CITY OF RIALTO CITY CLERK'S DATE STAMP
LIABILITY
CITY OF RIALTO
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY 2024 JUL -I AM 8: 10
RECEIYED
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occurence (Gov. Code §911.2). CHY CLERK
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code §911.2).
3.READ ENTIRE CLAIM FOR BEFORE FILING RETURN TO:
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FUJII DETAILS Rialto City Clerk's Office Mail: 150 S. Palm Ave., Rialto, CA 92376
Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
Peter Lawrence Freeland Attome o -244-5 Chan
FULL NAME
DATE OF BIRTH
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: June 7, 2024 TIME: 4:00 • AM XPM
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.
Damage occured at Bialto Police Dept evidence holding lo+. Reference case # 932314035
3. HOW DID DAMAGE OR INJURY OCCUR?
The investigators lost the sole key to the car, and left drivers window down for over six months, See attachment for specific de farls.
4. WERE POLICE AT THE SCENE? EYES • NO WERE PARAMEDICS AT THE SCENE? •YES ANO
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
The Rialto Police Dept lost the only electronic Key FoR for thecar, requiring a new key from dealer. They also mishanded the car while in police custody vesulting in more damage. See attachments for more details
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ 4,181.33 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: see attached Amount: $
Item/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ 4,181.33 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: _ See attached Amount: $
Item/Date
Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES:
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: Li. Lamont Quarker MANE: V. Gallagher
ADDRESS: Riatia PD ADDRESS: REalto PT
TELEPHONE: 900) 820-2634 TELEPHONE: (969, 820-2634
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME:
NAME:
N/A
ADDRESS: _
ADDRESS: —
TELEPHONE: L
TELEPHONE:
DATE:
• AM 0 PM DATE: TIME: • AM • PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of sireets, 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.
See attached
CURB
PARKWAY
7, SIDEWALK
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 Te I ERE ARE UNDER PENALTO EUE THAT TO FOREME SERUE AND TORETE SIGNATURÉ OF CLAIMANT OR AGENT
velar L. Freend 7/1/2024
TYPE OR PRINT NAME DATE
Self
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 Reimbursement Request - Pete Freeland Case #932514035
July 1, 2024
Item 1 - Key Replacement
The sole and only key for the vehicle was not present when car was released as part of case # 932314035, and was considered lost by the Rialto Police Department per discussion with Lt Lamont Quarker on Friday June 7. Neither the police department or the tow facility had the key, and the car was towed twice without the key prior to me taking possession of the car as evidenced by damage to the front tires. After the car was towed to Ontario Mercedes Benz the key was found in the gas cap, and had been exposed to the elements for the last 7 months. The key blade was physically intact, but the computer chips and electronics were destroyed, resulting in a useless item. The key had to be shipped from Germany as there was no spare key to provide for alternate programming.
Reimbursement request is for:
a) the key FOB that was replaced and programmed
b) the inspection required by the dealership to assess the damage to the car.
The tow from the tow yard Pepe's Towing to the dealership d) Two replacement front tires due to damage caused by the improper tows without the key, including damage to the inner fender caused by improper towing while in police custody
e) Two days of labor and time off work to secure car and key replacement - would not have been required if key was present in operable condition f) Replacement Post Office Box key that was on original key and was lost by Rialto PD Initial Condition of Car and Special Tow due to Lack of Key and New (with new PO Box/ key (left) & Old Key (right) FOBs
Steering Wheel Locked and Unable to Move so special towing required Front Tire and Fender Damage
Tires "flatspotted" due to car being dragged and not
Properly towed. Use of poor tow procedures ripped
out inner front wheelwell panels, requiring repair.
Item 2 - Interior Damage
The driver's side front window was found partially down, and as evidenced by the dirt and moisture damage inside the car it was apparent the window had been down since December 21, 2023. The car was inspected and it was determined the primary interior damage was to the driver's lower seat cushion, where the leather stitching had separated and the upholstery damaged beyond repair due to the constant moisture.
Reimbursement request is for:
a) Replacement of driver's lower seat cushion and installation by dealership 9:03 PM 81% m
= Multi Point Inspection $1743.26 4 Messages. F
8:47 PM 83%
= Multi Point Inspection $1743.26 #
Needs Immediate Attention: (17
items)
Needs Immediate Attention: (17
driver seat lower leather
cover torn
driver seat lower leather
cover torn
Total repair estimate: $1423.75
Parts: $511.17|
Labe 5867.85
$ 14.23
CLOSE
Comments: DRIVER SEAT LOWER
LEATHER WORN AND TORN, LEFT Comment: DRIVER SEAT LOWER
WINDOW LEFT DOWN WHEN PARKED LEATH Scroll For Estimates Repair Errinist: 51423.150 FI TEXT
L CALL
# TEXT L CALL AA : app.mykaarma.com
app.mykaarma.com
C
Total Reimbursement Request
Item Description Cost
1a / 1b Replacement key and Inspection $1433.36
1c Tow from Impound Pepe's Towing to dealership $100.00 1d Replacement front tires
$227.22
1e Lost wages (2 days @$490 per day) $980.00
NE Post Office Box key $17.00
Seat damage repair $1423.75
TOTAL $4,181.33
NOTICE OF STORED VEHICLE (22852 CVC) NOTE: CHP 180 IS FURNISHED TO ALL PEACE
OFFICERS BY THE CALIFORNIA HIGHWAY PATROL
REPORTING DEPARTMENT
LOCATION CODE DATE / TIME OF REPORT NOTICE OF STORED VEHICLE FILE NO.
DELIVERED PERSONALLY
LOCATION TOWED / STOLEN FROM ODOMETER READING
VIN CLEAR IN SVS? YES DATE / TIME DISPATCH NOTIFIED
NO LOG NO.
LIC CLEAR IN SVS? YES
NO
YEAR MAKE MODEL
BODY TYPE COLOR LICENSE NO.
• ONE MONTH/YEAR STATE
TWO
VEHICLE IDENTIFICATION NO.
ENGINE NO VALUATION BY
OFFICER OWNER
7 0-500 501-4000 4001+
REGISTERED OWNER
SAME AS R/O LEGAL OWNER
STORED • IMPOUNDED RELEASED
RECOVERED - VEHICLE / COMPONENT
TOWING / STORAGE CONCERN (NAME, ADDRESS, PHONE)
STORAGE AUTHORITY / REASON
REASON FOR STOP
AIRBAG? DRIVEABLE?
VIN SWITCHED?
YES 7 NO 2 YES NO JUNK LUNK
YES • NO
CONDITION YES NO ITEMS YES NO ITEMS YES NO
ITEMS YES NO TIRES / WHEELS CONDITION
WRECKED SEAT (FRONT) REGISTRATION
CAMPER LEFT FRONT
BURNED HULK per 431(c) CVC SEAT (REAR) ALT. / GENERATOR
VESSEL AS LOAD RIGHT FRONT
VANDALIZED RADIO
BATTERY FIREARMS LEFT REAR
ENG. /TRANS. STRIP TAPE DECK DIFFERENTIAL
OTHER RIGHT REAR
MISC. PARTS STRIP TAPES TRANSMISSION
SPARE
BODY METAL STRIP OTHER RADIO AUTOMATIC
HUB CAPS
SURGICAL STRIP per 431(b) CVC IGNITION KEY MANUAL
SPECIAL WHEELS
RELEASE VEHICLE TO RIO OR AGENT AGENCY HOLD
22850.3 CVC GARAGE PRINCIPAL / AGENT STORING VEHICLE (SIGNATURE) DATE / TIME NAME OF PERSON / AGENCY AUTHORIZING RELEASE I.D. NO. DATE CERTIFICATION: I, THE UNDERSIGNED, DO HEREBY CERTIFY THAT I AM LEGALLY
AUTHORIZED AND ENTITLED TO TAKE POSSESSION OF THE ABOVE DESCRIBED VEHICLE
SIGNATURE OF PERSON AUTHORIZING RELEASE SIGNATURE OF PERSON TAKING POSSESSION
SEE REVERSE FOR INFORMATION
ATE OF CALIFORNIA
ARMEN: OF CALIFORNIA HIGHWAY PATROL EVEDENCE
NOTE: CHP 180 IS FURNISHED TO ALL PEACE
EHICLE REPORT • Ex OFFICERS BY THE CALIFORNIA HIGHWAY PATROL 1P 180 (Rev. 4-16) OPI 061 ay to Rese M-Moro/es
06/524
NG DEPARTMENT NOTICE OF STORED VEHICLE FILE NO.
LOCATION CODE DATE/ TIME OFFS&
ALTO PD DELIVERED PERSONALLY
36$9 932314035
CATION TOWED / STOLEN FROM ODOMETER READING VIN CLEAR IN SV8? ZI YES OXONTAL LIC. CLEAR IN SVS? YES • NO 12:21,
MAKE MODEL
5 MERZ CLA 250 •4 DOOR BLK 9/23
CHICLE IDENTIFICATION NO *FICER DOWNER
• 501-4000 4001+ 2253,000
REGISTERED OWNER Z SAME AS RIO
PETER FREELAND, DANIEL BALDENMA
J L
Z STORED I IMPOUNDED • RELEASED • RECOVERED • VEHICLE / COMPONENT 92377 STORAGE AUTHORITY /REASON
PERE TOWING TOWING 2775 N LOCUST AVE RIATO 22655.5(8)
EASON FOR STOP AIRBAG? VIN SWITCHED?
INV
& YES • YES • NO
CONDITION YES NO ITEMS YES NO CONDITION
RECKED SEAT (FRONT)
URNED HULK per 431(c) CVC SEAT (REAR)
ANDALIZED RADIO 7
NG. / TRANS. STRIP TAPE DECK DIFFERENTIAL OTHER RIGHT REAR IISC. PARTS STRIP TAPES TRANSMISSION SPARE
ODY METAL STRIP OTHER RADIO AUTOMATIC HUB CAPS No
URGICAL STRIP per 431(b) CVC IGNITION KEY MANUAL SPECIAL WHEELS ELEASE VEHICLE TO: RIO OR AGENT AGENCY HOLD 22850.3 CVC GARAGE PRINCIPAL / AGENT STORING VEHICLE (SIGNATURE) DATE/ TIME 12/21/22
AME OF PERSON / AGENCY AUTHORING RELEASE CERTIFICATION: I, THE UNDESIGNED, DO HEREBY CERTIFY THAT I AM LEGALLY 067l ZY AUTHORIZED AND ENTITLED TO TAKE POSSESSION OF THE ABOVE DESCRIBED VEHICLE IGNATURE OF PERSON AUTHORING RELEASE STiE ON PERDU TAKING ROSES ON 110*6-5-27 STOLEN VEHICLE / COMPONENT EMBEZZLED VEHICLE • PLATES REPORT L2 - 7-24
JATE / TIME OF OCCURRENCE DATE / TIME REPORTED NAME OF REPORTING PARTY (R/P)
AST DRIVER OF VEHICLE DATE I TIME TELEPHONE OF R/P
( )
CERTIFY OR DECLARE UNDER PENALTY OF PER UR UNDER THE LAWS OF *HE STATE OF CALIFORNIA THAT THE FORECOG IS TRUE AND CORRECT. [LIST PROPERTY, TOOLS, VEHICLE DAMAGE, ARRESTS)
PETER FREELAND GRETE BILL OF LADING ATTACHED
OU THE ABOLE DATE THE ABOVE TIRE JHE ABOVE
DrIVER A STOPED PURSUIANT TO
THE ABOVE INURSI GATION ( 9525140350 . VESTICER WAS TONED THE ABOVE SECTRON. NO ITEME OF VALUE OBSTERNIOS ON
INVENTAL SEARCH
FRONT REAR TOP
LEFT SIDE
SENATURE OF OFFICER T KKING REPORT 1.D. NO. SUPERVISOR REQUIRED NOTICES SENT TO REGISTERED DYES DATE NOTIFIED 2264 21023 AND LEGAL OWNERS PER 22852 CVC? • NO 121123,00 An Internationally Accredited Agency Chp180_0416.pdf
simos
Yahoo Mail - Liability Claim Form
6/30/24, 5:08 PM
Liability Claim Form
From: Lieutenant Lamont Quarker ([email protected]) To:
Date: Friday, June 7, 2024 at 05:03 PM PDT
Good afternoon Mr. Freeland.
Attached is a claim form for your key. please include your case # 932414035 Lamont Quarker
Lieutenant
Rialto Police Department
(909) 820-2634-Watch Commander Desk
RIALTO
BLIGE
I meanted to Car Commenc
-Connect with us on social media-
nixle
Liability Claim Form (PDF) (4).pdf
49kB
https://mail.yahoo.com/d/search/keyword=lamont/messages/ADAsY._ycbPmWdkZWQ6gf08gMWCP2hnL613lJvX_5hGgUfuTZC89X6LnEaUPpANtpee Page 1 of 1
MERCEDES-BENZ OF ONTARIO
CUSTOMER #: 65132 544135
A FLETCHER JONES COMPANY
3787 E. Guasti Rd. • Ontario, CA 91761
PETER FREELAND * INVOICE* Phone (909) 212-8500 • Fax (909) 212-8598 www.mbontario.com
DUPLICATE 1 OPEN
PAGE 1 MON-FRI 7:00 AM to 7:00 PM
HOME: CONT: SAT 7:00AM 104:00 PM
BUS: BAR # ARD 269917 EPA: CAL000375245
CELL: SERVICE ADVISOR: 250649 CHRISTIAN LOPEZ
COLOR YEAR MAKE/MODEL
VIN LICENSE
MILEAGE IN / OUT TAG
Other 15 MERCEDES -BENZ CLA250
DEL. DATE PROD. DATE WARR. EXP. 197006/197009 T2789
PROMISED PO NO. RATE PAYMENT
INV. DATE
15JUL22 IS 17:00 10JUN24
R.O. OPENED 279.95 CASH 19JUN24
READY OPTIONS:
10JUN24 19JUN24
LINE OPCODE TECH TYPE HOURS
LIST NET TOTAL
A VEHICLE HAS BEEN RECEIVED WITHOUT GUEST PRESENT AND IS CONSIDERED AN "UNUSUAL CIRCUMSTANCE" AS OUTLINED IN BAR REGULATIONS 9884.9
TON VEHICLE HAS BEEN RECEIVED WITHOUT GUEST
PRESENT AND IS CONSIDERED AN "UNUSUAL
CIRCUMSTANCE" AS OUTLINED IN BAR REGULATIONS
9884.9
140 CP
PARTS: 0.00 LABOR: 0.00 0.00
0.00 OTHER: 0.00 TOTAL LINE A:
************************************************** 0.00 C DAS4NOKEY- REPLACE MISSING DAS4 KEY PER GUEST REQUEST. WHEN ALL KEYS
ARE MISSING, OPEN XSF CASE FOR FACTORY VERIFICATION AND ORDERING AND DUPLICATION/DRIVE AUTHORIZATION PURPOSES. PERFORM
REPLACEMENT OF ONE KEY AND BLADE
DAS4NOKEY DAS4NOKEY- REPLACE MISSING DAS4 KEYS
PER GUEST REQUEST. WHEN ALL KEYS ARE
MISSING, OPEN XSF CASE FOR FACTORY
VERIFICATION AND ORDERING AND
DUPLICATION/DRIVE AUTHORIZATION PURPOSES.
140 CP
450.00 450.00
1 222-905-22-10-0041 KEY 690.30
690.30 690.30
1 000-766-09-00 KEY MECHANIC 140.42 140.42
140.42
PARTS: 450.00 OTHER: TOTAL LINE C:
1280.72
197009 all keys lost 3.06 F$#8580745 > created xis case, T programmed additional key-key track 3, locked missing key tracks 2 and 1, verified blade key function.
*************************************************
D GUEST STATES VEHICLE WAS IN TOW YARD FOR 7 MONTHS. PROVIDE INSPECTION
AND PROVIDE ESTIMATE FOR LEFT FRONT LOWER SEAT CUSHION, FRONT TIRES, FRONT WHEEL WELL FENDER LINERS. GUEST ALSO STATES
VEHICLE FRONT WHEELS WERE DRAGGED ON THE TOW TRUCK WHEN CAR WAS TAKEN. PERFORM ROADTEST AND CHECK FOR CODES
00 GENERAL REPAIR
NOTICE TO CONSUMER DESCRIPTION TOTALS
PLEASE READ IMPORTANT INFORMATION ON BACK. LABOR AMOUNT
PARTS AMOUNT
I acknowledge notice and oral approval of an increase in the original estimated
GAS, OIL, LUBE
price.
SUBLET AMOUNT
MISC. CHARGES
X
TOTAL CHARGES
LESS INSURANCE
SALES TAX
ALL PARTS ARE NEW PARTS UNLESS STATED OTHERWISE.
PLEASE PAY
THIS AMOUNT
Copyugh: 2014 COK GobaLLC SERVICE INVOICE TYPE TYPE SIC IMAGING
CUSTOMER COPY
MERCEDES-BENZ OF ONTARIO
CUSTOMER #: 65132 544135
A FLETCHER JONES COMPANY
3787 E. Guasti Rd. • Ontario, CA 91761
* INVOICE* Phone (909) 212-8500 • Fax (909) 212-8598
PETER FREELAND www.mbontario.com
DUPLICATE 1 OPEN
MON-FRI 7:00 AM to 7:00 PM
PAGE 2 SAT 7:00 AM to 4:00 PM
HOME: CONT:
BAR # ARD 269917 EPA: CAL000375245
BUS: SERVICE ADVISOR:
COLOR YEAR 250649 CHRISTIAN LOPEZ
MAKE/MODEL
LICENSE MILEAGE IN / OUT
Other 15 MERCEDES-BENZ CLA250
DEL. DATE 197006/197009 T2789
PROD. DATE WARR. EXP. PROMISED PO NO.
RATE PAYMENT INV. DATE
15JUL22 IS 17:00 10JUN24 279.95
CASH 19JUN24
R.O. OPENED READY OPTIONS:
10JUN24 19JUN24
LINE OPCODE TECH TYPE HOURS LIST
NET TOTAL
140 CP
PARTS: 279.95 279.95
0.00 LABOR: 279.95 OTHER: 0.00 TOTAL LINE D: 279.95
197009 client request estimate 1.00 performed inspection and provided estimate on requested items.
* * * *ỏ *1 -ỏ-ô*ỏ*0 *ỏ *ỏ -ỏ 10****-*--***************************** E Perform California state COLD tire inflation check and correction as mandated by state law AB32
02 Perform California state COLD tire inflation
check and correction as mandated by state
law AB32
140 CP
0.00 0.00
PARTS : 0.00 LABOR: 0.00 OTHER: 0.00 TOTAL LINE E:
197006 0.00
Check, correct and record tire pressure according to manufacturer specifications.
Right Front PSI 36_ Right Rear PSI _32.
36_ Left Front PSI _ Left
Rear PSI_32
* * * * * 1 • * 1 ỏỏ * * * * * ************************************ PROVIDE COURTESY CAR WASH AT COMPLETION OF SERVICE A $24.95 VALUE 11 PROVIDE COURTESY CAR WASH AT COMPLETION OF
SERVICE A $24.95 VALUE
140 CP
0.00 0.00
PARTS : 0.00 LABOR: 0.00 OTHER: 0.00 TOTAL LINE F:
0.00 G PERFORM EDGE WORLD CLASS VEHICLE INSPECTION.
21 PERFORM EDGE WORLD CLASS VEHICLE INSPECTION.
140 CP 0.00
0.00 PARTS : 0.00 LABOR: 0.00 OTHER: 0.00 TOTAL LINE
0.00 197009 PERFORMED MULTI-POINT INSPECTION. PLEASE REVIEW THE PRINTED MULTI-POINT INSPECTION FORM FOR DETAILED AND SPECIFIC INFORMATION.
PLEASE CONTACT YOUR SERVICE ADVISOR WITH ANY QUESTIONS. ****1*11ô*01*ô*0*0ỏô1ỏ0*ỏô1ỏô101ô*ỏô*ỏ*ỏ0*0*********************.*.....** H DISCLOSURE: YOU UNDERSTAND AND ACKNOWLEDGE THAT YOUR VEHICLE MAY BE
SERVICED OR REPAIRED AT OUR OFFSITE SERVICE CENTER LOCATED AT
NOTICE TO CONSUMER DESCRIPTION TOTALS
LABOR AMOUNT
PLEASE READ IMPORTANT INFORMATION ON BACK.
PARTS AMOUNT
I acknowledge notice and oral approval of an increase in the original estimated GAS, OIL, LUBE price.
SUBLET AMOUNT
MISC. CHARGES
TOTAL CHARGES
LESS INSURANCE
SALES TAX
ALL PARTS ARE NEW PARTS UNLESS STATED OTHERWISE.
PLEASE PAY
THIS AMOUNT
Copynght 2014 COK GrObe. LLC SERVCE INVOICE TYPE 2 - SI2C- IMAGINC
CUSTOMER COPY
MERCEDES-BENZ OF ONTARIO
CUSTOMER #: 65132 544135 A FLETCHER JONES COMPANY
3787 E. Guasti Rd. • Ontario, CA 91761
*INVOICE* Phone (909) 212-8500 • Fax (909) 212-8598
PETER FREELAND
www.mbontario.com
DUPLICATE 1 OPEN
MON-FRI 7:00 AM to 7:00 PM
PAGE 3 SAT 7:00 AM to 4:00 PM
HOME: CONT: BAR # ARD 269917 EPA: CAL000375245
BUS : CELL: SERVICE ADVISOR: 250649
COLOR YEAR CHRISTIAN LOPEZ
MAKE/MODEL LICENSE
MILEAGE IN / OUT TAG
Other 15 MERCEDES-BENZ CLA250
DEL. DATE PROD. DATE WARR. EXP. 197006/197009 T2789
PROMISED PO NO. RATE PAYMENT
INV. DATE
15JUL22 IS 17:00 10JUN24
279.95 CASH 19JUN24
R.O. OPENED READY OPTIONS:
10JUN24 19JUN24
LINE OPCODE TECH TYPE HOURS LIST
NET TOTAL
305 SEQUOIA AVE. ONTARIO, CA 91761. CUSTOMER
INITIALS
OFFSITE DISCLOSURE: YOU UNDERSTAND AND ACKNOWLEDGE
THAT YOUR VEHICLE MAY BE SERVICED OR
REPAIRED AT OUR OFFSITE SERVICE CENTER
LOCATED AT 305 SEQUOIA AVE. ONTARIO, CA
91761. CUSTOMER INITIALS
140 CP
0.00 0. 00
PARTS : 0.00 LABOR: 0.00 OTHER• 0.00 TOTAL LINE H:
0.00 SS200 SPEND & SAVE SPECIAL- SAVE $200 WHEN YOU SPEND $1, 050+ BEFORE TAX ON SERVICE OR REPAIRS. CANNOT BE COMBINED. VALID THROUGH 6/30/246/30/24
CLD -200.00
-200.00
*********************** ***************************
ESTIMATE : 1,743.26 10JUN24 09:58 SA: 250649
CONTACT:
*********************
Peter Freeland 2789
ПАПТ
NOTICE TO CONSUMER DESCRIPTION TOTALS
LABOR AMOUNT 729.95
PLEASE READ IMPORTANT INFORMATION ON BACK.
PARTS AMOUNT 830.72
I acknowledge notice and oral approval of an increase in the original estimated GAS, OIL, LUBE 0. 00 price.
SUBLET AMOUNT 00
MISC. CHARGES 00
X
TOTAL CHARGES 1560.67
LESS INSURANCE 200.00
SALES TAX 72.69
ALL PARTS ARE NEW PARTS UNLESS STATED OTHERWISE.
PLEASE PAY
THIS AMOUNT
1433.36
Copyright 2014 CDK Global, LLC SERVCE INVOICE TYPE 2 - SI2C - IMAGING
CUSTOMER COPY
AMERICAN
FIND STORE HOURS
TIRE DEPOS AND LOCATIONS ONLINE
AMERICANTIREDEPOT.COM
A BIGBRAND TIRE & SERVICE COMPANY Started Time: 6/19/2024 5:30:09 PM Invoiced Time: 6/19/2024 6:14:12 PM
Invoice#i 1183-4934029
CUSTOMER INFORMATION VEHICLE INFORMATION
FREELAND, PETE Cust # ED-5623599 STORE LOCATION
2015 Mercedes-Benz CLA250 Base UPLAND #1183
Engine: 2.0L 14 F DOHC 16V BAR#.ard301193
1281 E FOOTHILL BLVD EPA# CAL000470367
Plate #:
Phone: UPLAND, CA 91786
Vil Number: Phone: (909) 946-5400
Emails:
Miles: 197020 Started By: JR4G1
Invoiced By: J JESUS RAMIREZ (JR461)
BRAND FARTE
ACC 1200026931 TECH CALESPERE PRICE
@225/45ZR17XL. PHI HWY 94W BW ACC • OnE TOTAL
Tire Serial # AG659 JR461 $72.99 2 0000
1001PB9274823 1001PB9274823 $145 98
Minimum Mileage Warranty 50000
******* CONSUMER ADVISORY ********* THIS /S A "WRATED TIRE IT HAS AMAXIMUM SPEED OF 168 APH. IT HAS "W" HANDLING CHARACTERISTICS. CONSULT YOUR OWNERS MANUAL FOR THE PROPER SPEED RATING RECOMIENDED FOR YOUR VEHICLE. CUSTOMERS
INITIALS
CDF CDF TIRE RECYCLING
AG659 JR461 $5.00 2.0000
$10.00
LBR WBHS HIGH SPEED WHEEL BALANCE
AG659 JR461 $20.75 2.0000
$41.50
SHP wW PREMIUM WHEEL WEIGHTS
AG659 JR481 $4.50 2.0000 $9.00
EW EW
TIRE MAINTENANCE CERTIFICATE -- EXTENDED WARRANTY AG659 JR461 $13.00 LIFETIME REPLACEMENT/REPAIRIREFUND CERTIFICATE *** SEE WEBSITE FOR DETAILS 2:0000 $26.00 STF STF CALIF. STATE TIRE FEE
AG659 JR461 $1.75 20000
i have been informed of the benels of 8BT's Tire Maintenance Certicate program, ALL-WHEEL DRIVE VEHICLE NOTICE - Most manufacturers recommend $3.50 the roting radius of all 4 tires must be the same. Tires should be replaced in sets of 4 to match brand, size, design and tread depth. Please consul your owners manual for the Original Equipment Vehicle Manufacturers recommendations, TWO TIRE PURCHASE ONLY - SAFETY ADVISORY- The Tire Association Council states that if only two new tires are installed on the front of a vehicle, the rear worn ties could loose the grip under load or slippery conations causing loss of contios.
DSC INSTANT INSTANT REBATE
AG659 JR461 $10.00 -2.0000 $-20.00
Vehicle Tire Pressure - F:39 R: 36
Pago 1 of 2
AMERICAN
FIND STORE HOURS
TIRE DEPOT AND LOCATIONS ONLINE
AMERICANTIREDEPOT.COM
A BIG BRAND TIRE & SERVICE COMPANY Started Time: 6/19/2024 5:30:09 PM Invoiced Time: 6/19/2024 6:14:12 PM
invoice#: 1183-4934029
CUSTOME INFORMATION VEHICLE INFORMATION
FREELAND, PETE Cust # ED-5623599 STORE LOCATIONA
2015 Mercedes Benz CLA250 Base
UPLAND #1183 BAR#:ard30119:3
Engine: 2.0L 14 F DOHC 16V 1281 E FOOTHILL BLVD
Plate #. EPA#:CAL000470367
Phone: UPLAND, CA.917.86
VIN Number: Phone: (909) 946-5400
Emails:
Miles: 197020 Started By: JR461
Invoiced By: J JESUS RAMIREZ (JR461)
Invoiced Summary
Revisions Payment
Invoice Totals
Date Emp. Prev. Revised Type Auth
Email/ Phone Type Amount
Parts: $144.98
CCD2 227:22 FET:
$0.00
2132035622
PETER L FREELAND Shop Fees: $0.00
Debit
NonTax: $71.00
EMV: APPLABEL US Tax: $11 24
DEBITIAID: 0000000980840|TVR 808
0048000 IAD:06010A03A08000|TSI:68
00/ARQC: 61CAFEBEEEF158A|ARC:
Total: $227.22
1 acknowledge below and receipt of this invoice
This estmate is based on our inspection at this time and does not cover additional parts and labor which may he required ater the work has been started. After the work has started, worn or damaged parts which aro not evident on first inspection may be discovered This estimate cannot cover such contingencies in cases where additonalwork is deemed necessary, customer authorization will be secured priorto commencemen! vehicle herein described on the streets, highways or elsewhere for the purpose oftesting andfor inspection. An express mechanic's lien is hereby acknowledged on above vehicle to secure the amount of repairs thereto. of that additional work This estimate expires 15 days from date I hereby authorize the repair work to be done along with the necessary material and hereby grant you and or your employees permission to operate the 12 months/12,000 miles forparts and labor. 6 months/6,000 miles for alignment warranties See website for additional warranty details. All parts are new unless otherwise specifed. Dealer not responsible for unavaitablity of parts or delays in parts shipments beyond dealers controi not for loss or damage to venicle or articles left in vehicle in case of fire, theft or any other cause beyond our control.
Customer Signature or Initials:
I acknowedge notice and oral approval of an Increase in the original eslimated price
UNITED STATE
OSTAL SERVIC
CRESTLINE
23921 LAKE DR
CRESTLINE CA 92325-0677
(800) 275-8777
06/20/2024 04:38 PM
..----
Product Qty Unit Price
Price
Key Fee $12.00
Box Number: 4713
Keys Delivered: 1
Key Deposit $5.00
Key Count: 1
Key Number: 62852
Total
$17.00
Grand Total: $17.00
Debit Card Remit $17.00
Card Name: VISA
Account #: XXXXXXXXXXXX6364
Approval #: 132394
Transaction #: 877
Receipt #: 028300
Debit Card Purchase: $17.00
AID: A0000000980840 Chip
AL: US DEBTT
PIN: Verified DEBIT
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UFN: 051896-0325
Receipt #: 840-59200171-2-5727641-1
Clerk: 1