PROGRESSIVE®
Payment Address Document Address
24344 Network Place P.O. Box 94639
Chicago, IL 60673-1243 Cleveland, Ohio 44101-9908
Phone: (877)818-0139
Fax: (888) 781-6947
3/3/2023 10:19:00 AM
Certified Mail certified number 9489-0090-0027-6330-8094-32 Return Receipt Requested
RIALTO CITY CLERK'S OFFICE
150 S. PALM AVE.,
RIALTO, CA 92376
Your Client: CITY OF RIALTO POLICE DEPT CITY CLERK RECEIVED 2023 MAR 14 AMII: 14 CITY OF RIALTO Your Claim Number: N/A
Our Insured: TAPIA VELAZQUEZ, PABLO
Our Claim Number: 22-4227389
Amount Subject to Reimbursement: $1,940.58
Amount of Insured's Deductible: $500
Please take this as formal notice of our subrogation rights relative to the above -captioned claim. We have completed our investigation into the facts of the above-captioned loss and find that your insured was the proximate cause of the accident.
Location of Loss: PARKED AT 1605 S RIVERSIDE AVE, RIALTO, CA Date and Time of Loss: 10/01/2022, 12:30 PM
Description of Loss: OUR INSURED'S VEHICLE WAS PARKED AT 1605 S RIVERSIDE AVE, RIALTO, CA WHEN A CITY POLICE VEHICLE OPERATERD BY OFFICER R. LAMM, FAILED TO MAINTAIN
PROPER LOOKOUT AND CONTROL OF VEHICLE, WHILE ATTEMPTING TO PARK NEXT TO OUR INSURED'S VEHICLE, STRUCK OUR INSURED'S VEHICLE. WE ARE SEEKING REIMBURSEMNT FOR OUR INSURED'S VEHICLE DAMAGES.
Please make your draft payable to Progressive West Insurance Company as subrogee of "TAPIA VELAZQUEZ, PABLO" ", in the amount stated above and mail it to the attention of the undersigned at your earliest convenience.
All supporting documentation is enclosed. Thank you for your anticipated, prompt attention to this matter.
Matther Hayward.
Progressive Subrogation
Progressive West Insurance Company
Tel. 877-818-0139
Fax. 888-781-6947
[email protected]
CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2023 MAR 14 AMII: 14
TO PERSON OR PROPERTY RECEIVED
CITY CLERK
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occurrence (Gov. Code §911.2).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code §911.2). RETURN TO:
3. READ ENTIRE CLAIM FOR BEFORE FILING
Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mail: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
Progressive West Insurance Company A/S/O TAPIA VELAZQUEZ, PABLO
FULL NAME DATE OF BIRTH
OH 44101
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: _ 10/01/2022 TIME: 12:30 PM •AM ≥ PM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
Where appropriate, give street names and addresses, measurements and landmarks.
PARKED AT 1605 S RIVERSIDE AVE, RIALTO, CA
3. HOW DID DAMAGE OR INJURY OCCUR?
OUR INSURED'S VEHICLE WAS PARKED AT 1605 S RIVERSIDE AVE, RIALTO, CA WHEN A CITY POLICE VEHICLE OPERATERD BY OFFICER R. LAMM, FAILED TO MAINTAIN PROPER LOOKOUT AND CONTROL OF VEHICLE, WHILE ATTEMPTING TO PARK NEXT TO OUR INSURED'S VEHICLE, STRUCK OUR INSURED'S VEHICLE. WE ARE SEEKING
4. WERE POLICE AT THE SCENE? YES NO WERE PARAMEDICS AT THE SCENE? YES NO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
KNOWN CV HIT PARKED IV
CITY OF RIALTO POLICE DEPT
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ $1,940.58 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: Amount: $
Item/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ $1,940.58 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date:
Amount: $Y OF RIALTO
Item/Date:
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: AR T4 AMII: 14
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessay CLERK ADDRESS: ADDRESS:
TELEPHONE: () TELEPHONE: _)
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: () TELEPHONE: |)
DATE: TIME: L AM LIPM DATE: TIME: • AM • PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of streets, including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by "X" and by showing house numbers or distances to street corners.
If a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the accident by "B-1" and the point of impact by "X".
→ NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT.
CURB
PARKWAY
SIDEWALK
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
MATTHEW HAYWARD 3/3/2023
-
TYPE OR PRINT NAME DATE
Progressive West Insurance Company
SUBROGATION SPECIALIST
RELATIONSHIP TO CLAIMANT
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376
CITY OF RIALTO
2023 MAR 14 AMII: 14
CITY CLERK RECEIVED
Claim Payment Detail (22-4227389 )
- Payment Information
Disbursement Number: 785789289 Total Amount: $1,440.58
EFT Trace Number: 715535086 Invoice Number: 103190167
Pay to the Order of: ALLSTAR COLLISION INC
Mailing Address:
CORONA, CA 92882-1965 USA
In Payment Of: Progressive Invoice Number: 103190167
- Reviewed Summary
Issuing Rep: A081064 Approved By:
Issue Date: 10-25-22 Review Date:
Last Updated Rep: A081064 Reviewed By:
-Bank Information
Type: Loss Bank Code: стВ
Stop Reason: Cleared: 10-27-22
Stop Date:
Exposure Detail: COLL
Party Name: TAPIA VELAZQUEZ, PABLO Amount Paid: $1,440.58 Property Description: 20 HONDA CIVIC Deductible Taken: $500.00 Payment Type: FINAL PAYMENT Property Damage: $0.00
Rental: $0.00
ALLSTAR COLLISION Estimate ID
522 RAILROAD ST, CORONA, CA 92882-1965 22-4227389-01
Office: (951) 279-9161 CITY OFSIALTO
Fax: (951) 279-1821 Claim Number
2023 MAR 14 22-4297389-01
[email protected]
Owner Insured Appraiser RECEIVED
PABLO TAPIA VELAZQUEZ PABLO TAPIA VELAZQUEZ GERRY MACIĂSCLERK [email protected]
Supplemented By Underwriter
GERRY MACIAS Progressive West Ins Co
[email protected]
Progressive West Ins Co
Insurance Company Claim Number Adjuster Deductible
Progressive West Ins Co 22-4227389-01 LEAH HALPAIN 500.00 - Not Waived (440) 910-4285 (Work)
[email protected]
Reported Date Loss Date Inspection Site
10/01/2022 10/01/2022 CARSTAR Allstar Collision (S
WE)
Corona CA 92882
Mobile)
2020 Honda Civic Sport 4 Door Sedan 2.0L 4 Cyl Gas Injected Auto Trans FWD Exterior Color License Condition
NH883P (Platinum White Good
Pearl)
Drivable Odometer Production Date Mitchell Service Code Yes 30192 02/2020 911818
Primary Point of Impact
Left Rear Side (8)
Options
Air Conditioning Alum/Alloy Wheels AM-FM Stereo Anti-Lock Brake Sys. (ABS) Auto Air Condition Automatic Headlights Auxiliary Input Bluetooth Wireless Cloth Seat Cruise Control Connectivity
Daytime Running Lights Driver-Front Air Bag Electric Defogger Electronic Stability Control First Row Bucket Seat Fog Lights Keyless Entry System Leather Steering Wheel Left-Curtain Air Bag MP3 Player Passenger-Front Air Bag Power Door Locks Power Remote Mirror Power Steering Power Windows Rear Bench Seat Rear Spoiler Rearview Camera Remote Vehicle Starter Second Row Side Airbag With System Head Protection
Side Airbags Smart Key System Steering Wheel Mounted Telematic Systems Theft Deterrent Sys.
Audio Control
Tilt Steering Wheel Tire Pressure Monitoring Traction Control/Electronic Trip Computer System
Committed On Version Mitchell Cloud Estimating™ Printed On Profile 10/24/2022 CALIFORNIA ALL PART TYPES Page 1 of&
10/24/2022 Mitchell Estimating 22.3 Copyright 1994-2022 Mitchell International, Inc 07:24 AM OEM OCT _22_V All Rights Reservec 07:24 AM
Profile Version
17.0 PABLO TAPIA VELAZQUEZ | 2020 Honda Civic Sport
Parts Profile Parts Profile Version CITY OF RIALTO
CALIFORNIA ALL PART TYPES NW 4.0
SWE 2023 MAR 14 AMI: 15
- LABOR REPARVED
Line # Description Operation Type Total Units Type Number CITY CLER Koty Total Price Tax Rocker / Pillars / Floor
S1 1 100389 L Roof Rail Blend Refinish 0.7# C Existing
2 100630 L Rocker Moulding Remove / Body 0.5 Existing
Install
Rear Door
3 101895 L Rear Door Outside Blend Refinish 0.8 C Existing 4 101405 L Rear Otr Door Belt Remove / Body 0.2# Existing Moulding Install
5 101903 L Rear Door Trim Panel Remove / Body 0.4 Existing Install
6 101913 L Rear Otr Door Handle Remove /Body 0.3 Existing Install
Roof
7 101418 L Roof Moulding Remove / Body 0.3 Existing
Install
Quarter Panel
8 100363 L Fuel Door Blend Refinish 0.2# C Existing
S1 9 103586 L Quarter Outer Panel Repair Body 5.0*# Existing S1 10 AUTO L Quarter Panel Outside Refinish Refinish 2.2C Existing Only
11 101131 L Quarter Fuel Filler Housing Remove / Body 0.5r# Existing Install
12 102680 L Quarter Wheelhouse Liner Remove / Body 0.4г Existing Install
Quarter Glass
13 100221 L Quarter Glass Remove / Glass 1.7# Existing
Install
Rear Lamps
14 100294 L Rear Combination Lamp Remove / Body 0.3 Existing Install
Rear Bumper
15 100297 Rear Bumper Cover Remove / Body 0.8 Existing
Install
16 101061 Rear Bumper Cover Repair Body 2.0° Existing
17 AUTO Rear Bumper Cover Refinish Refinish 2.6 C Existing Only
Additional Costs & Materials
18 AUTO Paint/Materials Additional $432.60* Yes
Cost
19 936012 Hazardous Waste Disposal Additional $4.00*
Cost
Additional Operations
20 AUTO Three Stage Additional Refinish 3.8 $0.00
Operation
Special / Manual Entry
21 900500 COVER CAR FOR Additional Body* 0.2° Aftermarket **Qual Repl Part 1 $10.00* Yes OVERSPRAY Labor New
Committed On Version Mitchell Cloud Estimating™ Printed On CALIFORNIA ALL PART TYPES Page 2 0f8 10/24/2022 Mitchell Estimating 22.3 Copyright 1994-2022 Mitchell International, Inc. 10/24/2022 07:24 AM All Rights Reserved 07:24 AM
Profile Version
17.0 - LABOR PART
Line # Description Operation Type Total Units Type Qty Total Price Tax
0.0* NONe OF RIAL T65.00*
S1 22 900500 PRO-TRIM Remove / Body* Sublet
Replace 2023 MAR 14
S1 23 900510 Line Markup 25.0% AM 11:51625
24 900501 SUPPLY & INSTALL DOOR
CLEAR DOOR EDGE CITY CLERK RECEIVED
GUARD
* JudgmentItem C Included in Clear Coat Calculation
T Included in Two Tone Calculation A Included in Clear Coat and Two Tone Calculation # Labor Note Applies r CEG R&R Time Used for this Labor Operation d Discontinued by Manufacturer [ ] Verify the part number and price before ordering Disclaimer: This estimate has been prepared based on the use of crash parts supplied by a source other than the manufacturer of your motor vehicle. Any warranties applicable to these replacement parts are provided by the manufacturer or distributor of the parts, rather than by the original manufacturer of your vehicle.
Estimate Totals
Labor Units Rate Sublet Add'l Amount Totals
Body Labor 10.9 $60.00 $654.00
Refinish Labor 10.3 $60.00 $618.00
Glass Labor 1.7 $60.00 $102.00
Total Labor 22.9 $1,374.00
Taxable $0.00
Tax 0.0000% $0.00
Non-Taxable $1,374.00
Labor Total $1,374.00
Parts Amount
Taxable Parts $10.00 $10.00
Parts Adjustments $16.25
Tax 8.7500% $0.88
Non-Taxable $65.00
Parts Total $92.13
Costs Amount
Other Additional Costs $4.00 $4.00
Paint Materials $432.60 $432.60
Taxable $432.60
Paint Materials Rate: $42.00 Tax 8.7500% $37.85
Rate Max: 99.9 units Non-Taxable $4.00
Additional Rate: $0.00 Costs Total $474.45
Gross Totals Amount
Gross Total $1,940.58 $1,940.58
Taxable $442.60
Tax $38.73
Non-Taxable $1,459.25
Gross Total $1,940.58
Adjustments Amount
Deductible -$500.00 -$500.00
Total Customer -$500.00
Responsibility
Committed On Version Mitchell Cloud Estimating T Printed On CALIFORNIA ALL PART TYPES Page 3 off 10/24/2022 Mitchell Estimating 22.3 Copyright 1994-2022 Mitchell International, Inc. 10/24/2022 07:24 AM OEM OCT_22_V 07:24 AM SWE
All Rights Reserved 170 versions
Estimate Totals
Net Estimate Total $1,440.58
Less Original Net Total RIAL TO $1,625.58
-$185.00
1: GERRY MACIAS -$185.00
Shop agrees to perform the specified repairs at the price indicated.
Repair Facility Authorized Signature
All manufacturers requirements regarding seat belt and supplemental restraint system replacement must be adhered to. If additional parts or operations are necessary to properly accomplish this, please contact the estimating claims rep.
THIS APPRAISAL HAS BEEN PREPARED BASED ON THE USE OF CRASH PARTS
SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE
PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAN BYTHE ORIGINAL MANUFACTURER OF YOUR VEHICLE. WE WARRANT THE PARTS
ARE AT LEAST EQUAL TO THE ORIGINAL MANUFACTURER PARTS IN TERMS OF KIND, QUALITY, SAFETY, FIT, AND PERFORMANCE.
************* IMPORTANT INFORMATION: READ CAREFULLY************* The customer has the right to select the repair shop. Pursuant to CA Code of Regulations sec 2695.8(e) Progressive does not require you to have your vehicle repaired at a specific repair shop. The customer has the right to select a repair shop of their choice. This is a damage appraisal only based on damage visible or certain at the time it was written. Per Business & Professions Code section 9884.9 the customer, not Progressive, must give authorization for the repairs before they can begin. This appraisal is not an authorization for Committed On Version Printed O CALLFORNIA ALL PART TYPES Page 4 of g 10/24/2022 Mitchell Estimating 22.3 opyrich 194-202 MEte international, In 10/24/2022 07:24 AM OEM OCT 22 V Il Rights Reserve 07:24 AM SWE
Profile Version
17.0 repairs. If frame or unibody repair is included on this appraisal, the amount shown includes time or allowance for measuring before, during CITY OF RIALTO and after those repairs. To ensure proper and prompt payment for 2023 MAR 14 AMI: 15 additional damage discovered during the course of repairs, contact CITY CLERK RECEIVED Progressive for supplement procedures. Progressive honors the prevailing labor market rate in your area for your property. If you choose a shop that charges in excess of prevailing labor market rates, you will be responsible for the difference.
Lifetime guarantee for sheetmetal and plastic parts.
The replacement parts written on this appraisal are intended to return your vehicle to its pre-loss condition with proper installation.
After repair, if any sheet metal or plastic body part included in this appraisal fails to return your vehicle to its pre-loss condition (assuming proper installation), in terms of form, fit, finish, durability or functionality, Progressive will arrange and pay for the replacement of the part, to the extent not covered by a manufacturer's or other warranty. This service will be performed at no cost to you (including associated repair and rental car costs). To obtain service under this Guarantee, call Progressive at 1-800-274-4641. This Guarantee applies as long as you own or lease the vehicle. This Guarantee is not transferable and terminates if you sell or otherwise transfer your vehicle.
THIS GUARANTEE DOES NOT COVER NORMAL WEAR AND TEAR OR DAMAGE CAUSED BY IMPROPER MAINTENANCE, NEGLECT, ABUSE OR SUBSEQUENT ACCIDENT. THIS
GUARANTEE IS LIMITED TO ARRANGING FOR THE SELECTION OF REPAIR PARTS THAT WILL RETURN YOUR VEHICLETO ITS PRE-LOSS CONDITION. ACCORDINGLY,
PROGRESSIVE WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL OR
CONSEQUENTIAL DAMAGES THAT RESULT FROM THE INSTALLATION OR USE OF Committed On Version Mitchell Cloud Estimating T Printed On CALIFORNIA ALL PART TYPES Page 5 of 8 10/24/2022 Mitchell Estimating 22.3 0/24/202
Copyright 1994-2022 Mitchell International, Inc. 7.24 A SWE 07:24 AM OEM OCT 22 V All Rights Reserved
Profile Version
17.0 THESE PARTS.
California Residents: As required by California regulations, the CITY OF RIALTO legend below should be used to identify whether replacement parts 2023 MAR 14 AMII: 15
RECEIVED
listed on this appraisal are "new", "used", "rebuilt", or CITY CLERK "reconditioned" and whether the crash parts described on this appraisal are "original equipment manufacturer" (OEM) parts or "non-original equipment manufacturer aftermarket crash" parts.
New, OEM or part number displayed = New, original equipment manufacturer part
Aftermarket New, nonOEM aftermarket = New, non-original equipment manufacturer aftermarket crash part
Remanufactured = Rebuilt used OEM part
Used, Quality Recycled Part = Used OEM part
Re-cored = Reconditioned used OEM part
Re-chromed = Reconditioned used OEM part
Sublet = Repair work assigned to third party
Existing = Part is already on the vehicle
Progressive's Lifetime Guarantee does not cover repairs you request the shop to make that are not related to this accident, including but not exclusive to unrelated prior damage and pre-existing damage. "For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison."
Disclaimer: For your protection California law requires the following statement to appear on this form. Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison.
Cycle Time Information Estimate Event Log
Due In 10/18/2022 Job Created 10/13/2022 12:34 PM
Estimated Completion Date 10/26/2022 Supplement 1 Started 10/18/2022 01:27 PM Supplement 1 Printed 10/24/2022 07:24 AM
Arrived At Shop 10/18/2022 Supplement 1 Committed 10/24/2022 07:24 AM Estimate Version 1
Committed On Version Mitchell Cloud Estimating™ Printed On CALLFORNIA ALL PART TYPES Page 6 off Mitchell Estimating 22.3 Copyright 1994-2022 Mitchell International, Inc 10/24/2022 00-244022 OEM OCT 22_V 07:24 AM
All Rights Reserved Profile Version
17.0 Date: 10/24/2022 7:24:56 AM
Estimate ID: 22-4227382-01
Supplement: 1 - 10/24/20229524:55,AM
Profile ID: CALIFORNIAPALL PART TYPES
SWE AMI: 15
CITY CLERK RECEIVED
Supplement Delta Report
Comparison of Estimate 22-4227389-01 Supplement 0 and Supplement 1 Damage Assessed By: GERRY MACIAS
Supplemented By: GERRY MACIAS
Insured: PABLO TAPIA VELAZQUEZ
Owner: PABLO TAPIA VELAZQUEZ
Vehicle: 2020 Honda Civic Sport
Date of Loss: 10/01/2022
Line Labor Line Item Part Dollar Labor CEG
Item Type Operation Description Type/Num Amount Units Unit Changed Entries
Refinish REFINISH L Roof Rail Existing
1 0.00 1.60 1.60
Existing
Refinish BLEND< L Roof Rail Existing
1 0.00 0.70< 0.80-
Existing
Body REPAIR L Quarter Outer Panel Existing 0.00 7.5* 0.00 9 Existing
REPAIR L Quarter Outer Panel Existing 5.00• 0.00
9 Body Existing 0.00
18 ADD'L COST Paint/Materials 478.80* T
18 ADD'L COST Paint/Materials 432,600 T
20 Refinish ADD'L OPR Three Stage 0.00 4.00 0.00
20 Refinish ADD'L OPR Three Stage 0.00 3.80< 0.00
Added Entries
REMOVE/REPLACE PRO-TRIM Sublet 65.00* 0.0* 0.00
22 Body Sublet
23 LINE MARKUP Line Markup 25.0% 16.25
SUPPLY & INSTALL
24 DOOR CLEAR DOOR
EDGE GUARD
Committed On Version 0124/202 CALIFORNIA ALL PART TYPES Page 7 of8 10/24/2022 Copyrial 94-202 dehi termational, nc.
07:24 AM 7:24 AM
All Rights Reserved Profile Version
17.0 Global Changes
CITY CLERK
Original
Estimate 1,625.58
Supplement
1 -185.00
Orig Total
Tax 42.78
Supp 1 38.73
Total Tax
Net
Supplement -185.00
Amount
Net Total 1,440.58
Program Calc Data Versions
Version
Supp 0 2 OCT 22V
Supp 1 2 OCT_22_V
Software Copyright (C) 1994 - 2022 Mitchell International
22.3 Version:
All Rights Reserved
Committed On Version Printed On Profile Page 8 of8
Mitchell Cloud Estimating™ 10/24/2022 CALIFORNIA ALL PART TYPES 10/24/2022 Mitchell Estimating 22.3 Copyright 1994-21 Rights Reservederational, Inc. 07:24 AM 07:24 AM SWE
Profile Version
17.0 CITY OF RIALTO
2023 MAR 14 AMII: 15
CITY CLERK RECEIVED
Claim: 22-4227389 01 PABLO TAPIA VELAZQUEZ
Left Front.jpg Left Rear.jpg
187262930
Right Rear.jpg Right Front.jpg
CITY OF RIALTO
2023 MAR 14 AMII: 15
CITY CLERK RECEIVED
Claim: 22-4227389 01 PABLO TAPIA VELAZQUEZ
Photo 03.jpg Photo 04.jpg
Photo 02.jpg Photo 07.jpg
Progressive
PO Box 94639
Cleveland, OH 44101
0090 0027 6330 8094
CITY CLERK RECEIVED 2023 MAR 14 AMII: 15 CITY OF RIALTO
PROGRESS/I
Milil
jiijolll
CELTIPO
erdlz M + 80 C202
Sin
2/ 900953