Beruflich Dokumente
Kultur Dokumente
SAILESH PATEL
7811 GOVERNOR PRINTZ BLVD
CLAYMONT, DE 19703-2615
sampatelde@yahoo.com
Home/Day: (609)433-1641
FAX:
Control Information
Claim # : 031190749-01
Loss Date/Time: 12/27/2014 07:00 AM
Deductible: $500.00
Ins. Company: Liberty Mutual
Address: 399 CAMPUS DRIVE
PO BOX 6807
City State Zip: SOMERSET, NJ 08873
Work/Day: (800)500-8061
Home/Evening:
FAX:
12/29/2014 05:06 PM
CollisionMax of Marlton
22 West Main Street
Marlton, NJ 08053
Left Front Corner
Yes
Assigned Date/Time:
First Contact Date/Time:
Inspection Type:
Contact:
Work/Day:
FAX:
Secondary Impact:
Rental Assisted:
Appraiser License # :
Repairer
Repairer:
Address:
City State Zip:
License # :
CollisionMax of Marlton
22 West Main Street
Marlton, NJ 08053
00075-A
Contact:
Work/Day:
FAX:
Regulation ID:
Jim Rush
(856)983-1313
(856)983-9012
52-2079443
Remarks
SUPPLEMENTS MUST BE INSPECTED PRIOR TO REPAIR
FAILURE TO NOTIFY LIBERTY MUTUAL COULD RESULT IN NON PAYMENT OF SUPPLEMENT.
12/30/2014 08:48 AM
Page 1 of 6
12/30/2014 08:32 AM
393658
Lic State:
VIN:
Mileage:
Mileage Type:
Code:
Int. Color:
Int. Refinish:
Int. Trim Code:
06/2013
Good
LAVA GRAY PRL
Two-Stage
1R1R,LZ7L
DE
WA1LFAFP6EA012025
27,057
Actual
68764A
GRAU
IE
AM/FM CD Player
Amplifier
Auto-Leveling Headlamps
Carpeting
Color-Keyed Bumper(s)
DVD Player
Digital Signal Processor
Dual Air Conditioning
Dual Zone Auto A/C
Fog Lights
Heated Front Seats
High Definition Radio
Intermittent Wipers
Keyless Ignition System
Leather Shift Knob
MP3 Decoder
Overhead Console
Pearlescent Paint
Power Door Locks
Power Trunk (open/close)
Pwr Accessory Outlet(s)
Rear Fog Lamp
Rear View Camera
Roof/Luggage Rack
Smokers Package
Strg Wheel Radio Control
Theft Deterrent System
Tire Pressure Monitor
Trip Computer
Xenon Headlamps
Guide
MC Description
MFR.Part No.
Price
ADJ% B%
Hours
Page 2 of 6
1 RI
2 RI
500
502
Front Bumper
3 E
47
4 L
47
01 Cover,Front Bumper LT
13 Cover,Front Bumper LT
5 E
6 L
152
152
01 Spoiler,Lower Front
Spoiler,Lower Front
7 E
57
01 Filler,Front Bumper LT
12/30/2014 08:32 AM
R & I Assembly
R & I Assembly
0.3
0.3
SM
SM
$495.00
0.9
2.6
SM
RF
$346.00
0.5
1.2
SM
RF
$123.00
INC
SM
$925.00
1.5
SM
0.4
SM
Repair
Refinish
0.5 Surface
Repair
1.0*
0.5*
SM
RF
5.0*
SM
Refinish
1.8 Surface
0.6 Two-stage
2.4*
RF
2.8
2.8
SM
RF
0.5*
SM
2.0*
RF
0.9
0.4
0.4
SM
SM
SM
5.0*
1.9*
SM
RF
0.6
0.3
SM
SM
8R0807107KGRU
Refinish
1.7 Surface
0.6 Two-stage setup
0.3 Two-stage
8R0807061DGRU
Refinish
1.0 Surface
0.2 Two-stage
8R0807681G01C
83
13
83
14 E
15 L
103
103
Panel,Hood
Aluminum
10 Panel,Hood
Front Doors
16 I
207
17
207
18 RI
19 RI
20 RI
225
253
315
Door Shell,Front LT
Repair
>> Repair door edge (rubbing fender).
10 Door Shell,Front LT
Refinish
1.6 Surface
0.4 Two-stage
>> Partial base, full clear coat.
Mldg,Front Door Belt LT
R & I Assembly
Cover,Frt Door Mirror LT
R & I Assembly
Handle,Front Door Otr LT
R & I Assembly
287
287
Door Shell,Rear LT
10 Door Shell,Rear LT
Rear Doors
21 I
22 L
23 RI
24 RI
471
305
Manual Entries
25 SB
25 Items
12/30/2014 08:48 AM
$347.00
Repair
Refinish
1.5 Surface
0.4 Two-stage
HAZARDOUS WASTE
Sublet Repair
$3.00*
SM*
Page 3 of 6
12/30/2014 08:32 AM
MC
Message
01
10
13
$1,311.00
$925.00
$361.80
$2,597.80
$181.85
@ 7.000%
Rate
$47.00
$50.00
$48.00
$47.00
$27.00
Labor Total
Tax on Labor
Sublet Repairs
Tax on Sublet
Gross Total
Less: Deductible
Net Total
8.9
11.9
13.4
Total Hrs
20.8
$977.60
13.4
$629.80
34.2 Hours
@ 7.000%
@ 7.000%
$1,607.40
$112.52
$3.00
$0.21
$4,502.78
$500.00$4,002.78
Alternate Parts Y/00/00/00/00/00 CUM 00/00/00/00/00 Zip Code: 08053 Liberty Mutual
Recycled Parts Y/0/0 Zip Code: 08053
Page 4 of 6
12/30/2014 08:32 AM
Op Codes
* =
EC =
ET =
TE =
L =
TT =
BR =
CG =
AA =
User-Entered Value
QUALITY REPL. PART
Partial Replace Labor
Partial Replace Price
Refinish
Two-Tone
Blend Refinish
Chipguard
Appearance Allowance
E =
OE =
EP =
PM =
PC =
SB =
I =
RI =
RP =
Replace OEM
OEM SURPLUS PART
QUALITY REPL. PART
Replace PXN Reman/Reblt
Replace PXN Reconditioned
Sublet Repair
Repair
R & I Assembly
Related Prior Damage
NG =
UE =
EU =
UM =
UC =
N =
IT =
P =
Replace NAGS
OEM SURPLUS PART
LIKE KIND & QUALITY
Replace Reman/Rebuilt
Replace Reconditioned
Additional Labor
Partial Repair
Check
This report contains proprietary information of Audatex and may not be disclosed to any third party (other than
the insured, claimant and others on a need to know basis in order to effectuate the claims process) without
Audatex's prior written consent.
Copyright (C) 2014 Audatex North America, Inc.
Audatex Estimating is a trademark of Audatex North America, Inc.
12/30/2014 08:48 AM
Page 5 of 6
12/30/2014 08:32 AM
SAILESH PATEL
031190749-01
12/27/2014 07:00 AM
12/29/2014 05:06 PM
2014 Audi Q5 2.0T Prem Plus 4 DR Wagon
4cyl Gasoline Turbo 2.0
Automatic Tiptronic
Damages
Line
Op
Guide
Wheels
1 SB
1
MC
994
Description
MFR.Part No.
Wheel,Front RT
>> Curb rash.
Sublet Repair
Price
ADJ% B%
Hours
SM
Items
Replace
Hrs
Labor
Sheet Metal (SM)
Mech/Elec (ME)
Frame (FR)
Refinish (RF)
Paint & Materials
Rate
$47.00
$50.00
$48.00
$47.00
$27.00
$0.00
These damages are unrelated to the stated loss incident. The stated costs are representative only and
may differ based upon such factors as the involved incident facts, completion of the damages estimate and/or
actual repair.
12/30/2014 08:48 AM
Page 6 of 6