01/14/2010 AT 11:25 AM JOB NUMBER: 24233 101574 ROYAL MOORE BUICK PONTIAC GMC INC 1459 SE ENTERPRISE CIRCLE HILLSBORO, OR 97123 (503)648-4542 FAX: (503)693-1373 PRELIMINARY SUPPLEMENT 1 WITH SUMMARY WRITTEN BY: MARK HAILE ADJUSTER: INSURED: KHOI NGUYEN CLAIM # OWNER: KHOI NGUYEN POLICY # ADDRESS: **************** DEDUCTIBLE: HILLSBORO, OR 97123 DATE OF LOSS: 12/22/2009 DAY: TYPE OF LOSS: BUSINESS: POINT OF IMPACT: INSPECT ROYAL MOORE BUICK PONTIAC GMC IN BUSINESS: (503)648-4542 LOCATION: 1459 SE ENTERPRISE CIRCLE HILLSBORO, OR 97123 INSURANCE METLIFE COMPANY: 7 DAYS TO REPAIR 2009 MAZD 3 4-2.3L-FI 4D WGN SILVER INT: VIN: JM1BK*********** LIC: OR PROD DATE: ODOMETER: 10622 AIR CONDITIONING REAR DEFOGGER TILT WHEEL CRUISE CONTROL TELESCOPIC WHEEL INTERMITTENT WIPERS KEYLESS ENTRY REAR WINDOW WIPER STEERING WHEEL CONTROLS MESSAGE CENTER BODY SIDE MOLDINGS DUAL MIRRORS CONSOLE/STORAGE TRACTION CONTROL STABILITY CONTROL FOG LAMPS REAR SPOILER CLEAR COAT PAINT POWER STEERING POWER BRAKES POWER WINDOWS POWER LOCKS POWER MIRRORS AM RADIO FM RADIO STEREO SEARCH/SEEK CD PLAYER AUXILIARY AUDIO CONNECTIO ANTI-LOCK BRAKES (4) DRIVER AIR BAG PASSENGER AIR BAG HEAD/CURTAIN AIR BAGS FRONT SIDE IMPACT AIR BAG 4 WHEEL DISC BRAKES CLOTH SEATS BUCKET SEATS 5 SPEED TRANSMISSION OVERDRIVE ALUMINUM/ALLOY WHEELS ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 S01 FRONT SUSPENSION 2 S01 O/H FRT SUSP LT M 2.8 M 3* S01 REPL LT ROTOR 2.3L 1 99.72* INCL. 4 S01 REPL RT BEARING RETAINER RING 1 8.03 5 S01 REPL LT BEARING FROM 1/05 W/ABS 1 54.53 MINCL. 6* S01 REPL LT LOWER CNTRL ARM W/O TURBO 1 152.55* MINCL. M 7 S01 REPL LT KNUCKLE W/ABS 1 144.79 MINCL. M 8 S01 REPL LT STRUT W/O TURBO W/17" WHEEL 1 135.88 MINCL. 9 WHEELS 10* S01 REPL LT/FRONT WHEEL, ALLOY 17" LIO 1 500.35* M 0.4* M FUNG 11* S01 REPL LT/REAR WHEEL, ALLOY 17" LIO 1 500.35* M 0.4* M FUNG 12# SUBL ALIGNMENT 1 80.00 X 13# S01 SUBLET MARK-UP, ALIGNMENT 1 20.00 14# SUBL MOUNT AND BALANCE, X"S TWO 1 36.00 X 15# S01 SUBLET MARK-UP 1 9.00 16# S01 SUBL DIAGNOSE 1 105.00 X 17# S01 NITROGEN, TIRE, 2X'S 1 10.00 0.6 M 18# S01 TOW BILL 1 70.00 19# S01 SUBLET MARK-UP 1 17.50 ------------------------------------------------------------------------------- SUBTOTALS ==> 1943.70 4.2 0.0 PARTS 1722.70 MECHANICAL LABOR 4.2 HRS @$105.00/HR 441.00 SUBLET/MISC. 221.00 ---------------------------------------------------- SUBTOTAL $ 2384.70 ---------------------------------------------------- GRAND TOTAL $ 2384.70 ADJUSTMENTS: DEDUCTIBLE 0.00 ---------------------------------------------------- CUSTOMER PAY $ 0.00 INSURANCE PAY $ 2384.70 WE CONDITIONALLY GUARANTEE ALL WORK PERFORMED AND ALL INSTALLED BY "ROYAL MOORE INC." FOR AS LONG AS YOU OWN YOUR VEHICLE. THIS WARRANTY COVERS ONLY REPAIRS MADE NECESSARY DUE TO WORKMANSHIP AND SAID REPAIRS MUST BE PERFORMED BY "ROYAL MOORE, INC." THIS WARRANTY DOES NOT COVER CONDITIONS RESULTING FROM MISUSE, NEGLIGENCE, ALTERATION, ACCIDENT OR RUST. PARTIAL REPAIRS INSISTED UPON AND SO ORDERED BY CLIENT ARE NOT COVERED UNDER THIS WARRANTY, NOR WILL "ROYAL MOORE INC." ACCEPT ANY LIABILITY FOR SUCH REPAIRS. THIS ESTIMATE ALSO DOES NOT REFLECT ANY HIDDEN DAMAGES FOUND DURING THE REPAIR PROCESS, AND DOES NOT INCLUDE ANY CONSIDERATION FOR PART PRICE CHANGES AS PERVIDED BY DEALER INVOICES.