Feb 26, 2013 ... Claim #: Adjuster: Vehicle: 2007 CHEVROLET UPLANDER. Policy/Ref #: ... Auto
& Light Duty Truck .... Front Body Headlamp Mounting Panel.
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308 Phone: 586-752-1460 Fax: 586-752-4537 Email:
[email protected]
Inspection Summary Report Pioneer State Mutual - Flint-MI Branch
Co Fax #:
Assignment Information Claim #:
Vehicle Information Total Loss
13-
Adjuster: Policy/Ref #: Our File #:
84042
Owner type:
Insured
Owner:
Karianne
Insured:
Karianne
Date of Loss:
2/26/2013
Loss Type:
Collision
Vehicle:
2007 CHEVROLET UPLANDER
VIN:
1GNDV23167D
Mileage:
87194
Color:
Prior Damage:
n/a
Prior Dam Type:
Betterment:
n/a
Condition:
Drivable:
Yes
No
Plate #: Gold
Good
At Repair Facility:
Yes
No
Agreed by:
3/1/2013
Copy to shop:
Yes
No
Copy to owner:
Justin Niles
Stock #:
Complete date: Appraiser:
Yes
No
Repair Days:
ShopTax ID: Agreed Price:
2/28/2013
MI
Shop of Choice:
Assignment date: 2/27/2013 Inspection date:
810-733-7298
Inspection Location Name:
Grass Lake Chev
Address:
11851 E Michigan Avenue
City/St:
Grass Lake, MI
Phone:
517-879-5627
No
Claim Totals Total Repair Amt:
** Total Loss **
Deductible Amt:
$500.00
49240 Fax:
Yes
Other Deductions:
n/a
Net Claim Amt:
n/a
Contact: Email: ShopTax ID:
Unrelated Prior:
Comments SEE FIELD REPORT FOR MORE INFORMATION
$0.00
* No deduction taken
Auto & Light Duty Truck Field Report Appraiser: JUSTIN NILES
Date: Friday, March 1, 2013
Claim #: 13-
Insured:
Claimant: KARIANNE
Our File #: 84042
KARIANNE
Inspection and Completion Information Inspection Type: Non-classic Automobile
The unit was inspected: At the repair facility.
Unit was inspected within two business days.
Yes
Owner notified immediately after the inspection. Yes. Person contacted: KARIANNE
Date Contacted: Friday, March 1, 2013
Time: 12 PM
Report completed within one business day of inspection. Yes. Damages consistent with loss description.
Uploaded from field
Yes.
Repair and/or Total Loss Information DANA Estimate Amount: $6,520.82
Our estimate, open items and old damages are 78
Shop Estimate Amount: $0.00
It is our opinion that the unit is: A total loss.
Initial Savings:
The repair facility has a copy of our estimate. No, unit is a total loss.
$0.00
Explanation if no savings.
% of estimated value.
Depreciation applied to this appraisal: None recommended. There is the possibility of open items: Not likely.
Open items are:
Possible Amount:
Old, unrelated damages: None determined at this time. Old, unrelated damages are: Further Total Loss Information Location: GRAFF CHEVROLET
Address: 4580 E. PICKARD ST, MOUNT PLEASANT, MI 48858
Phone #:
Towing Charge: $192.00
(989) 773-3937
Vehicle moved: Not required by client. Salvage Bids: Not requested.
Storage Charge: $25.00
per day since Feb 26, 2013
Location/Stock #: Called into: Not Required
Value:
Reference #:
Some alternative parts may not have been included on our estimate: Source:
Phone Number
Findings:
Source:
Phone Number
Findings:
Source:
Phone Number
Findings:
Date: Estimate ID: Estimate Version: Committed Profile ID:
3/ 1/2013 04:24 PM 84042 0 * JUSTIN
DAMAGE APPRAISERS OF NORTH AMERICA P.O. BOX 81817 HOME OFFICE 586-752-1460, ROCHESTER, MI 48308 (989) 909-9709 Fax: (989) 828-4109 Email:
[email protected]
Damage Assessed By:
Condition Code: Date of Loss: Contact Date: Deductible: Policy No: Insured: Owner: Address: Telephone:
JUSTIN NILES
Good 2/26/2013 2/28/2013 500.00
Type of Loss: Arrival Date: Accident Date: Claim Number:
Karianne KARIANNE Home Phone:
Mitchell Service: Description: Body Style: VIN: Mileage: OEM/ALT: Color: Options:
Line Item
Entry Labor Number Type
1 2 3 4 5 6 7 8 9
002300 000014
Operation
000030 000031 000032
OVERHAUL REMOVE/REPLACE REFINISH REMOVE/REPLACE REMOVE/REPLACE REMOVE/INSTALL REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE
10 11
000035 000036
BDY BDY
REMOVE/REPLACE REMOVE/REPLACE
12 13 14 15
000037
BDY BDY BDY BDY
REMOVE/REPLACE CHECK/ADJUST REMOVE/REPLACE REMOVE/REPLACE
000038 000051
910285
2007 Chevrolet Uplander LS VanPassExt 121" WB Drive Train: 3.9L Inj 6 Cyl FWD 1GNDV23167D License: MI 87,194 A Search Code: L735613 GOLD PASSENGER AIRBAG, DRIVER AIRBAG, POWER LOCK, POWER WINDOW, POWER STEERING REAR WINDOW DEFOGGER, MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN LUGGAGE RACK, ANTI-LOCK BRAKE SYS., TRACTION CONTROL, FRONT AIR DAM TINTED GLASS, THIRD ROW SPLIT BENCH SEAT, TELEMATIC SYSTEMS DRIVER SIDE SLIDING VAN DOOR, ANTI-THEFT SYSTEM, AUTOMATIC HEADLIGHTS VEHICLE THEFT TRACKING/NOTIFICATION, DAYTIME RUNNING LIGHTS AM/FM STEREO CD/MP3 PLAYER, ELECTRONIC STABILITY CONTROL, FRONT BUCKET SEATS PASSENGER SIDE SLIDING DOOR, POWER DISC BRAKES, REAR WINDOW WIPER SECOND ROW FOLDING BUCKET SEATS
BDY BDY REF BDY BDY BDY BDY BDY BDY
000022 000029
Collision 2/28/2013 2/26/2013
Line Item Description Front Bumper Frt Bumper Cover Assy Frt Bumper Cover Frt Bumper Cover L Frt Bumper Bracket Frt Lwr Bumper Valance Panel Frt Bumper Cover Frt Bumper Adhesive Emblem Frt Bumper Impact Absorber Frt Bumper Impact Bar Grille Upr Grille Lwr Grille Front Lamps R Front Combination Lamp Assembly Headlamps L Front Combination Lamp Assembly R Daytime Running Lamp Assembly
ESTIMATE RECALL NUMBER: 03/01/2013 16:23:52 84042 Mitchell Data Version: OEM: JAN_13_V MAPP:JAN_13_V Copyright (C) 1994 - 2013 Mitchell International Software Version: 7.0.483 All Rights Reserved
Part Type/ Part Number
Remanufactured 15235853 GM PART ** QUAL REPL PART 20831223 15292536 15184654
GM PART GM PART GM PART
Dollar Amount
Labor Units
2.0 INC C 2.5 41.08 INC 193.99 INC INC 51.20 0.1 140.37 INC 150.98 0.2 353.00
# #
# #
#
** QRP CAPA ** QRP CAPA
125.00 140.00
INC # INC #
Remanufactured
158.75
Remanufactured ** QUAL REPL PART
158.75 37.99
INC # 0.4 INC # INC #
Page
1
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4
Date: Estimate ID: Estimate Version: Committed Profile ID: 16 17 18
000052
BDY BDY BDY
REMOVE/INSTALL REMOVE/REPLACE REMOVE/INSTALL
BDY REF REF BDY BDY
REMOVE/REPLACE REFINISH REFINISH REMOVE/REPLACE REMOVE/REPLACE
19 20 21 22 23
000058
24 25 26
002521 000099
BDY BDY BDY
REMOVE/REPLACE REMOVE/REPLACE REMOVE/INSTALL
27 28 29 30
002292 002544
MCH MCH BDY MCH
REMOVE/REPLACE REMOVE/REPLACE REMOVE/INSTALL REMOVE/REPLACE
31 32 33 34 35 36 37
002517 000163
REF BDY REF
REFINISH REPAIR REFINISH/REPAIR
000164 000176 000184
BDY BDY BDY
REPAIR REMOVE/REPLACE REMOVE/REPLACE
38 39 40 41 42 43 44 45 46
000195
BDY REF MCH BDY BDY BDY BDY BDY REF
REMOVE/REPLACE REFINISH REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REPAIR REFINISH
47
931104
MCH
ADD'L LABOR OP
48 49
936000 936003
50
000580
51 52 53
936001 936012 936014
54 55 56
933006
BDY *
ADD'L OPR
933031
FRM
ADD'L OPR
933005 933018 933019
REF BDY REF BDY
ADD'L OPR ADD'L OPR ADD'L OPR ADD'L OPR
57 58 59 60 61
000074 000071
000057 000194 000187 000190 000208
ADD'L COST ADD'L COST BDY
REMOVE/REPLACE ADD'L COST ADD'L COST ADD'L COST
ADD'L COST
R Frt Combination Lamp L Daytime Running Lamp Assembly L Frt Combination Lamp Hood Hood Panel Hood Outside Add For Hood Underside Hood Support Rod Clip Hood Latch Cooling Cooling Radiator Cooling Electric Fan Assy Air Cleaner Assy A/C /Heater/Ventilation A/C Refrigerant Recovery -M Air Cond Condenser Assy -M Radiator Evacuate & Recharge A/C -M Front Fender L Fender Outside R Fender Panel R Fender Panel MODIFIED REFINISH WITH FULL CLEAR COAT L Fender Panel L Fender Liner L Fender Splash Shield Front Inner Structure Front Body Radiator Support -S Radiator Support Complete Add To R&R Mechanical Components -M Front Body Headlamp Mounting Panel L Front Body Brace Lwr Front Body Air Deflector L Front Body Air Deflector L Lwr Front Body Side Rail -S L Lower Side Rail FRAME FRONT END ALIGNMENT Additional Costs & Materials Freon & Oil Coolant Electrical L Low Note Horn Assy Additional Costs & Materials Towing Hazardous Waste Disposal Flex Additive FRAME FRAME/RACK SET UP AND MEASURE PULL FOR MASH ADDITIONAL OPERATIONS Clear Coat Restore Corrosion Protection Mask For Overspray Taped Stripe Additional Costs & Materials Paint/Materials
ESTIMATE RECALL NUMBER: 03/01/2013 16:23:52 84042 Mitchell Data Version: OEM: JAN_13_V MAPP:JAN_13_V Copyright (C) 1994 - 2013 Mitchell International Software Version: 7.0.483 All Rights Reserved
** QUAL REPL PART
3/ 1/2013 04:24 PM 84042 0 * JUSTIN INC # INC # INC #
37.99
88948583
GM PART
388.37
15571260 15183477
GM PART GM PART
2.20 37.51
** QUAL REPL PART ** QUAL REPL PART
194.00 204.00
** QUAL REPL PART
165.00
0.9 C 2.5 C 1.3 INC INC # INC # INC # 0.3 INC # INC # 1.4 C 1.6 1.0* # C 1.5*
Existing
Existing 15247659 GM PART ** QUAL REPL PART 15871561
GM PART
589.28
15798109 15221435 15206750 15206751 Existing
GM PART GM PART GM PART GM PART
242.30 26.18 85.52 44.03
Sublet
3.0* # INC 0.2
24.67 6.00
8.7 # 1.5 0.5 # INC # INC INC INC 2.0* # 1.0
49.95 *
0.0*
32.50 * 19.95 * 89046916
GM PART
67.56
INC #
192.00 * 3.00 * 5.00 * 1.0* 2.0* 2.4 0.3* 5.00 * 15.00 *
0.3*
371.80 *
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4
Date: Estimate ID: Estimate Version: Committed Profile ID:
3/ 1/2013 04:24 PM 84042 0 * JUSTIN
* - Judgment Item # - Labor Note Applies ** QRP CAPA - Quality Replacement Parts CAPA Certified ** QUAL REPL PART - Quality Replacement Parts C - Included in Clear Coat Calc
SHERMAN & ASSOCIATES 61166 VAN DYKE RD. WASHINGTON MI 48094 (586) 677-6800 (800) 345-9487 5 15 17
** CCC765A-22 ** CCC765A-120R ** CCC765A-120L
KEYSTONE AUTOMOTIVE 1411 LAKE LANSING RD. LANSING MI 48912 (800) 968-7509 (517) 482-0046 193.99 37.99 37.99
2 10 11 24 25 28 37
ALLSTAR AUTOLIGHTS NORTH 38309 ABRZZI DR. WESTLAND MI 48185 (877) 204-0074
** GM1000745R ** GM1200575C ** GM1200574C ** RAD2881 ** GM3115196 ** CNDDPI3008 ** GM1250136
353.00 125.00 140.00 194.00 204.00 165.00 6.00
12 14
** 114-00859-R ** 114-00860-L
158.75 158.75
Estimate Totals ________________________________________________________________________________
I.
Labor Subtotals
Units
Rate
Add'l Labor Amount
Body Refinish Frame Mechanical
20.1 14.3 2.0 2.2
48.00 48.00 55.00 70.00
15.00 5.00 0.00 0.00
Sublet Amount 0.00 0.00 0.00 49.95
Non-Taxable Labor Labor Summary
III.
Totals
Part Replacement Summary Taxable Parts Sales Tax
Amount @
3,665.72 219.94
6.000%
Total Replacement Parts Amount
3,885.66
1,985.15
38.6
1,985.15
Additional Costs
Amount
Taxable Costs Sales Tax
II.
979.80 691.40 110.00 203.95
@
6.000%
IV.
429.25 25.76
Adjustments
Amount
Insurance Deductible
500.00-
Customer Responsibility Non-Taxable Costs
195.00
Total Additional Costs
650.01
500.00-
Paint Material Method: Rates Init Rate = 26.00 , Init Max Hours = 99.9, Addl Rate = 0.00
I. II. III.
Total Labor: Total Replacement Parts: Total Additional Costs: Gross Total:
IV.
Total Adjustments: Net Total:
ESTIMATE RECALL NUMBER: 03/01/2013 16:23:52 84042 Mitchell Data Version: OEM: JAN_13_V MAPP:JAN_13_V Copyright (C) 1994 - 2013 Mitchell International Software Version: 7.0.483 All Rights Reserved
1,985.15 3,885.66 650.01 6,520.82
500.006,020.82 TOTAL LOSS
Page
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Date: Estimate ID: Estimate Version: Committed Profile ID:
3/ 1/2013 04:24 PM 84042 0 * JUSTIN
THIS ESTIMATE HAS BEEN PREPARED BASED ON USE OF AFTERMARKET CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES THAT APPLY TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER, DISTRIBUTOR OR INSURER OF THESE PARTS. Point(s) of Impact 15 Total Loss (P)
Insurance Co: Address:
Body Shop: Address: Telephone: Fax Phone: State Lic. No:
GRAFF CHEVROLET 4580 E. PICKARD RD MOUNT PLEASANT, MI 48858 (989) 684-4411 (989) 772-6046 01-0757892
IMPORTANT INFORMATION FROM DAMAGE APPRAISERS OF NORTH AMERICA THIS IS NOT AN AUTHORIZATION FOR REPAIRS. Authorization for repairs can only come from the owner. Our estimate represents the estimated dollar amount of repairs only and is not an instruction on how to repair this unit. The insurance company may review our estimate and make changes to it. This estimate may or may not have a deductible applied to it. You should confirm the approved dollar amount and deductible with the insurance company. Estimated dollar prices for some items were obtained from competitive suppliers. Damage Appraisers of North America does not require that those suppliers or any suppliers be utilized. If a supplement is required; you must first contact our home office at 1-586-752-1460 and set up a supplement file for tracking and prompt handling. Or you may go to our website to upload the supplement at www.damageana.com. All supplements will require photographs, invoices and an opportunity to inspect the additional damages before completed. Our Home office email is
[email protected] Our Home office phone is 586-752-1460 Our Home office fax is 586-752-4537
ESTIMATE RECALL NUMBER: 03/01/2013 16:23:52 84042 Mitchell Data Version: OEM: JAN_13_V MAPP:JAN_13_V Copyright (C) 1994 - 2013 Mitchell International Software Version: 7.0.483 All Rights Reserved
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SingleVal
Page 1 of 1
NADA Official Used Car Guide Friday, March 01, 2013
Vehicle Appraisal Retail Value Region:
Central - March 2013
Vehicle Description: 2007 CHEVROLET TRUCK
Reference #: 84042 1GNDV23167D
VIN:
Uplander-V6 Extended Wagon 4D LS NADA Base Clean Retail: Mileage Value (87,194 Miles) Accessories Value: NADA Adjusted Clean Retail:
$9,000 -$250 $0 $8,750
Options: Options Total:
$0
NADA assumes no responsibility or liability for any errors or omissions or any revisions or additions made by anyone on this report. All NADA values are reprinted with permission of NADA Used Car Guide, NADASC.
http://nada3.nada.com/UCGWeb/ReportOutput.aspx?s=ovq4OQ-220216367-7664&pt=html... 3/1/2013
Total Loss and Market Survey Report for Auto & Light Duty Trucks Date: Date of Loss: 2/26/13
3/1/13 Claim #: 13-
Insured: KARIANNE
Policy #:
Adjuster Phone:
Appraiser: JUSTIN NILES
Zip Code: 48878
Loss State: Michigan
Collision
Claimant Phone:
Claimant: KARIANNE
Insured Phone:
Adjuster:
Type of Loss:
Third Party Claim
Leased Vehicle Type of Loss: Collision
Unit Information VIN: 1GNDV23167D
Year: 2007
Body Style: 4 Door
Engine Size: 3.9L
Mileage (UNK if Unknown): 87,194
Make: CHEVROLET
Model: UPLANDER LS
Cylinders: 6
Transmission: Automatic
Vehicle Equipment Power Accessories
Radios/Alarms
Power Steering (PS) Power Windows (PW) Power Locks (PL) Power Mirror (PM) Power Brakes (PB) Power Antenna (PA) Power Trunk/Tailgate (PT) Power Adj. Petals (PP) Power Steering (PS) Heated Mirrors (DHM) Cruise Control (CC) Tilt Steering Wheel (TW) Telescope Str Whl (TEL) Rear Defroster (DEF) Air Conditioning (AC) Dual Air Cond (DAC) Climate Control (AAC) Dual Zone A/C (DZA)
Safety/Brakes Anti-Lock Brakes (ABS) Anti-Lock Rear (ARB) Airbag (ABR) Dual Airbags (DAB) Side Airbags (SAB) Head Airbags (HAB) Rear Side Airbags (RSA) Rear Wiper (RWW) Remote Trunk Rel (RTR) Locking Differential (LCF) Limited Slip Diff (LDS) Night Vision (VZ) Intelligent Cruise (IC) 4 Wheel Disc Brakes (DB Rollover Protection (DB) Traction Control (TX) Stability Control (T1) Auto Level (AL)
Seats
Roof
Bumpers
Other
Landau Roof (LAN) Rear Step Bumper (RSB) Power Seat (ES) AM Radio (AM) Hardtop (HTR) Tubular Bumper (TUB) Dual Power Seats (ES2) AM/FM Stereo (FMS) Luggage Rack (RAK) Chrome Bumpers (CHB) Heated Seats (HFS) AM/FM Tape (FMC) Roll/Light Bar (BAR) Chrome Stp Bumper (CHS) AM/FM Cass/CD (CDT) Heated F&R Seats (HTS) Power Convertible (PTP) Bumper Cushion (BC) CD Player (CD) Split Bench (SBS) Soft Top (STP) CD Changer (CDC) Bumper Guard (BG) Bucket (SBS) Power Slide Sunroof (PSU) In Dash Chgr + FMC (CCT) Cloth/Velour (VEL) Manual Sld Sunroof (MSR) Wheels/Tires/Accessories MP3 Player (MP3) Leather (LTH) Pwr Glass Moonroof (PMO) Wire Wheels (WW) Str Wheel Controls (TQ) Vinyl (VNS) Pop-up Roof (PMR) Wire Wheel Covers (WWC) Aux Audio (M3) Captains Chairs 2 (CC2) T-Top Glass (GPR) A/M Alloy (ALW) CB Radio (CB) 6 (CC6) 4 (CC4) T-Top Solid (TTP) A/M Chrome (CHR) 8 Track (8T) nd Row Captains (SRC) Dual Sunroof (DSR) 2 Chrome Alloy (CHA) Satellite Stereo (SXM) Electric Steel Roof (ES) nd 2 Row Buckets (SRB) Removed Styled Steel (STY) Skyview Roof (OR) Alarm System (ALR) Third Row Seat (3S) 20" or Larger (W2) Dual Power Roofs (SD) Phone (CTP/VAC) Power Third Seat (3P) Deluxe Wheel Cover (DC) Manual Steel Roof (MS) Remote Starter (RMS) Retractable Seats (R3) Full Wheel Cover (FC) Manual Convertible (MV) Keyless Entry (KES) 12 Passenger (2P) Spoke Aluminum(SA) Detachable Roof (RM) OnStar (ONS/SOS) 15 Passenger (2P) Vinyl Roof (VR) Rally Wheels(RW) Navigation System (NAV) Cabriolet Roof (RF) Swivel Seats (SS) Locking Wheel Covers (LC) Tachometer (TCH) Padded Landau Roof (LP) Auto Lock Hubs (ALH) Paint/Trim/Glass Center Console (CTC) Padded Vinyl Roof (PV) Manual Lock (MLH) Two Tone (TN2) Overhead Console (OHC) Soft Top (CT) Wide Tires (WDT) Special Paint (CPT) Lighted Entry Sys (LES) Dual Rear Wheels (DRW) Trucks/Vans/CVRS Metallic Paint (MET) Rear Entertainment (REN) 5th Wheel (W5M) Refrigerator (RFR) Front Entertainment (ENT) Graphics (GRA) Trailer/Camper (TOW) Television (BTV, CTV) Reverse Sensing (RSS) Deluxe 2 Tone (D2) Trailer Hitch (TRH) Raised Roof (RSR) Parking Assist (PAS) Three Stage (HP) Running Boards (RNB) Bay Windows 2-3-4 Communications Sys (C2) Clearcoat (IP) Spare Tire Carrier (SOT) Dual Pwr Sld Doors (DPD) Heads Up Display (HU) Dual Mirrors (DM) Side Steps (SST) Pwr Sld RH Door (PSD) Wood Interior Trim (WT) Heated Mirrors (HM) Tubular Side Steps (TSS) Pwr Sld LH Door (PSL) Electronic Instruments (EI) Headlamp Washers (HV) Tonneau Cover (TNC) Sld Driver Side Door (SSD) On Board Computer (IB) Bodyside Mouldings (BN) Hard Tonneau Cover (HTC) Ladder (LDR) Message Center (MC) Tinted Glass (TNT) Memory Package (MM) Tinted A/M Privacy Glass (PRG) Sunscreen Glass (SSG) Rear Spoiler (SPL)
Grill Guard (GG) Fog Lights (FOG) Winch (WCH) Canopy (CAN) Camper Shell (CSH) Bedliner (BDL) Spray-on Bedliner (SBL) Tool Box (TBX) Extra Tank (AUX) Hydraulic Liftgate (HGT) Lift Kit (LO3, LO6, L10) Ground Effect Pkg (GRD) Lowered (LOW) in. Sld Rear Window (SRW) Pwr Sld Rear Win (PSR) Bra (BRA) Air Dam (FAD) Rear Heater (RHT) Bug Shield (BSH) Custom Exhaust (CUE) Mini Blinds (MNB) Lojack System (LOJ) Rack Cross Bars (RCB) Rear Win Deflector (RWD) Xenon Headlamps (XE) Bed Rails (AR) Dual Rear Tires (WD) Aux Fuel Tank (XT) 3rd Truck Door (3D) 4th Door Truck/Van (4D) California Emissions (EM) Stone Guard (SG)
Refurbishments Transmission:
Purchase Price:
Mileage:
Engine:
Purchase Price:
Mileage:
Tires:
Purchase Price:
# of Tires:
Paint:
Type:
Purchase Price:
Date Painted:
Interior:
Type:
Purchase Price:
Date:
Camper Shell:
Purchase Price:
Date:
Carpet Kit:
Purchase Price:
Date:
Special Wheels:
Purchase Price:
Date:
Other
Description:
Restored
Restored Amount:
Package/Special Features/Additional Options (XXXX=CALL BACK)
Purchase Price:
Date:
Item Conditions, Total Value, and Location Information Condition Rating - Rate each of the following. (0=Fair, 1=Average Private, 2= Dealer Retail, 3=Above Average)
Comments
Engine
0
1
2
3
Transmission
0
1
2
3
Paint
0
1
2
3
Front Tires
0
1
2
3
Rear Tires
0
1
2
3
Body/Glass
0
1
2
3
Interior
0
1
2
3
NADA Book Value Attached: Yes
Value $8,750.00
KELLY PRIVATE attached:
Value $5,589.00
Yes
Location: GRAFF CHEVROLET Address:
4580 E. PICKARD, MOUNT PLEASANT, MI 48858
Phone Number: KELLY RETAIL attached:
Yes
Value $7,389.00 Towing Charge:
Old, Unrelated Damage
(989) 773-3937
No
Comments: VEHICLE IS IN AVERAGE CONDITION FOR THE YEAR.
$192.00
Storage per Day: $25.00
Tear Down Fee: From Date of:
$0.00 2/26/13
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: LT FRNT
Description: RT FRNT
3/1/2013 4:53:36 PM
Page 1 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: VIN
Description: LT DOOR PANEL
3/1/2013 4:53:36 PM
Page 2 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: ODOMETER
Description: INTERIOR
3/1/2013 4:53:36 PM
Page 3 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: LT DOOR PANEL
Description: LT REAR
3/1/2013 4:53:36 PM
Page 4 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: LICENSE
Description: RT REAR
3/1/2013 4:53:36 PM
Page 5 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: RT HEADLIGHT DAMAGE
Description: FRNT REINFORCEMENT DAMAGE
3/1/2013 4:53:36 PM
Page 6 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: FAN ASSY DAMAGES
Description: COOLER DAMAGES
3/1/2013 4:53:36 PM
Page 7 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: LT FENDER DAMAGE
Description: LT FRNT FRAME RAIL DAMAGE
3/1/2013 4:53:36 PM
Page 8 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: HORN DAMAGE
Description: HOOD DAMAGE
3/1/2013 4:53:36 PM
Page 9 of 10
Damage Appraisers of North America PO Box 81817 Rochester, MI 48308
Photo Sheet - Initial Appraisal
Claim #:
13-
DOL:
2/26/2013
Owner: Our File #:
84042
Description: FRNT
Description: RT FRNT
3/1/2013 4:53:36 PM
Page 10 of 10
