CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY
CITY OF RIALTO
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY 2074 JAN 23 AMID: 18
RECEIVED
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occumence (Gov. Code §911.2). CITY CLLAX
2. Claims for damages to real property must be filed no later than one (1) year after the occumence (Gov. Code 59112).
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., Riatto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
EAnEVAnS
FULL NAME DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO. 2217 E. 4TH STRET, OMARIO, CA 91764 157965-1063
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE LOSe N. TEASURD, BIALTO
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(it different from home address provided above): CA 92376
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 11-27-2023 TIME: 10:75 DAMOPM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
FOOD 4 LESS SHOPING CENTER LOCATED ON SOOTHE AN
CEDAR INCIDENT OCCLRER AT SOTHERA EXIT (SEEITERAT).
3 HOW DID DAMAGE OR INJURY OCCUR?
FRONT FASSENGER BIm TIRE DETACHED FrOm
VEHICLE KESULTAG FROM UNATTUNDED POTHOLE LOCATIO
SNIn SIDEWALEXIT.
4. WERE POLICE AT THE SCENE? P Z YES • NO WERE PARAMEDICS AT THE SCENE? YES DANO
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 ok damage, if known.
INANEANED tOOLE THAT THE CIT OF bIALTO HAS
FAILED TO ADDRESS AND REPAIR TO THIS DATE.
6. GIVE TOTAL AMOUNT OF CLAIM include estimate of amount of any prospective injury or damage $5,286.18 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
TRE/ 12-11-2023/TO0 Amounts 290.00/1204
Item/Date:
Item/Date: REPAR LABOR /PARES Amount: $ 480.00 310.
: TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ 5,288.18 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: ESTIMAK- BODY REPAIR (12-3024 Amount: $ 3,727.12 Item/Date: Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $3.727.62
1. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) BALTO PD | SEE DEPORT
ADDRESS: ADDRESS:
TELEPHONE: ( TELEPHONE: | 1
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITALS) VISITED:
NAME: N/ A HIA
ADDRESS: ADDRESS:
TELEPHONE: 12//4 TELEPHONE: _ M/#
DATE: TIME: • AM •PM 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 op 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 FY THE SITUATION, RLEASEATTACH A PROPER DIAGRAM SIONED BY THE CLAMANT 2024
CURB AN
CITY OF RIALTO
PARKWAY
X SIDEWALK ERK
AMIC: 18
I HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS TO
THOSE MATES WIGH ARE HERE ATED UPON MY NIE ALTO PERLE THAT RETE TRUE ARE TORET,
SIGNATURE OF CLAIMANT OR AGENT
JeAn Eums 1-23-2024
TYPE OR PRINT NAME DATE
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, CÁ 92376
CAD Operations Report
231127-0108 Printed: 1/10/2024 1:14:09 PM
Call Number:
Call Detall Information Jurisdiction: RIALTO
Pos Call Owner Status Date - Time Received
Call Number Taker
DGALLAR C 11/27/2023 10:26:46 0
231127-0108 3
--
Ten Code Priority Fire Grade Class Alarm How Received
Complaint
3 T WIRE
1126
Apart/Suite Fir Incident City State ZIP
Incident Location
SHOPPING CTR // W FOOTHILL RIALTO CA 92376
Caller Name Telephone Alt Telephone Tower ID
SHAWN EVANS 951-965-1063 909-511-0306
Caller Location Apart/Suite Fir Caller City State ZIP
8028 FOOTHILL BLVD FON CA 92376
Landmark Weapons
IRA Grid Disp Zone Fire Run Zn EMS Run Zn ESN Tract
132 3
Contacts Fire Plan Hazard Images Medical Traffic Previous BOLO Warrant RMS CH RMS Al InProg Rpt Rea Sub Reg
Ali Time Call Rec'd Xmit Dispatch Enroute OnScene Departed Arrived 10:26:29 10:26:46 10:28:53 10:29:38 10:29:38 10:34:22
Comp Unit X. Y: Z:
10:56:10 M1
LWE: Upr:
W FOOTHILL BLVD N CEDAR BLVD
CONTROLLED COPY
CONFIDENTIAL COPY
RESTRICTED PC 11142-111.
NOT FOR THIRD PARTY RE
PAPHE RIALTO POLICE DEPAF
EVILI VIVU
1/10/2024 1:14:09 PM
Narrative...
[11/27/2023 10:56:09: pos4 : SPAVLOVICH]
[Cleared with unit m1]
[11/27/2023 10:56:08 : pos4: SPAVLOVICH]
Unit: m1
veh out of roadway, nat
[11/27/2023 10:35:05 : pos3: DALLARDO!
PEPES ADV // ER
[11/27/2023 10:34:33: pos4: SPAVLOVICH]
Unit : m1
1185
11/27/2023 10:30:15: pos3: GALLARDO]
1301 SHOPPING CTR
[11/27/2023 10:28:53 : pos3: GALLARDO]
ALI X Coordinate: 34.10696983
ALI Y Coordinate: -117.399044
ALI Z Coordinate: 71
IN MIDDLE OF INNERSECTION
FACING SB - EXITNG FOOD FOR LESS
BLK TOYT FORERUNNER - TIRE POPPED OFF VEH
Department Numbers
Department Dept Number Unit Id
3609 231127-00080 M1
Call Dispositions
Date Time Disposition Unit ID
11/27/202310:56:09 nat m1
Call Log
Unit Status Date Time Dept Type Comments Officers Odo
M1 ENR 11/27/2023 10:29:38 3609 POL SHOOPING CENTER // FOOTHILL, 01323 0 FON
m1 ONS 11/27/2023 10:34:22 3609 POL SHOOPING CENTER I/ FOOTHILL, 01323 0 RIALTO
M1 COM 11/27/2023 10:56:09 3609 POL COM 01323
BUN TREM LIdOW COPY
Unit Dept DIS ENR ONS LEF ARR
CONFIDENT 10:5009 COPY
M1 3609 10:29:38 10:34:22
RESTRICTED PO 11142-1114
NOT FOR THIRD PARTY REI
PaPHE RIALTO POLICE DEPAF
REL TO: SEAN EVANS
BY: M.M. 01.10.2024
PO Box 7450, Moreno Valley CA 92552 Pepe's Towing Serv
Printed 11/27/3
Phone: (951) 682-5682 | Fax: (951) 682-5030
Released To SEAN EVANS Reason for Impound O/R OWNERS REQUEST 23-1127-25555 VIN Number
Invoice #
25555 Model
Call # 1997 Toyota 4Runner (Black)
Case # O/R
License Plate 3XVH405 (CA)
Case # O/R
Drivable Yes
RIALTO PD
Account Keys Yes INSIDE VEHICLE
Date/Time Requested 11/27/2023 10:38 AM
11/27/2023 10:38 AM Towed from FOOTHILL AND CEDAR
Date/Time Dispatched Stored at Rialto Yard
Date/Time Towing Time: 11/27/2023 11:03 AM
11/27/2023 12:00 AM 2775 N Locust, Rialto CA 92377
Date/Time Completed:
Date/Time Impounded: 11/27/2023 10:38 AM
Vincent G.
priver
TRK 89
Truck
Date/Time Released: 11/27/2023 2:04 PM
Days Held in Impound 1 days
Notes
Quantity Price Line T
Storage charges
1 $70.00 $70
(Storage - Storage Fees) Impounds/Storage: Daily Impound Rate Quantity Price Line Ta
Towing charges
1 h $350.00 $350
(Towing) TOWING FEE PORT TO PORT (price per hour)
Towing SubTotal $350.
Storage - Storage Fees SubTotal $70.1
Subtotal $420.0
Taxes $O.
Grand Total $420
Amount Due: $0.00 / P
Visa payment (Ref # CC 7598) of $420.00 applied on 11/27/20 Pepe's Towing Service appreciates your business; if you have any questions regarding this invoice, please contact us at 951-682-5682. Thank you.
Damage Disclaimer:
Have been advised that my vehicle may be damaged if winched, towed, unlocked, jump started, tire changed or left on unattended premises. I recognize the ficulty involved and I agree not to hold Pepe's Towing Service responsible for such damages should it result. I, the undersigned do hereby certify that l am le uthorized and entitled to take possession of the vehicle described and all personal property therein. I have received the vehicle and all personal property in itisfactory condition.
nature: Date: _
CA# 117433 USDOT: 1005094
pon request, you are entitled to receive a copy of the Towing and Storage Fees and Access Notice Property Release Form
11/27/23, 12:00 PM
Pepe's Towing Service
PO Box 7450, Moreno Valley CA 92552
Phone: (951) 682-5682 | Fax: (951) 682-5030
Release of Personal Property & Promise to Pay
Reason for Impound O/R OWNERS REQUEST
Invoice # 23-1127-25555
VIN Number
Call # 25555
Model 1997 Toyota 4Runner (Black)
Case # O/R
O/R License Plate 3XVH405 (CA)
Case #
RIALTO PD Drivable Yes
Account
11/27/2023 10:38 AM Keys Yes INSIDE VEHICLE
Date/Time Requested
Date/Time Dispatched 11/27/2023 10:38 AM Towed from FOOTHILL AND CEDAR Date/Time Towing Time: 11/27/2023 11:03 AM Stored at Rialto Yard 2775 N Locust, Rialto CA 92377
Date/Time Completed: 11/27/2023 12:00 AM
Date/Time Impounded: 11/27/2023 10:38 AM
Driver Vincent G.
Truck TRK 89
Description of Property Received
MISC
nformation hereon is true and correct. I also acknowledge that I have read and understand the Advisory printed above and that I have not been certify that I have received, and that I am legally entitled to take possession of, the items listed above from the above described vehicle and tha owing company that is in possession of the vehicle in a timely fashion, notwithstanding any insurance claim. I understand that if 1 do not redee nto signing this document. I also agree to redeem this vehicle and pay the towing, storage and other fees that are due, or may become due, to 1 eficiency balance that may, and probably will, result from the Lien Sale. I understand that the storage charge will increase each day the vehicle ehicle, that it will be sold pursuant to the applicable California Vehicle Codes and/or California Civil Codes and that I will be responsible for the claimed. I understand that the storage rate per calendar day for this vehicle is $70.00 Date:
anature:
CA# 117433 USDOT: 1005094
IMANA TOU
rk Order:. R244008
t Name: ger JT3GN87R4V0031198
it Name: sfgs
inse: 3xvh405
г: 97
inclan: aj
meter: 3453
1/17/09 3:40 AM
Toyota 1997-99 4Runner 4X2
Before Measurements
Left Front Right Front
Camber
Camber
20 3.9°
Caster
Caster
Front
0, 68°
63° Toe
30°
Toe
Total Toe
0.051
02°
Steer Ahead
Right Rear
Left Rear
0 5°
0 Camber
Camber
Reat
-0 07° 0 11°
039 Toa
Toe
Total Too
-0099
Thrust Angle
Current Measurements
Left Front Right Front
10 -0.40
Camber
Camber
Caster
Conter
Front
ioge
1.09 1.198 Toe
Toe
Total Toe
00°
Steer Ahead
Lott Rear Right Rear
0.19 -0 5°
Camber
Camber
0. -0. 409°
04° Toe
Toe
Total Toe
SONORA TIRES Invoice
MUFFLERS - BRAKES - ALIGNMENTS Date Invoice #
17977 Valley Blvd 12/4/2023 145941
Bloomington, CA 92316
MON - FRI BAM-5PM
909-877-6350 SATURDAY 8AM-5PM
SONORATIRESINC.COM 12/04/2023 SUNDAY 8AM-2PM
VIN #
CUSTOMER INFORMATION:
SEAN EVANS
.... Year Make & Model Mileage
1997 TOYOTA 4RUNNER
PAYMENT TYPE
NEW TIRES ONLY. (TIRE ROTATIONS RECOMMENDED EVERY 3,000 MILES OR EVERY OIL CHANGE FREE FLAT TIRE REPAIR & FREE TIRE ROTATIONS FOR THE LIFE OF TIRES, WITH PURCHASE OF REPARACIÓN DE LLANTA Y ROTACION GRATIS POR VIDA DE LA LLANTA. ROTACION SE VISA RECOMIENDA CADA 3,000 MILLAS O CADA CAMBIO DE ACEITE
Price E... Amount
PART# DESCRIPTION
QTY ITEM CODE 480.00
480,00
UPPER AND LOWER BALL JOINT
Labor
BRAKE HOSE
INNER AND OUTER TIE ROD END
14.40) 14.40
| FEES CREDIT CARD 3% FEES CREDIT CARD 3%
MANUFACTURER MILEAGE WARRANTY NO WARRANTY
ON USED TIRES.
40,000 45,000 50,000 55,000 NO WARRANTY
UN ANY TYPE VI
RIM REPAIR
60,000 65,000 70,000 60,000
Subtotal $494.40
NO WARRANTY ON TIRES RAN FLAT
NO WARRANTY ON POTHOLE DAMAGE TIRES SONORATIRESINC
NO REFENDS ON ESED TIRES REFERALS &
NO EXCHANGE OR REEEND, ALS. SALES ARE FINAL Follow us on Instagram! Sales Tax (7.75%) $0.0
DEPOSTIS ARE NOT REFENDABLE NO EXCEPTIONS REVIEWS ARE
W TIRES ARE COVERED UNDER MANUFACTURER DEFECTS Tag us in your photos GREATLY Hoonoretiresinc APPRECIA IEU!
g ta your own your vehicle. Regular tune-ups recommended every 20,800 miles. No warranty on Total $494.40 horize the above regair work te be done along with the necessary matarial, & hereby grant agbrays for the purpose of teating andior inspection of vohicle. An express mount of repairs thereto. Special ordered custom wheels are manufactured to Payments/Credits -$494./ n your order you became liable & unconditionaily accept omerhip, there is no re not responsible for lost hub caps, wheel locka. All auto parta are NEW unless ER MILEAGE WARRANTY. Please vinit the corresponding manufacturer so for MILEAGE WARRANTY Balance Due S0.0/ сира тканану моцио ме мо
arideg. Signs of in odfications, stretched B os due to bed Sales Order
AUTHORIZED
LA SIERRA TIRES & WHEELS AUTHORIZED
AUTHORIZED TRELLI
- 3067 STEERA AVE GOODFVEAR Date S.O. No.
FONTANA. CA 92335 BFGoodrich DEALER
DEALER
909-429-1081 DEALER 12/11/2023 4125
12 11 2023 17:15:25
CREDIT CARD :RRA AVE. FONTANA CA 92335 - (909) 429-1081
VISA CALE
<xxXxxxxxxxX7598 Ship To
Card =
The card Visa Credit
ID A0000000031010
EQ -: 11
6 itch =.
5 ans.
proval Code: 011871
LANS ID: 383346014842021
ty Method Chip Read
sde: Issuer
P.O. No. Project
ALE AMOUNT $100.00
THANK YOU Ordered Rate Amount
Description
116.00 232.00T
CUSTOMER COPY CCELERA IOTA 2 20.01 40.02
DEP$100
BAL$190
Subtotal $272.0
COSTUMER SIGNATURE: Sales Tax (7.75%) S17
CANCELLATION OF ANY WHEEL, TIRE OR SUSPENSION ORDER, Total $29 WILL RESULT IN A 30% RESTOCKING FEE
All sales are final. No refund on deposit six months warranty on chrome finish. All claims must be accompanied by this invo baconeNuTe ARTER 20 MILES. TIGHTEN IF NECESAR
: Fontana Suspension and Auto Repair INVOICE
17474 Foothill bivd Unit A 1302
Fontana, CA. 92335 Org. Est. # 002244
Phone: 909-320-7757 ARD00289338
For all your repair needs!
INVOICE Date: 05/26/2021
EVANS. SEAN 1997 Toyota - 4Runner Limited - 3.4L, V6 (206CI) VIN(N) Lic # : Odometer In: 336989
Odometer Out: 336989
VIN#:
Qty Sale Ext Labor Description Ext
Part Description / Number
1.00 18.72 BALL JOINT - Remove & Replace - Lower,One Side - 110.00 DL OIL PRESSURE SWITCH/Engine
Oil Pressure Switch [DOES NOT include alignment.)
PS254 4 WHEEL ALIGNMENT 80.00
BALL JOINT/Suspension Ball Joint 1.00 70.78 70.78 Hazardous Materials 3.00 MK90263
Labor: 190
Current Estimate 289.39
289.39 Revisions 0.00 Parts: 8
Org. Estimate
HazMat:
SubTotal:
Tax:
Total
Bal Due:
Legments: 1 Thank you for your business! Customer Nurt
Vehicle Received: 5/28/2021
(Thereby suinorie the above repair work to be done along with the necessary material and hereby grant you andor your employees permission to operate the car of truck here described on street, higheys or elsewhere for the purpose to testing and/or inspection. An express mechanic' lien is hereby acknowledged on above car or truck to secure amount of repains hereto. Warranty on parts and tabor is one years or 12,000 miles whichever comes first 1 month on used parts as indicated on invoice. Warranty work hall nomied in our shop & cannot exceed the original cost of repai Date
ALL MAGIC PAINT & BODY FONTANA Workfile ID: 03412b1f
PartsShare: 732BZ9
18150 Foothill Bivd, Fontana, CA 92335 BAR: 296862
Phone: 909) 434-0500
FAX: (909) 822-1602
Preliminary Estimate
Customer: EVANS, SEAN
Written By: Deirdre Ingham
EVANS, SEAN Policy #: Claim #:
Insured:
Date of Loss: Days to Repair: 0
Type of Loss:
Point of Impact: 02 Right Front Pillar (Right
Side
Owner: Inspection Location: Insurance Company:
EVANS, SEAN ALL MAGIC PAINT & BODY FONTANA CUSTOMER PAY 18150 Foothill Blvd
Fontana, CA 92335
Repair Facility
(909) 434-0500 Business
VEHICLE
1997 TOYO 4Runner Limited Automatic 4D UTV 6-3.4L Gasoline EFI BLACK VIN: Interior Color: Mileage In: Vehicle Out:
License: Exterior Color: BLACK Mileage Out:
State: CA Production Date: 12/1996 Condition: Job #:
TRANSMISSION DECOR RADIO SEATS
Automatic Transmission Dual Mirrors AM Radio Bucket Seats Overdrive Privacy Glass FM Radio Leather Seats
POWER Console/Storage Stereo WHEELS
Power Steering CONVENIENCE Search/Seek Aluminum/Alloy Wheels Power Brakes Air Conditioning Cassette PAINT
Power Windows Intermittent Wipers SAFETY Clear Coat Paint Power Locks Tilt Wheel Drivers Side Air Bag TRUCK
Power Mirrors Cruise Control Passenger Air Bag Power Rear Window Power Driver Seat Rear Defogger Anti-Lock Brakes (4) Running Boards/Side Steps Power Passenger Seat Rear Window Wiper 4 Wheel Disc Brakes mer: EVANS, SEAN IYO 4Runner Limited Automatic 4D UTV 6-3.4L Gasoline EFI BLACK Part Number Qty Extended Labor Paint
Орег Description
Price $
RONT LAMPS
R&I RT Park lamp assy to 1/97 0.2
ENDER
R&I RT R&I fender assy 1.5
LLARS, ROCKER & FLOOR
Rpr RT Hinge pillar w/Limited 6.0 1.0
Repl RT Running board 5108335070 1 991.98 1.1
Repi RT Running board mount bracket 5179335010 30.78 Ind. #1
ONT DOOR
R&J RT R&I door assy 0.6
Rpr RT Outer panel w/Limited ZO 2.2
Add for Clear Coat 0.9
R&U RT Belt w'strip 0.3
R&I RT Lower cladding 0.5
Rpr RT Lower cladding 2,0 0.6
Add for Clear Coat 0.1
R&I RT Mirror assy power, SR5 & 0.4
Limited black
R&I RT Door glass Toyota bronze 0.5
* R&I RT Glass run 0.2
R&I RT Handle, outside SR5 & Limited 0.4
dark
R8I RT R&I trim panel 0.4
Corrosion protection 3.00 0.3
Cover car 10.00 0.5
Mask for primer 5.00 X 0.5
Color tint 0.5
Color sand and polish 1.0
Pre scan 0.5 M
Post scan 1 0.5 M
OTHER CHARGES
E.P.C. 1 5.00
SUBTOTALS 1,045.76 24.4 5.3
428433 Page 2
Preliminary Estimate
EVANS, SEAN
ForD 4fumner Umited Automatic 4D UTV 6-3.4L Gasoline EFI BLACK
ESTIMATE TOTALS
Basis Rate Cost $
Category
1,035.76
Parts
Body Labor 23.4 hrs @ $ 75.00 /hr 1,755.00
Paint Labor 5.3 hrs @ $ 75.00 /hr 397.50
Mechanical Labor 1.0 hrs @ $ 135.00 /hr 135.00
Paint Supplies 5.3 hrs @ $ 55.00 /hr 291.50
Miscellaneous 5.00
Other Charges 5.00
Subtotal 3,624.76
Sales Tax $ 1,327.26 @ 7.7500 % 102.86
Grand Total 3,727.62
FOR YOUR PROTECTION CALIFORNIA LAW REQUIRES THE FOLLOWING 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.
THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY
BE USED TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED:
MOTOR ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART,
A=APPROXIMATE PRICE. LABOR TYPES: B-BODY LABOR, D-DIAGNOSTIC, E=ELECTRICAL, F=FRAME, G=GLASS, M=MECHANICAL, P=PAINT LABOR, S=STRUCTURAL, T=TAXED MISCELLANEOUS, X=NON TAXED
MISCELLANEOUS. CCC ONE: ADJ=ADJACENT, ALGN=ALIGN,
A/M=AFTERMARKET, BLND=BLEND, CAPA=CERTIFIED AUTOMOTIVE
PARTS ASSOCIATION, D&R=DISCONNECT AND RECONNECT,
EST=ESTIMATE, EXT. PRICE-UNIT PRICE MULTIPLIED BY THE QUANTITY, INCL=INCLUDED, MISC=MISCELLANEOUS, NAGS=NATIONAL AUTO GLASS SPECIFICATIONS, NON-ADJ=NON ADJACENT, O/H=OVERHAUL,
OP=OPERATION, NO-LINE NUMBER, QTY=QUANTITY,
RECOND=RECONDITION, REFN=REFINISH, REPL-REPLACE, R&I-REMOVE AND INSTALL, R&R=REMOVE AND REPLACE, RPR-REPAIR, RT-RIGHT, SECT=SECTION, SUBL=SUBLET, LT=LEFT, W/O=WITHOUT, W/_=WITH/_ SYMBOLS: #=MANUAL LINE ENTRY, *-OTHER [IE MOTORS DATABASE INFORMATION WAS CHANGED], **=DATABASE LINE WITH AFTERMARKET, N=NOTES ATTACHED TO LINE. OPT OEM-ORIGINAL EQUIPMENT
MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT.
1/2/2024 3:57:45 PM 428433 Page 3
[email protected]
Subject Online Form Submittal: Service Request
Date: Jan 16, 2024 at 8:12:42 AM
1O:
Service Request
Please complete and submit the form to request street maintenance assistance.
Your Name Sean Evans
Your Email
Dangerous Potholes in sidewalk exit.
Subject
Problem With (Check All That Potholes in Street
Apply)
Indicate Major Streets Foothill and Cedar at South Food4Less exit between Home De- pot and Food4Less at stop light.
Your Message A pothole in the south exit of food 4 less parking lot snapped my ball joint leading to my rim/tire being dislodged from my vehicles axle. As an obvious result This incident cause severe damage to my car.