESTIMATE s REVISED ESTIMATE s I HEREBY ACKNOWLEDGE THAT 1 WAS NOTIFIED AND GAVE ORAL APPROVAL OF AN INCREASE IN THE ORIGINAL ESTfMATED PRICE. x CUSTOMER SiGNATURE ; PLEASE PAY CUSTOMER SIGNATURE � THIS AMOUNT x 25.00 25.00 �.� —18.45 —18.45 � � . � Y � SEE REVERSE S1DE FOR LIMITED WARRANTY � ON PARTS AND ACCESSORIES. � "IRE �NF�ATION FOUNJ AT ?E�OpT Ser aT 3RAY:E FRONT NEL� REPORT REAr7 NE'.N VOUR$ YOUFS P51 PSi ;�I����7��4 '���i,=K��`� JUN c� .� 20dr � •/ W DUPLICATE 1 PAGE 2 �� . ROBERTA PRINCIPE BAR # AG 190236 SERVECE ADVISOR JOSE MALDONADO EPA # CA0000734632 , . :: :._.: _:: : : :: ::.::: .. .... _..: ._.,.,., .. �:.�rr.�aK� Nvars.. �... . .,-..�:..::.:�.:-: ...:;...: .......:�;.:.- :;::.. . . . .:.:�:..:�.�:. _ .:.: .: : . ...... .::. . Kv!Vit.s.:... :, :::;:. ;;:i.;WAtT��: .. .:ESdi'E:A@A.11Y:::::::.�s'fQGR.Nb:.:;`::;.;:::;;V.EkI}CL�lI3�17tE9CA7fON:::.._..;: .::: �)t�ST':;.fi10i::';.:.;..TACGNRZ;::.::;:P:�:fifQ:.:::'i: <':::PSIN7EQ.':.;��:::i::: 02JUN06 03JUN06 1012534 T4075 Q3JTJN0 .. .: . .... ... .. . .. :. .. .. . . . .: : :........:. : ::: ....::.: . :. ..:. . � .::.. ;. . ::.,�,., ..::.. .: .: 1NE READY.: .YEAR:;':. ,; ; '[ :.;.;;'_NWkE&NIQDEC .>:_:;;:..; : ;..' :;`:TE48R11E7ME,p117: ;.:'..:::::::. ` .:.. . : ;<;.;:: :...:s: :ofiTE.`.. : ::` .. :.BY: `. ; TIARE IN : �7 . : . : .. 13:11 12:27 94 HONDA CIVIC 341-8850 I09JAN01 7 , :: .... . ..... . . .. ......: ....... .... .... .. ..: : ._ .. >:. , :t �v :raa::::.: :.:::; .::..:..::::.. ... .:.:. ... ......... . . .. . .. . ... . .. . ;.. M1kEAG� )At.:: lG . 9E. . . . ... 77173 . .... . . .... . � � . .-�. . � V6l'P.. �: �.' '1Ytb'.. . .MolMfa� .�. ..:.,L61MIfF:':"�::' �. �: IQiRlNR'•. �' � ... �'�7DT11L..� . � � .EST: 282.00 02JUN06 13:33 SA: 712 � ** PRE—INVOICE ** CUSTOMER SAT{SFACTION IS OUR #1 PRIOR{TY IF FOR ANY REASON YOU ARE NOT COMPLETELY SATISFIED, PLEASE CONTACT OUR SERVICE MANAGER. OUR SERVICE DEPARTMENT IS DEDICATED TO YOUR COMPLETE SATISFACTION. WE CARE! HONDA OF THE DESERT 68-025 KYLE ROAD CATHEDRAL CITY, CA 92234 (760) 328-8981 . . . i1E.S.di�!Ti0A1: :: _ ' . .': TO`TAi:S':`.. LABOR AMOUNT ZZC . SS ORIGINAL ESTIMATE REVfSED ESTfMATE PARTS AMOUNT 234 . �� GA5,OIL, LUBE O. OO $ $ SUBLET AMOUNT ZS . OO I HEREBY ACKNOWLEDGE 7HAT I WAS NOTIFIED AND MISC. CHARGES O. OO �RIGINALESTIMATED PRI EF AN INCREASE IN THE TOTAL CHARGES 375 . 55 LESS 1NS./ ADJ. O. OO x SALES TAX 1$ . 1Q CUS70MER SIGNATURE PLEASE PAY CUSTOMER SIGNA7UFE TH1S AMOUNT �g� �:�;� X *THANK YOU FOR YOUR PATRONAGE!* *********SERVICE HOURS********* MONDAY THRU SATURDAY 7:00 AM TO 6:00 PM 1d17: ': ; ,'.; i 154655 ;'. :: �r.x :.::.::' : ' ;: 712 DISCLAIMER OF WARRANTIES � The seller hereby expressly disclaims all warranties � aither express or implied, including any implied I warranty of inerchantability or fitness for a particular purpose and neither assumes �or authorizes any other i person to assume for it any liability in connection with y ihe sale of said products. SEE REVERSE SIDE FOR LIMITED WARRANTY I ON PARTS AND ACCESSORIES. I TIRE I�JF�pT10N FO�,ND AT REPORT SET AT 3RAKE 'rRON7 tVEW REPORT RcAR NEN' YOJRS YpURS PS� P5� CLOSED SUNDAY SAR# AG190236 � I �4'� •:�� - Enterprise � � '� — � c�,Fi�������� . , , r-.� 7{-;} �t • r�,- , r . �. 1^ � +_ . , OWNER OF VEHICLE: `i��ij'.:� �� `r2�'�'J��. �'f? :. b � l;j ''i,{.;...-7•p:s �c�S � • BRANCH ADDRESS: �-'�1i ��+ �G CL'.���� Li=+. �'�:.�' ;. t ._;; � � }? . � u -. � � a �.� -� . -� f : ;•,p,. Y I . .t � c. .. r� { START Cr1ARGES IF DIfFERE1dT � IORIGINAL VEHICLE � i-4at°R `?!'�E�'"�i j4�, � .jlY S ��C i3 RENTAL r ���� � TYPE RE��R t�t I F'�'� ;t!i�C �� f i� CUSTOMER COPY )1�� ;�:'��:h.- :iz:� ', ;;;+,;: - ., ' ,.. � (,�_.t ,-,�- . r' �`{ `:i � l)'. jt^� ^ rt ; i�.( l�' :a �: n._tH"" t. 'it'�i_'•�, .�L)tt�;!;ti.i^i- ^]�f;i"!F `-0�� . �- - . D L1,;; ` � � L!t'. :� '-' C.`{ J�2f �� I('� f'�t.� .}�:c�' _ {'d% LNc-;f�'���' �:JS� � �1�_�;� t �Ll:1r� ` 2� i' � ,, tl�.%,'i�i;l�� IMILE- I IN BILL �COMPANV �- --�- -- - � . . j AGE I OUT i-� �.�'� � qT�TN �—'— — PHONE--�'---" EXT.----- EMPLO�EE p � cor1D�*ON�OqEEO 70 x ' REFERENCE NUMBER J REMEit �J �—� ADdTiONALAUTHORIZEDDRNER(S)-IXCEPT/�I�E�Ii�([Y�AWj�(�N��iT�Pllfl�� ° � I�J j W����PR�,� ,.� � rit �>> O I REWEST OWNER'S PERMISSION TO N10W IO I I �jj a WHO IS UNDER MY COpI.�ROL ANDp�t ECTION TO DRIVE V HiCI FOF ME AND ON MY BEHALF I AM l 1 LLL RESPONSIBLE FOR TIjEIRACTS WfiIUE THEY ARE DRIVIN kNq� FOR FULFILLING TERMS AND COND'TiONS I - � I�� �_ OF 7MIS x TAL AG EMENT (AC�RE�MENT� USc OP VE aLd'6Y AN UNAUTHORIZEq DRIVER WILL OAFF�Ci V � BILI�AN�S RI('.MTFlr mc.. . -- � i ' , 1. �� �' w \� � .c��.* -. sc.��c� wEa�eenwr� re� a� -, pERMISSION GHANTED j0 OPERAtE VEHICLE�bN�Y IN THE STATE � RENTAL AND lu ouT E 1i8 va 3�a � s�e va ne F THE FOLLOWING STATE(S): �.r� ��,�� ; r4'^ . . • _J �E ' , ' . , lr' , . � Ik E ti8 i14 3.'6 tY2 518 ]74 ;�8 F OPERAT�Ot�W.W+O7�IERSTR7E0RCOLk7RV-NriLAFFE�.LY,�R�IaBU-Q%A�+OR�GHTSUNDEFiTMISAG�EMENi � RETITER DECLWES OPTIOIJAL DAMA('aE RENTER ACCEP75 OPTIONAL DAYAGE RENTER. X ' DAMAGE WAIVER NOTICE: w iow�aw�sw�so�ce �MANER(DM�IATFEESHOWNINCOL- RENTER ACKNOWLEDGES '� O1s��r SEEPAGE2 PARAGiiAPM UUN70R�GHT SEE DWNOTICETO RECEIPT �F ORAL DIS- � ' �EFT'4JJpPAGE3,PARACRAPHI6DW IS NOT iNSURANCE CLOSURE THAT DAMAGE X � .- I WAIVER MAY BE DUPLICA- RENTERDECLJNESOP'TpNl1LPER50NAl RENTERALCEPTSOPTIONALPERSONAL RENTER X , Hi INSUIJ/ANCE (PAl1. ACCIDFJIT INSURANCE (PA1) AT FEE TIVE OF COVERAGE MA{N- 1 � � ti,, SHOtiVNiNCOLUVNTORIGH75EEPAGE �TAINED UNDER HIS OR `1 , 3.PARAGRAP}i1H HER OWN POLICY OF ��X` �'�- - -- � _.. _.___-. M OTO R V E H I C LE I N S U R- NES OPf10NAL SUiPLEMEiJ�L RENTe'R ACCEPTS OPTpNAL SUPPLE- ftENTER x , PR07ECT10N (SL� SEE PAGE 2 ��'�T%� ��uTY PROTECTKIN I�1 ANCE. THE PURCHASE OF w�,� � ATFEESHOWNMCOLUMNTO.�IGM / SEE PAGE 3. PARqGRAP�� 17 � DAMAGE WAIVER IS :x...___._.__ __ __',-� OPTIONAL AND MAY BE ACKNOWLEDGMENT OF THE ENTIRE AGREEMENT, DECLINED. WHICH CONSISTS OF PAGES 1 THROUGH 4. , i HAVE READ ANC AGR'c= TO THE TERMS A�D CONDITIONS ON PAGES 7 7hR0UGh q OF TF:�S AGREElAcA i IV�D BY MY S�GNATURe BELO'N i AM TnE'RENT=R' UN�ER TH�SAGREEME?:T BY SIGNING BELON.I MIAUTHORIZRIG OWNER TO PROC�SS CHARGES ON MY CREDR CAFtDiS)AND/OR DE BIT CARD(S� FOR ADVANCE OEPQSiTS, I.�C.RE�IENTlLL AU7tl�RVAT�ONSlDEPoSITS. AtiD �HARGES MCURRED, AS YIELLAS PAYN,ENiS RE=USED BY A THl 'Y TO WHOV 9iL�I�G V.�AS DiRECTEO 1 CERTIFY THAT T}iE DRNERS , RE NTE R: X UCEMSE(S) PRESEHROac nioocun v vs� in �uD N0T 5 NDED, EXPfRED, REVOI�D. CANCELLED OR SURRENDERED , ` ! . � REPLACEMENT VEHlCLE RENTER• x 1�! >.% -='' '`'i i I e . .._-- . . .. � ° OINNER EMPL ".�-�?'• ' REP X # I �O_OR I iCE��E �+O 1 WILL RETURN CAR BY' DEPOSIT(S): `'-" � DATE TIME AMOUNT PAID BY i r.4�DEl __ I - _ - EC"vRa . " , .. . . .. . . . . . �� . . _,�� ? � . . ��=. i:. � � .i�,' 4��; � v��=_ � i�a � ` a�`' i o�T ' � aooirior�a� wFo�r,�r.ron I EMPLOVEEa ICChDi'10l.�GREE7 TO y REH1cF _ O � _ � � O � � � _ i �� //��� I�I O I%_-Di��� -._�Pa*Cti BNEpI � 10 �F OUT E �l'o '�d 3�e 1,2 �%E 3•� 7l2 F U E ' IN E+.8 %ti 3:8 +�I S/& 3:< 7�8 F 0`1'.VeR IS AN AFFILIqTE QF E�VTERPRISE RENT-A•CAR �011PANY, YJHICH 06"1'VS ALl RIGHTS TO ENTERPRIS� NA'.1ES A�p �tARKS. t3l� Y �_ -y _.�. . =.}:� , E. r'`,. �.�� � , :, , � w � i:i-� r �"ri �,, �:%'?. ��f�; il .�'� . . � . . :.� . . r��lr::. .i3 - . �� . ... t..if� � 'i::, ; TOTAL CHARGES DEPOSITS � REFUNDS � � � CLOSED BY PAiD?Y , CASH CHECK CF RECE4PTOF DATE AMOUNT � RECEI` r - t,> ��t+�UN'J O Enterprise Rent-A-Car Company of Los Angefe: • X 5,y� �� 1V101 / �i + � �i seB�ey� 6u�ddiys •s.iiede� ;o �unowe ey3 em�es o; pe6pa�nnou��e si uai� s,�iueyoew sseadxe uy •uoi��adsui puz Bui3se3 ;o sasodmd ao; 3uewdin e a�eaedo ol uoissiw�ad �uea6 SlaVd 1`d101 Pue �eue�Ew l,.iossaoeu eyl y�inn euop aq ol �{�o�n nede� anoqe e43 aziaoyln� �Sqe�ay � � �G. ki08tll 1V101 'lo�3uoo �no puoAaq esns� �ay;o �Cue ao uay� ao en; �Cq sso� ao� a�qisuodsa� ;oN '31�IH3A af10�1 NJlltl 3M Fi31�t1 S3lIW Q00`ti 4NM 000'£ N33M138 ��3H�3a 1N3WNJIld 33li� � ��. � . _ . .. ---. . _ � � � sl�npad p�es �o e�es ayl 4l!m uoi�euuo� w/���qeq �ue �� �o{ ewnsse ol uos�ed �eylo �(ue sezuoylne �ou sawnsse �eyliau pu2 'esodmd �e�na�ued e ao{ sseuilJ �o ���qeluey��ew �o tiueuem �,�dw, �(ue 6uipnpui 'peqdwi io sse�dxe ,ay�ia •se��ueLem pe swie��sp �(�ssa�dxa /�qeaay (diys�a�eep paweu anoqe) ie��es ayl 'me� q pep�nad asinvey�o sse�u� Slatld 1d101 . 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