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Home My WebLink About322133 02/21/18 CITY OF CARMEL, INDIANA VENDOR: 370133 ONE CIVIC SQUARE BUTLER AUTO COLLISION CHECK AMOUNT: $"****5,893.77* CARMEL, INDIANA 46032 931 N RANGELINE ROAD CHECK NUMBER: 322133 9y�roN .` CARMEL IN 46032 CHECK DATE: 02/21/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1205 4351000 101416 802798 5,893.77 AUTO REPAIR MAINTENAN Prescribed by State Board of Accounts City Form No.201(Rev.1995) VOUCHER NO. WARRANT NO. ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 370133 BUTLER AUTO COLLISION IN SUM OF$ CITY OF CARMEL 931 N RANG ELIN E ROAD An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CARMEL, IN 46032 Payee $5,893.77 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# General Administration - Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# s Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 101416 802798 43-510.00 $5,893.77 I hereby certify that the attached invoice(s),or 2/20/18 802798 $5,893.77 1205 101 1205 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Wednesday, February 21,2018 Crider,James Administration I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer ® Qn =fir Workfile ID: c2ebcdeb ' Butler Auto Collision Center Federal ID: 351432428 Repairing All Makes &All Models With Integrity ToyotaWhy Use T°Y°ta°.�e°T°�tci°^°and Since 1966 5lete f-1h.-aAbcti1yg.t You Deck Certified . Oe tOC,, "� � '� " Collision 931 North Range Line Road, Carmel, IN 46032 !'! CollislonCenter .� ° Phone: (317) 848-2471 FAX: (317) 848-2489 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Job Number: 802798 Written By:Shane Couch Adjuster:Thornsbury,Sabrina,(630)961-8640 Evening Insured: CITY OF CARMEL Policy#: CT501PEHK8103036P64 Claim#: FBU7374001 A Type of Loss: Collision Date of Loss: 12/30/2017 4:00 AM Days to Repair: 11 Point of Impact: 02 Right Front Pillar(Right Side) Owner: Inspection Location: Insurance Company: CITY OF CARMEL CITY OF CARMEL TRAVELERS ONE CIVIC SQUARE ONE CIVIC SQUARE NAPERVILLE CL CLAIM CARMEL,IN 46032 . CARMEL,IN 46032 CHICAGO (317)571-2403 Business Work (317)571-2403 Business VEHICLE 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER VIN: 1FT7X2B68HEC81017 Interior Color: GREY Mileage In: 8,600 Vehicle Out: - License: 44891 Exterior Color: SILVER Mileage Out: 8,600 State: IN Production Date: 1/2017 Condition: Job#: 802798 TRANSMISSION Air Conditioning Passenger Air Bag Clear Coat Paint t Automatic Transmission Intermittent Wipers Anti-Lock Brakes(4) Metallic Paint Overdrive Tilt Wheel 4 Wheel Disc Brakes Stone Guard 4 Wheel Drive Message Center Traction Control OTHER POWER Telescopic Wheel Stability Control California Emissions Power Steering RADIO Front Side Impact Air Bags TRUCK Power Brakes AM Radio Head/Curtain Air Bags Rear Step Bumper DECOR FM Radio SEATS Trailer Hitch Dual Mirrors Stereo Reclining/Lounge Seats Trailering Package Tinted Glass Search/Seek WHEELS Overhead Console SAFETY Styled Steel Wheels CONVENIENCE Drivers Side Air Bag PAINT Get live updates at www.carwise.com/e/3mMYAe 2/20/2018 8:57:44 AM 031856 Page 1 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL ]ob Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER Line Oper Description Part Number Qty Extended Labor Paint Price$ 1 FRONT BUMPER 2 R&I RT Outer molding 0.1 3 GRILLE 4 S02 R&I Grille assy chrome 1.0 5 FRONT LAMPS 6 R&I RT R&I headlamp assy _ 0.4 7 FENDER 8 Blnd RT Fender w/o wheel opening 1.3 m]dg(ALU) 9 R&I RT Nameplate"F-250 XL" 0.2 10 R&I RT Rear molding w/narrow 0.1 molding _11 S02 R&I RT Fender liner_ 0.6 12 CAB ^ 13 * S02 Rpr RT Aperture panel(ALU) 8_0 1_5 Note:INCLUDES DENT ON CAB CORNER 14 Rep] RT Running board HC3Z16450BA 1 277.63 0.9 15 R&I RT Scuff plate ebony 0.2 16 S02 Repl RT Protect strip FL3Z1521702A 1 9.43 0.1 17 * S02 Repl RT Lower molding FL3Z1829076AB 1 53.32 0.2 0.7 18 S02 Overlap Minor Panel -0.2 19 FRONT DOOR 20 Repl RT Door shell(ALU) FL3Z1620124B 1 815.63 6.1 3.6 21 Overlap Major Adj. Panel -0.4 22 Add for Stone Guard 0.5 23 R&I RT W'strip on body super cab 0.4 24 REAR DOOR 25 Repl RT Door shell fr 12/05/2016 HL3Z1824630A 1 603.80 5.1 3.4 (ALU) 26 Overlap Major Adj.Panel -0.4 27 Add for Stone Guard 0.3 28 PICK UP BOX 29 Rep] RT Side panel w/o wheel opening HC3Z9627840A 1 450.18 14.2 3.8 molding(ALU) a 30 Overlap Major Adj. Panel -0.4 31 Add for Stone Guard 0.3 32 Clear Coat 2.5 33 Rep[ RT Side panel adhesive kit TAI 1 71.05 34 R&I R&I box assy 3.6 35 # R&I TOPPER 1.0 36 * S02 Repl RT Front deflector HC3Z99292A22A 1 10.95 0.1 37 Repl RT Decal"4X4"red/silver FL3Z9925622AA 1 67.03 0.3 38 * Repi RT Panel extn rivet blind type A W702512S900C 8 4.88 Incl. 2/20/2018 8:57:44 AM 031856 Page 2 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Job Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER 39 * Repl RT Panel extn rivet blind type C W708777S900C 4 2.56 Incl. 40 * Repl RT Panel extn rivet blind type D W707638S900C 34 20.40 Incl. 41 # SO4 Repl RT Panel exetn rivet blind type D W707638S900C 23 13.80 42 R&I RT Rear deflector 0.3 43 R&I RT Rear molding 0.1 44 REAR BUMPER 45 R&I R&I bumper assy Incl. 46 MISCELLANEOUS OPERATIONS 47 ** Repl A/M Cover Car 1 5.00 0.2 48 # S02 Rpr ELECTRONIC DIAGNOSTIC 0.5 M Note: DOOR ISSUES WITH ELECTRONICS 49 # S02 Rpr WIRING FOR STROBES 2.0 M 50 # SO4 Subl SALES TAX DEDUCTION 1 -209.03 X Note: NO SALES TAX DUE TO THE FACT THEY ARE A GOVERNMENT INTITY 51 # SO4 Repl SEAM SEALER 1 20.00 1.0 52 ** SO4 Repl A/M CLIPS ACS 1 29.34 53 # SO4 Rpr ***FINAL BILL*** 54 OTHER CHARGES 55 # Hazardous Waste 1 3.00 SUBTOTALS 2,248.97 46.7 16.5 NOTES Estimate Notes: *** REPAIRABLE VEHICLE *** FOR RENTAL OR PAYMENT QUESTIONS PLEASE CONTACT—Sabrina Thornsbury-860.961.8640 PLEASE PROVIDE YOUR REPAIR SHOP WITH A COPY OF THE TRAVELERS APPRAISAL PRIOR TO BEGINNING REPAIRS. THE SHOP IS TO PRE-ORDER PARTS PRIOR TO DROPPING OFF AT REPAIR FACILITY THE SHOP IS TO CONTACT THE SUPPLEMENT HOTLINE IF ALTERNATE PARTS QUOTED ON THIS APPRAISAL ARE NOT AVAILABLE AT TIME OF PART ORDERING. ALL SUPPLEMENTS MUST BE CALLED INTO 888-299-7456 OPTION 2 PRIOR TO REPAIRING.ALL SUPPLEMENT PARTS MUST BE SAVED FOR INSPECTIONM REPAIR HOURS:55.0 HRS REPAIR DAYS: 11 ESTIMATED REPAIR COMPLETION DATE:TBD with appointment ALTERNATIVE PART SEARCHES - APS NA-IN parts law APPRAISER—Joe Mason-317.864.4971 EMAIL—JNMASON@TRAVELERS.COM 2/20/2018 8:57:44 AM 031856 Page 3 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Job Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER ESTIMATE TOTALS Category Basis Rate Cost$ Parts 2,455.00 Body Labor 44.2 hrs @ $48.00/hr 2,121.60 Paint Labor 16.5 hrs @ $48.00/hr 792.00 Mechanical Labor 2.5 hrs @ $80.00/hr 200.00 Paint Supplies 16.6 hrs @ $32.00/hr 531.20 Miscellaneous -209.03 Other Charges 3.00 Subtotal ( 5,893.77 Sales Tax $2,986.20 @ 7.0000% 209.03 Grand Total 6,102.80 Deductible 2,500.00 CUSTOMER PAY 2,500.00 INSURANCE PAY 3,602.80 2/20/2018 8:57:44 AM 031856 Page 4 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Sob Number: 802798 2017 FORD Super Duty F-250 vv/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER SUPPLEMENT SUMMARY Line Oper Description Part Number Qty Extended Labor Paint Price$ Changed Items 41 # S02 Repl RT Panel exetn rivet blind type D W707638S900C 19 -11.40 41 # SO4 Repl RT Panel exetn rivet blind type D W707638S900C 23 13.80 50 # S02 Subl SALES TAX DEDUCTION 1 -207.80 X 50 # SO4 Subl SALES TAX DEDUCTION 1 -209.03 X NOTE: NO SALES TAX DUE TO THE FACT THEY ARE A GOVERNMENT INTITY 51 # S02 Repl SEAM SEALER 1 -20.00 T -1.0 51 # SO4 Repl SEAM SEALER 1 20.00 1.0 1Deleted'Items _ -- 24 S02 Repl RT Window switch super,crew GB5Z14529CB 1 -14.05 Incl. cab w/o power mirror ,Added Items _ Y 52 ** SO4 Repl A/M CLIPS ACS 1 29.34 53 # SO4 Rpr ***FINAL BILL*** SUBTOTALS -399.14 0.0 0.0 TOTALS SUMMARY Category Basis Rate Cost$ Parts 37.69 Paint Supplies 0.00 Miscellaneous -436.83 Subtotal -399.14 Sales Tax $17.69 @ 7.0000% 1.24 Additional Supplement Taxes -0.01 Total Supplement Amount -397.91 NET COST OF SUPPLEMENT -397.91 2/20/2018 8:57:44 AM 031856 Page 5 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Job Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate '5,773.35 JOE MASON JR. Supplement S01 -204.79 JOE MASON JR. Supplement S02 . 932.15 Shane Couch Supplement S03 0.00 Shane Couch Supplement SO4 -397.91 Shane Couch Job Total: $ 6,102.80 CUSTOMER PAY: $ 2,500.00 INSURANCE PAY: $ 3,602.80 .**THIS IS ONLY A PRELIMINARY VISIBLE DAMAGE ESTIMATE ONLY. ADDITIONAL DAMAGE OR REPAIRS MAY BE FOUND ONCE THE VEHICLE HAS BEEN DISASSEMBLED. **YOU WILL BE NOTIFIED IF ADDITONAL REPAIRS ARE NEEDED TO REPAIR YOUR VEHICLE WHICH WILL INCREASE THE AMOUNT OF THIS VISUAL ESTIMATE. **PARTS PRICES SUBJECT TO CHANGE AS PER INVOICE PRICING FROM SUPPLIER. **Special Order Parts REQUIRE a 50% Deposit prior to being ordered that is non-refundable if repair is not completed. **Customer pay repairs may require a 50% Deposit prior to repairs starting depending on the size of the repair and parts involved. **.*We are not responsible for Inherit or Diminshed Value to your vehicle. Please know that Butler Auto Collision Center will warranty all of our labor repairs on your vehicle for as long as you own it. The parts that were replaced on your vehicle from the accident are guaranteed by the manufacture's warranty. THANK YOU FOR ALLOWING US TO EARN YOUR BUSINESS The Butler Auto Group Family www.butierauto.com **Central Indiana's only Toyota Certified Collision Repair Center** **Certification by Toyota Motor Sales of America We also repair all makes and models of vehicles, and warranty our workmanship for as long as you own the vehicle. Parts replaced are warranteed by the manufacture's warranty. ***ANY DISCOUNT COUPONS OR DISCOUNT CARDS OR AFFILIATIONS MUST BE PRESENTED AT TIME OF SCHEDULING OR WHEN VEHICLE IS DROPPED OFF FOR REPAIRS. IF NOT,THEY WILL NOT BE HONORED***** ****Butler Auto Collision Center is not responsible to provide you with a rental or loaner vehicle, and or liable to pay for any rental charges. Rental coverage is something that is chosen by the insurance policy holder 2/20/2018 8:57:44 AM 031856 Page 6 J Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Job Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER when you are purchasing your vehicle insurance. The rental coverage is your choice to purchase and the type and amount of rental coverage. All supplements must be pre-approved by Travelers. Please call 888-299-7456 (prompt 2) Supplement repair charges may be subject to rejection unless approved by Travelers prior to repairs. This instrument is not an authorization to repair. Repair must be pre-authorized by the vehicle owner. Vehicle owner maintains the right to repair vehicle at a repair facility of their choice. Please present this estimate to the repair facility prior to repairs. A PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD AN INSURER FILES A STATEMENT OF CLAIM CONTAINING ANY FALSE, INCOMPLETE, OR MISLEADING INFORMATION COMMITS A FELONY. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE REPLACEMENT PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE REPLACEMENT PARTS RATHER THAN BY THE MANUFACTURER OF YOUR MOTOR VEHICLE. 2/20/2018 8:57:44 AM 031856 Page 7 Preliminary Supplement 4 with Summary Customer: CITY OF CARMEL Job Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER Estimate based on MOTOR CRASH ESTIMATING GUIDE and potentially other third party sources of data. Unless otherwise noted, (a)all items are derived from the Guide DR2ME17, CCC Data Date 2/8/2018, and potentially other third party sources of data; and (b)the parts presented are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk(*) or Double Asterisk(**) indicates that the parts and/or labor data provided by third party sources of data may have been modified or may have come from an alternate data source. Tilde sign (N) items indicate MOTOR Not-Included Labor operations. The symbol (<>) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non-Original Equipment Manufacturer aftermarket parts are described as Non OEM, A/M or NAGS. Used parts are described as LKQ, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign (#) items indicate manual entries. Some 2017 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The CCC ONE estimator has a list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. The following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to be repaired or replaced: SYMBOLS FOLLOWING PART PRICE: m=MOTOR Mechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category. X=Miscellaneous Non-Taxed charge category. SYMBOLS FOLLOWING LABOR: D=Diagnostic labor category. E=Electrical labor category. F=Frame labor category. G=Glass labor category. M=Mechanical labor category. S=Structural labor category. (numbers) 1 through 4=User Defined Labor Categories. OTHER SYMBOLS AND ABBREVIATIONS: Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. Bind=Blend. BOR=Boron steel. CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel. Incl.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part. O/H=Overhaul. Qty=Quantity. Refn=Refinish. Repl=Replace. R&I=Remove and Install. R&R=Remove and Replace. Rpr=Repair. RT=Right. SAS=Sandwiched Steel. Sect=Section. Subl=Sublet. UHS=Ultra High Strength Steel. N=Note(s) associated with the estimate line. CCC ONE Estimating -A product of CCC Information Services Inc. The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR=Bureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number. 2/20/2018 8:57:44 AM 031856 Page 8 INDIANA RETAIL TAX EXEMPT Page 1 of 1 City ®'J�" Cc(�rmeICERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER Jl FEDERAL EXCISE TAX EXEMPT 101416 ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL—1997 SHIPPING LABELS AND ANY CORRESPONDENCE PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 2/20/2018 370133 BUTLER AUTO COLLISION General Administration VENDOR 931 N RANGELINE ROAD SHIP 1 Civic Square TO Carmel, IN 46032- CARMEL, IN 46032- PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT 23603 QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Department: 1205 Fund., 101 General Fund Account: 43-510.00 1 Each Auto Repair and Maintenance $5,893.77 $5,893.77 Sub Total $5,893.77 f `13�t•k� +�" • �p � �• ,.• as �t fit ti _ y 1, t IV 1 Send Invoice To: Dept of Administration �✓ a 1 Civic Square Carmel, IN 46032- :k PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT $5,893.77 SHIPPING INSTRUCTIONS `AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN 'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN `C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY TITLE CONTROL NO. 101416 CLERK-TREASURER Preliminary Supplement,*-with Summary Customer: CITY OF CARMEL Job Number: 802798 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER ESTIMATE TOTALS Category Basis Rate Cost$ Parts 2,455.00 Body Labor 44.2 hrs @ $48.00/hr 2,121.60 Paint Labor 16.5 hrs @ $48.00/hr 792.00 Mechanical Labor 2.5 hrs @ $80.00/hr 200.00 Paint Supplies 16.6 hrs @ $32.00/hr 531.20 Miscellaneous -209.03 Other Charges Subtotal �77 Sales Tax $2,986.20 @ 7.0000% 737.. Grand Total 6,102.80 Deductible 2,500.00 CUSTOMER PAY 2,500.00 INSURANCE PAY 3,602.80 2/20/2018 8:57:44 AM 031856 Page 4 Claim#: FBU7374001 Wordle ID: c2ebcdeb Supplement of Record 1 Summary 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER CUMULATIVE EFFECTS OF SUPPLEMENT(S) Estimate 5,773.35 JOE MASON JR. Supplement S01 -204.79 JOE MASON JR. Workfile Total: $ 5,568.56 TOTAL AD7USTMENTS: $ 2,500.00 NET COST OF REPAIRS: $ :1 4?i068.56 All supplements must be pre-approved by Travelers. Please call 888-299-7456 (prompt 2) Supplement repair charges may be subject to rejection unless appr6ved by Travelers prior to repairs. This instrument is not an authorization to repair. Repair must be pre-authorized by the vehicle owner. Vehicle owner maintains the right to repair vehicle at a repair facility of their choice. Please present this estimate to the repair facility prior to repairs. A PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD AN INSURER FILES A STATEMENT OF CLAIM CONTAINING ANY FALSE, INCOMPLETE, OR MISLEADING INFORMATION COMMITS A FELONY. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE REPLACEMENT PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE REPLACEMENT PARTS RATHER THAN BY THE MANUFACTURER OF YOUR MOTOR VEHICLE. 1/30/2018 8:37:02 AM 125955 1 1.6.09.03151 Page 6 Claim#: FBU7374001 Workfile ID: c2ebcdeb Supplement of Record..1.Summary 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6,75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER Estimate based on MOTOR CRASH ESTIMATING GUIDE and potentially other third party sources of data. Unless otherwise noted, (a) all items are derived from the Guide DR2ME17, CCC Data Date 1/17/2018, and potentially other third party sources of data; and (b) the parts presented are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk(*) or Double Asterisk(**) indicates that the parts and/or labor data provided by third party sources of data may have been modified or may have come from an alternate data source. Tilde sign (N) items indicate MOTOR Not-Included Labor operations. The symbol (<>) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non-Original Equipment Manufacturer aftermarket parts are described as Non OEM, A/M or NAGS. Used parts are described as LKQ, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign (#) items indicate manual entries. Some 2017 vehicles contain minor changes from the previous year, For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the."previous year may be used. The CCC ONE estimator has a list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. The following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to be repaired or replaced: SYMBOLS FOLLOWING PART PRICE: m=MOTOR Mechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category. X=Miscellaneous Non-Taxed charge category. SYMBOLS FOLLOWING LABOR: D=Diagnostic labor category. E=Electrical labor category. F=Frame labor category. G=Glass labor category. M=Mechanical labor category. S=Structural labor category. (numbers) 1 through 4=User Defined Labor Categories. OTHER SYMBOLS AND ABBREVIATIONS: Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. Bind=Blend. BOR=Boron steel. CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel. Incl.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part. 0/H=Overhaul. Qty=Quantity. Refn=Refinish. Repl=Replace. R&I=Remove and Install. R&R=Remove and Replace. Rpr=Repair. RT=Right. SAS=Sandwiched Steel. Sect=Section. Subl=Sublet. UHS=Ultra High Strength Steel. N=Note(s) associated with the estimate line. CCC ONE Estimating -A product of CCC Information Services Inc,, he following is a list of abbreviations that may be used in CCC':ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE: BAR=Bureau of Automotive Repair. EPA=Environmental Protection.Agency. NHTSA= National Highway Transportation and Safety Administration. PDR=Paintless DentiRepair. VIN=Vehicle Identification Number. 1/30/2018 8:37:02 AM 125955 1.6.09.03151 Page 7 TRAVELERS Naperville-Claim Department-BI PO Box 3204 Naperville, IL 60566 Claim#: FBU7374001 Phone: (800) 842-6172 Workfile ID: c2ebcdeb Supplement of Record 1 Summary Written By:JOE MASON JR., 1/30/2018 8:37:01 AM Adjuster:Thornsbury,Sabrina,(630)961-8640 Evening Insured: CITY OF CARMEL Owner Policy#: CT501PEHK8103036P64 Claim#: FBU7374001 A Type of Loss: Collision Date of Loss: 12/30/2017 03:00 AM Days to Repair: 11 Point of Impact: 02 Right Front Pillar Deductible: 2500.00 (Right Side) Owner(Insured): Inspection Location: Appraiser Information: Repair Facility: CITY OF CARMEL CITY OF CARMEL jnmason@travelers.com Butler Auto Collision Center ONE CIVIC SQUARE ONE CIVIC SQUARE (317)864-4971 931 N Rangeline Rd CARMEL,IN 46032 CARMEL,IN 46032 Carmel,IN 46032 (317)571-2403 Business Work (317)848-2471 Business (317)571-2403 Business i t! VEHICLE 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6,7.,5'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER VIN: 1FT7X2B68HEC81017 Production Date: Interior Color: GREY License: 44891 Odometer: 860G, Exterior Color: SILVER State: IN Condition: TRANSMISSION Air Conditioning Passenger Air Bag Clear Coat Paint Automatic Transmission Intermittent Wipers Anti-Lock Brakes(4) Metallic Paint Overdrive Tilt Wheel 4 Wheel Disc Brakes Stone Guard 4 Wheel Drive Message Center Traction Control OTHER POWER Telescopic Wheel Stability Control California Emissions Power Steering RADIO Front Side Impact Air Bags TRUCK Power Brakes AM Radio Head/Curtain Air Bags Rear Step Bumper DECOR FM Radio SEATS Trailer Hitch Dual Mirrors Stereo Reclining/Lounge Seats Trailering Package Tinted Glass Search/Seek WHEELS Overhead Console SAFETY Styled.Steel Wheels CONVENIENCE Drivers Side Air Bag PAINT---- 1/30/2018 8:37:02 AM 125955 1 1.6.09.03151 Page 1 Claim#: FBU7374001 Workfile ID: c2ebcdeb Supplement of Record 1 Summary 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER fY-,.. Line Oper Description Part umber Qty Extended Labor Paint Price$ 1 FRONT BUMPER 2 R&I RT Outer molding HC3Z17K833A 0.1 3 FRONT LAMPS 4 R&I RT R&I headlamp assy HCIZ13008A 0.4 5 FENDER 6 Bind RT Fender w/o wheel opening JC3Z16005C 1.3 m]dg(ALU) 7 R&I RT Nameplate"F-250 XL" HC3Z16720AB 0.2 8 R&I RT Rear molding w/narrow HC3Z16A038AA 0.1 molding 9 CAB 10 * Rpr RT Aperture panel(ALU) HC3Z28211A10A 5.0 1_5 NOTE: INCLUDES DENT ON CAB CORNER 11 Rep] RT Running board HC3Z16450BA 1 277.63 0.9 12 R&I RT Scuff plate ebony FL3Z1813208AA 0.2 13 Rep] RT Lower molding FL3Z1829076AB 1 62.55 0.2 0.7 14 Overlap Minor Panel -0.2 15 FRONT DOOR 16 Repl RT Door shell(ALU) FL3Z1,620124B 1 815.63 6.1 3.6 17 Overlap Major Adj. Panel '" -0.4 18 Add for Stone Guard 0.5 19 R&I RT W'strip on body super cab HC3Z182,0708A 0.4 20 REAR DOOR 21 Repl RT Door shell fr 12/05/2016 HL3Z1824630A 1 603.80 5.1 3.4 (ALU) 22 Overlap Major Adj. Panel -0.4 23 Add for Stone Guard 0.3 24PICK UP BOX _ 25 Rep] RT Side panel w/o wheel opening HC3Z9627840A 1 450.18 14.2 3.8 molding(ALU) 26 Overlap Major Adj.Panel -0.4 27 Add for Stone Guard 0.3 28 Clear Coat 2.5 29 Repl RT Side panel adhesive kit TAS 1 71.05 30 R&I R&I box assy NONE 3.6 31 # R&I TOPPER 1.0 32 Repl RT Front deflector HC3Z99292A22A 1 13.65 0.1 33 Repl RT Decal"4X4"red/silver FL3Z9925622AA 1 67.03 0.3 34 * Repl RT Panel extn rivet blind type A W702512S900C 8 4.88 109L• 35 * Repl RT Panel extn rivet blind type C W70$?.?7S9000 4 2.56 Incl. 36 * Repl RT Panel extn rivet blind type D W7Q7638S900C 34 20.40 Incl. 37 R&I RT Rear deflector HC3,Z99292A22AA 0.3 YC V. 1/30/2018 8:37:02 AM 125955,1 1.6.09.03151 Page 2 Claim#: FBU7374001 Workfile ID: c2ebcdeb Supplement of Record 1 Summary 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 4D SHORT 8-6.2L Flex Fuel Sequential MPI SILVER 38 R&I RT Rear molding HC3Z9929038AB 0.1 39 REAR BUMPER 40 R&I R&I bumper assy HC3Z17906GPTM Incl, 41 MISCELLANEOUS OPERATIONS 42 ** Repl A/M Cover Car 1 5.00 0.2 43 # S01 Sub! Sales tax deduction 1 -204.79 X 44 OTHER CHARGES 45 # Hazardous Waste 1 3.00 SU$TOTALS 2,192.57 38.5 16.5 NOTES. Estimate Notes: *** REPAIRABLE VEHICLE *** FOR RENTAL OR PAYMENT QUESTIONS PLEASE CONTACT—Sabrina Thornsbury'=•860.961.8640 PLEASE PROVIDE YOUR REPAIR SHOP WITH A COPY OF THE TRAVELERS APPRAISAL PRIOR TO BEGINNING REPAIRS. THE SHOP IS TO PRE-ORDER PARTS PRIOR TO DROPPING OFF AT REPAIR FACILITY THE SHOP IS TO CONTACT THE SUPPLEMENT HOTLINE IF ALTERNATE PARTS QUOTED ON THIS APPRAISAL ARE NOT AVAILABLE AT TIME OF PART ORDERING. ALL SUPPLEMENTS MUST BE CALLED INTO 888-299-7456 OPTION 2 PRIOR TO REPAIRING.ALL SUPPLEMENT PARTS MUST BE SAVED FOR INSPECTION!11 REPAIR HOURS:55.0 HRS REPAIR DAYS: 11 ESTIMATED REPAIR COMPLETION DATE:TBD with appointment ALTERNATIVE PART SEARCHES APS NA-IN parts law APPRAISER—Joe Mason-317.864.4971 EMAIL—JNMASON@TRAVELERS.COM 1/30/2018 8:37:02 AM 125955 1 1.6.09.03151 Page 3 Claim#: FBU7374001 Workfile ID: c2ebcdeb Supplement of Rea'rd 1 Summary 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box,4D SHORT 8-6.21-Flex Fuel Sequential MPI SILVER ESTIMATE TOTALS Category Basis Rate Cost$ Parts 2,394.36 Body Labor 38.5 hrs @ $48.00/hr 1,848.00 Paint Labor 16.5 hrs @ $48.00/hr 792.00 Paint Supplies 16.6 hrs @ $32.00/hr 531.20 Miscellaneous -204.79 Other Charges 3.00 Subtotal 5,363.77 Sales Tax $2,925.56 @ 7.0000% 204.79 Total Cost of Repairs 5,568.56 Deductible 2,500.00 Total Adjustments 2,500.00 Net Cost of Repairs 3,068.56 1/30/2018 8:37:02 AM 125955 1 1.6.09.03151 Page 4 Claim#: FBU7374001 Workfile ID: c2ebcdeb Supplement of Record 1 Summary 2017 FORD Super Duty F-250 w/Single Rear Wheels XL Supercab 4WD w/6.75'Box 41)SHORT 8-6.21-Flex Fuel Sequential MPI SILVER SUPPLEMENT SUMMARY Line Oper Description Part Number Qty Extended Labor Paint Price$ Added Items 43 # S01 Subl Sales tax deduction 1 -204.79 X SUBTOTALS -204.79 0.0 0.0 NOTES Estimate Notes: *** REPAIRABLE VEHICLE *** FOR RENTAL OR PAYMENT QUESTIONS PLEASE CONTACT—Sabrina Thornsbury-860.961.8640 PLEASE PROVIDE YOUR REPAIR SHOP WITH A COPY OF THE TRAVELERS APPRAISAL PRIOR TO BEGINNING REPAIRS. THE SHOP IS TO PRE-ORDER PARTS PRIOR TO DROPPING OFF AT REPAIR FACILITY THE SHOP IS TO CONTACT THE SUPPLEMENT HOTLINE IF ALTERNATE PARTS QUOTED ON THIS APPRAISAL ARE NOT AVAILABLE AT TIME OF PART ORDERING. ALL SUPPLEMENTS MUST BE CALLED INTO 888-299-7456 OPTION 2 PRIOR TO REPAIRING.ALL SUPPLEMENT PARTS MUST BE SAVED FOR INSPECTIONI!! REPAIR HOURS: 55.0 HRS REPAIR DAYS: 11 ESTIMATED REPAIR COMPLETION DATE:TBD with appointment ALTERNATIVE PART SEARCHES APS ., NA-IN parts law APPRAISER—Joe Mason-317.864.4971 EMAIL—JNMASON@TRAVELERS.COM TOTALS SUMMARY Category Basis Rate Cost$ Parts 0.00 Paint Supplies 0.00 Miscellaneous -204.79 Subtotal -204.79 Total Supplement Amount -204.79 NET COST OF SUPPLEMENT -204.79 1/30/2018 8:37:02 AM 125955`1 1:6:69.03151 Page 5 896D 9048,8074 7204' SA01743 - TRAVELERS J� _ DATE: -01/29/18 — LOSS DATE: 1'2/30/17 CITY OF CARMEL FILE NUMBER: 028 AD FBU7374 P ONE C,I VI C .SQUARE CARMEL LN 46032 AGENT: HYLANT GROUP INC ACCOUNT NAME: CITY OF CARMEL,CARMEL CLAY THE TRAVELERS INDEMNITY COMPANY EXPLANATION OF PAYMENT Collision $3068:56 TOTAL PAID $3068.56 .201.7 FORD F250 VIN 1017 REPAIR ESTIMATE ` GD5 FOR ADDITIONAL INFORMATION, CONTACT: SABRINA THORNSBURY AT (630).96i —8640 029001765 DETACH CHECK DETACH CHECK -----Original Message----- From: ctricoh(cDcarmel,in.gov [mailto:ctricohL@carmel in Dov]. Sent:Thursday, February 08, 2018 9:32 AM To: Walthall, Dianne S. Subject: Message from "RNP00267345FCOB" This E-mail was sent from "RNP00267345FCOB" (Aficio MP C5502A). Scan Date:02.08.2018 09:31:43 (-0500) Queries to: ctricoh@carmel.in.gov 1