HomeMy WebLinkAboutRisk Pool AppraisalInvoice
Invoice Date:3/21/2016
Invoice #:750
Bill To:
Washington Counties Risk Pool
2558 RW Johnson Road SW, Suite 106
Tumwater, WA 98512-6103
Tri-State Adjusting Service
LLCP O Box 253
Mead WA 99021
Claim No:KT2015061013
Our File #:
Insured Name Kittitas County
Your prompt payment is appreciated.
Thank you for your business.
Federal tax ID #46-4223475
Phone #509-891-7703
Total
Balance Due
Payments/Credits
Date of Serv...DescriptionHours/Qty Rate Amount
3/9/2016 Set up File0 79.00 0.00
3/17/2016 Travel Seattle, WA-Cle Elum, WA (3.0 - .5)2.5 60.00 150.00
Mileage/200-25175 0.70 122.50
Inspect & Estimate claimant vehicle2.5 50.00 125.00
3/21/2016 First/Final Report0 79.00 0.00
Sales Tax: WA B&O Tax - 1.5 %5.96 5.96
$403.46
$403.46
$0.00
WA.0567
Box 253
Mead, WA 99021
(509) 891-7703/(509) 891-7734-fax
Company Adjuster: Lisa McMeekin Email:
Insurance Carrier: WA Counties Risk Pool Claim #: KT2015061013
Insured: Kittitas County Vehicle Owner: Greg Lutousky
Date of Loss: 12/16/15 Tri-State File #: WA.0567
APPRAISAL STATUS: We have: Inspected this Vehicle Completed the Appraisal
We have been unable to complete the appraisal due to the following:
Unable to Contact Owner Contacting Owner by Mail Necessary Disassembly of Unit
Incorrect Address or Phone No. Securing Parts Prices Other – See Comments
APPRAISAL AMOUNT: $8,091.14
Agreed Price Obtained: Yes No Shop of Owner’s Choice Yes No
Agreed by (Shop): Owner has not chosen shop Tax #:
Parts: LKQ Exch X AM RC Available: Yes No N/A
Vendors Contacted (1) Phone #
(2) Phone #
Depreciation/Betterment Yes No Total $
Explain:
Appearance or Cash Allowance Yes No Total $
Explain:
Areas of Possible Additional Damage Yes None Found Approx. Dollar Amt. $
Describe:
Previous or Unrelated Damage Yes None Found Approx. Dollar Amt. $
Describe:
TOTAL LS BORDERLINE TOTAL
ACTUAL CASH VALUE: $
High Salvage Bid: $ Appraiser’s Opinion of Salvage $
Vehicle Year 2015 Make Audi Model Q5 Prestige
Appraisal: Called In Faxed Expressed Date Time
Date Appraiser: Rec’d 3/9/16 Cont’d 3/10/16 Insp. 3/17/16 Cls’d 3/21/16
Comments: We inspected the claimant’s vehicle on 3/17/16. Upon inspection, we noted heavy rock
chips to both headlamps, grille, hood, windshield, roof and mirrors. The chipping/pitting appears
extreme and is all over the vehicle. Other than the rock chips, the vehicle is in excellent condition and
well maintained.
I have prepared an estimate in the amount of $8,091.14. The claimant has not chosen a shop at this
time. Also enclosed are photographs taken during our inspection.
Future Handling: I believe this will complete the assignment you have given to us. We are closing our
file at this time with our final service invoice attached. Please contact me if you have any questions.
Thank you again for the assignment.
Enclosures: Tri-State estimate w/photos
Service invoice
Appraiser: Dave Wilson
davewilson@tri-stateadjusting.com
Direct:
509-891-7703
Date: 3/21/16
Date: 3/19/2016 06:34 AM
Estimate ID:47
Estimate Version:0
Preliminary
Profile ID:* Mitchell
Tri-State Adjusting
P.O.Box 253, Spokane Valley, WA 99021
(509) 891-7703
Fax: (509) 891-7734
Damage Assessed By:TOM WILSON
Classification:Field
Deductible:UNKNOWN
Claimant:Greg Lutousky
Owner:Greg Lutousky
Mitchell Service:911207
Description:2015 Audi Q5 Prestige
Body Style:4D Ut Drive Train:3.0L Turbo Inj 6 Cyl Dsl AWD
VIN:WA1VMAFP9FA106416 License:AVG4873 WA
Mileage:22,937
OEM/ALT:O Search Code:None
Options:PASSENGER AIRBAG, POWER DRIVER SEAT, POWER LOCK, POWER WINDOW, POWER STEERING
REAR WINDOW DEFOGGER, AIR CONDITIONING, REAR WINDOW WIPER, CRUISE CONTROL
TILT STEERING COLUMN, AM/FM STEREO, DRIVER AIRBAG, HEATED EXTERIOR MIRROR
REAR (DUAL-ZONE) AC, LEATHER SEAT, POWER PASSENGER SEAT
FRONT SIDE AIRBAG WITH HEAD PROTECTION, LUGGAGE RACK, PREMIUM SOUND SYSTEM
ANTI-LOCK BRAKE SYS., TRACTION CONTROL, FOG LIGHTS, ALUM/ALLOY WHEELS
REARVIEW CAMERA, POWER LIFTGATE\TRUNK, TIRE INFLATION/PRESSURE MONITOR
MEMORY SEAT, ANTI-THEFT SYSTEM, NAVIGATION SYSTEM, AUXILIARY INPUT
BLUETOOTH WIRELESS CONNECTIVITY, HARD DRIVE, HD RADIO, LEATHER STEERING WHEEL
SATELLITE RADIO, CD PLAYER, POWER ADJUSTABLE EXTERIOR MIRROR, SUNROOF/MOONROOF
PRIVACY GLASS, GENUINE WOOD TRIM, AUTO AIR CONDITION, TRIP COMPUTER
FIRST ROW BUCKET SEAT, UNIVERSAL GARAGE DOOR OPENER
REAR HEATING, VENTILATION & AIR CONDITIONING, ALL WHEEL DRIVE, SIDE AIRBAGS
AUTOMATIC HEADLIGHTS, SECOND ROW SIDE AIRBAG WITH HEAD PROTECTION
INTERIOR AUTOMATIC DAY/NIGHT OR ELECTROCHROMATIC MIRROR
REMOTE DECKLID OR TAILGATE RELEASE, DUAL SUNROOF, MP3 PLAYER, TONNEAU COVER
DRIVER SEAT WITH POWER LUMBAR SUPPORT, ELECTRONIC PARKING AID
ELECTRONIC STABILITY CONTROL, EXTERIOR MEMORY MIRRORS, FRONT HEATED SEATS
KEYLESS ENTRY SYSTEM, POWER FOLDING EXTERIOR MIRRORS, RAIN SENSING WIPERS
REAR BENCH SEAT, REAR SPOILER, SIDE BLIND ZONE ALERT
STEERING WHEEL AUDIO CONTROLS
Line Entry Labor Line Item Part Type/Dollar Labor
Item Number Type Operation Description Part Number Amount Units
1 102043 BDY REMOVE/INSTALL Frt Bumper Cover INC
2 103644 REF REFINISH Frt Bumper Cover C 3.0
3 103642 BDY OVERHAUL Frt Bumper Cover Assy 3.8
4 103358 BDY REMOVE/REPLACE R Frt Otr Bumper Grille ORDER FROM DEALER 355.00 INC #
5 103359 BDY REMOVE/REPLACE L Frt Otr Bumper Grille ORDER FROM DEALER 311.00 INC #
6 103454 BDY REMOVE/REPLACE Grille Assembly ORDER FROM DEALER 675.00 *INC #
7 900500 BDY REPAIR front bumper Existing 2.5**
8 101159 BDY REMOVE/INSTALL R Front Combination Lamp INC #
9 101160 BDY REMOVE/INSTALL L Front Combination Lamp INC #
10 103650 BDY CHECK/ADJUST Headlamps 0.4
11 900500 BDY REMOVE/REPLACE rt. fog lamp assy.New 121.00 *0.4**
12 900500 BDY REMOVE/REPLACE left fog lamp assy.New 121.00 *0.4**
13 103376 BDY REMOVE/REPLACE R Frt Combination Lamp Assembly 8R0 941 004 AP 1,049.00 *0.4 #
14 103456 BDY REMOVE/REPLACE L Frt Combination Lamp Assembly 8R0 941 003 AP 1,049.00 *0.4 #
15 100005 REF REFINISH Hood Outside C 3.0
16 103408 BDY REPAIR Hood Panel (Alum)Existing 2.5*
17 103555 BDY REPAIR R Fender Panel Existing 1.5*#
18 AUTO REF REFINISH R Fender Outside C 1.6
19 103556 BDY REPAIR L Fender Panel Existing 1.5*#
ESTIMATE RECALL NUMBER: 03/19/2016 06:02:01 47
Mitchell Data Version:OEM: DEC_15_V
Copyright (C) 1994 - 2015 Mitchell International Page 1 of 3
Software Version:7.1.191 All Rights Reserved
Date: 3/19/2016 06:34 AM
Estimate ID:47
Estimate Version:0
Preliminary
Profile ID:* Mitchell
20 AUTO REF REFINISH L Fender Outside C 1.6
21 103913 BDY REMOVE/INSTALL R Fender Moulding 0.2
22 103914 BDY REMOVE/INSTALL L Fender Moulding 0.2
23 104179 GLS REMOVE/REPLACE W/Shield Glass FW03822GTY 722.50 4.5 #
24 AUTO BDY REMOVE/REPLACE Add w/Rain Sensor 0.6
25 101111 REF REFINISH R Frt Mirror Cover C 0.7
26 101112 REF REFINISH L Frt Mirror Cover C 0.7
27 101115 BDY REMOVE/INSTALL R Frt Rear View Mirror 0.8 #
28 101116 BDY REMOVE/INSTALL L Frt Rear View Mirror 0.8 #
29 101099 BDY REMOVE/INSTALL R Frt Door Trim Panel INC
30 101100 BDY REMOVE/INSTALL L Frt Door Trim Panel INC
31 102923 BDY REMOVE/INSTALL R Roof Rail 0.3 #
32 102924 BDY REMOVE/INSTALL L Roof Rail 0.3 #
33 101447 BDY REPAIR Roof Panel Existing 1.5*
34 AUTO REF REFINISH Roof Panel Outside C 2.4
35 900500 BDY REMOVE/INSTALL luggag rack Existing 1.5**r
36 100007 REF BLEND R Quarter Panel Outside C 0.8
37 101173 REF BLEND L Quarter Panel Outside C 0.8
38 101174 REF BLEND R Quarter Panel Edge C 0.2
39 101175 REF BLEND L Quarter Panel Edge C 0.2
40 100736 BDY REMOVE/INSTALL R Rear Combination Lamp 0.4 #
41 AUTO BDY REMOVE/INSTALL Liftgate Trim Panel 0.4
42 100737 BDY REMOVE/INSTALL L Rear Combination Lamp 0.4 #
43 101157 BDY REMOVE/INSTALL Rear Bumper Cover 1.0
44 AUTO REF ADD'L OPR Clear Coat 3.8
45 AUTO ADD'L COST Paint/Materials 582.80 *
46 AUTO ADD'L COST Hazardous Waste Disposal 94.00 *
* - Judgment Item
# - Labor Note Applies
C - Included in Clear Coat Calc
r - CEG R&R Time Used For This Labor Operation
Estimate Totals
______________________________________________________________________________________________________________________________
Add'l
Labor Sublet
I.Labor Subtotals Units Rate Amount Amount Totals
Body 22.2 53.00 0.00 0.00 1,176.60 T
Refinish 18.8 53.00 0.00 0.00 996.40 T
Glass 4.5 53.00 0.00 0.00 238.50 T
Taxable Labor 2,411.50
Labor Tax @ 8.000 %192.92
Labor Summary 45.5 2,604.42
II.Part Replacement Summary Amount
Taxable Parts 4,403.50
Sales Tax @ 8.000%352.28
Total Replacement Parts Amount 4,755.78
III.Additional Costs Amount
Taxable Costs 676.80
Sales Tax @ 8.000%54.14
Total Additional Costs 730.94
Paint Material Method: Rates
Init Rate = 31.00 , Init Max Hours = 99.9, Addl Rate = 0.00
IV.Adjustments Amount
Customer Responsibility 0.00
I.Total Labor:2,604.42
II.Total Replacement Parts:4,755.78
III.Total Additional Costs:730.94
Gross Total:8,091.14
ESTIMATE RECALL NUMBER: 03/19/2016 06:02:01 47
Mitchell Data Version:OEM: DEC_15_V
Copyright (C) 1994 - 2015 Mitchell International Page 2 of 3
Software Version:7.1.191 All Rights Reserved
Date: 3/19/2016 06:34 AM
Estimate ID:47
Estimate Version:0
Preliminary
Profile ID:* Mitchell
IV.Total Adjustments:0.00
Net Total:8,091.14
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
Point(s) of Impact
12 Front Center (P)
Insurance Co:Kittitas County Risk Pool
Address:205 W 5th Ave. Suite 105
Ellensburg, WA 98926
ESTIMATE RECALL NUMBER: 03/19/2016 06:02:01 47
Mitchell Data Version:OEM: DEC_15_V
Copyright (C) 1994 - 2015 Mitchell International Page 3 of 3
Software Version:7.1.191 All Rights Reserved
PHOTO LOG
Owner: Greg Lutousky
Vehicle: 2015 Audi Q5
Claim Number:
Date of Loss:
Date Inspected:03 -18 -16
Location Inspected:Owners place of business
Damaged Area:Rock chips entire vehicle
1.) rear center hatch assy.
2.) left front corner / rock chips noted on hood, both headlamps assy. , grille assy and fog lamps.
3.) right front corner / rocks chips noted on right head lamp, right fog light, chrome on grille, and hood.
4.) close up of left headlamp / rock chips noted on headlamp and bumper assy.
5.) hood -windshield / rock chips noted on both hood top and pitting noted on windshield.
6.) lower right corner / rock chips noted on right headlamp, grille , bumper and hood.
7.) lower left / rocks chips noted on fog lamp assy and lower grille.
8.) lower front grille, pitting noted on chrome portion of grille
9.) vin plate:
10.) vehicle ID tag
11.) odometer ( 22,937)
12.) Registration / vehicle registered in owner’s business name.
13.) left rear
14.) rear center
1.) Rear hatch and bumper assy.
2.) left front / rock chips marks on hood, fenders, grille,headlamps
3.) right front corner / rock s chips on bumper, grille, headlamps, hood
4.) right front headlamp deep chip marks in lens assy.
5.) Top of hood right side heavy rock chips.
6.) lower right front headlamp, grille, fog lights marked with chips
7.) outer grille assy. , left fog light marked with rock chips.
8.) front grille assy, / chrome marked with rock chips.
9.) vin plate
10.) vehicle ID information
11.) odometer
12.) registration
13.) left rear corner , top and side mirrors marked with chips.
14.) rear center