CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY
CITY OF RIALTO
CLAIM FOR DAMAGES
7026 FEB 13 PH 3:53
TO PERSON OR PROPERTY
RECEIVED
CITY ClEAn
1. Claims for death, Injury to person, op to personal property must be filed not later than six (6) months after the occumence (Gov. Code §911.2).
2. Clalms for damages to real property must be filed not later than one (1) year after the occumence (Gov. Code §911.2). RETURN TO SE FEBE
3. READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Ottice
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mall: 150 S. Palmy Ave., Ralto, CA 92376 nev sterne Address: 290 W; Rialto Ave., Riatto, CA 92376 CLAIMANT INFORMATION: #032401852 co
Geraldo Rodriguer
FULL NAME DATE OF BIRTH
T HOME TELEPHONE NO. Cell
HOME ADDRESS INCLUDING CITY, STATE & ZIP
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: 712/26 TIME: 5:15pm- 6pm DAMEP
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
Where approprate, give street names and addresses, measurements and landmarks Vehide was parked in the Front of 1044 N. Clord Awe AptiA MaltaCA, 92376, corner of Shamak st a clifford Are.
3. HOW DID DAMAGE OR INJURY OCCUR? Der
venice was parker; Officer he was backing up his car (reverse) in between a tw truck and ma parker vehiole when he made Contact with di Kar passenger, side a mu rear driver side back end.
4. WERE POLICE AT THE SCENE? EYES • NO WERE PARAMEDICS AT THE SCENE? •YESZINO
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.
No shier Supervisor arrived totescere, took report 4 Photos card provited to me with the following info. Dot: 0112/26 comment: 932401882 + offiver: V. Herrera, Badge No. 110
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective Injury or damage 9, 662.82 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, Ilst doctor bllls, repale estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE: full replacement.
Wo cherout Caravo hack dinner rear Amount s 8,802.17
Item/Date:
2- w curt rental, our while Amount: $_ 860.65
Item/Date:
damayos are fixed.
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ 9,662.82 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN: All magy Amount: $. 8,800.17
Item/Date: (vil / driver back replacent a paint-Islas- sAmount $7,305.65 TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $ 9,662.82 7 (carrepurs
7. WITNESSES TO DAMAGE OR INJURY LIst all persons known to have Information (attach additional pages, It necessary) @rental NA
ADDRESS: ADDRESS:
FEB 13 CITY OF
TELEPHONE: ( TELEPHONE: 1
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITALS) VISITED:c. Ri.
N A
ADDRESS: ADDRESS:
TELEPHONE: TELEPHONE: |)
DATE: TIME: • AM • PM DATE: . TIME: DAM DIPM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehlcle 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 vehlcle 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 vehlcle 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.
PARKWAY
TOyaN CiFurd Ave SIDEWALK
Apt.A Midito CA, 92376
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 MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUE I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CŁAIMANT OR AGENT
Coraldo Couviquer 0113/26.
TYPE OR PRINT NAME DATE
Owner of vetine claimant.
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 Claim for Property Damage - Collision Report Summary
On February 12, 2026, between approximately 5:15 p.m. and 6:00 p.m., a vehicle collision occurred in front of my residence located at 1049 North Clifford Avenue, Apartment A, Rialto, California 92376, at the corner of West Shamrock Street (300 W) and North Clifford Avenue (1000 N). At the time of the incident, my vehicle, a 2013 Chevrolet Camaro, license plate 2026 FEB 13 PM 3:53 CITY OF RIALTO number was legally parked and unoccupied.
According to the on-scene statement provided by Officer V. Herrera (Badge #110), he was operating a Ford patrol vehicle, license plate number 1256929, site/unit number R517, and was reversing between my parked Camaro and a tow truck positioned across from my vehicle.
While backing into the space between both vehicles, Officer Herrera's patrol vehicle made contact with the rear driver's side of my vehicle using the rear driver's side of his vehicle. As a result, my vehicle sustained damage to the rear driver-side back end.
Shortly thereafter, a supervising officer from the Rialto Police Department arrived at the scene, conducted an on-site review, and took photographs and an official report. I was issued a courtesy notice card documenting the incident with the following details: Date: 02/12/2026; Digital Numeric Reference: 932601882; Officer: V. Herrera; Badge Number: 110.
In support of this claim, I have attached two independent auto repair appraisals detailing the collision-related damages. Additionally, I have included three vehicle rental estimates based on a minimum projected repair timeframe of approximately two weeks, as indicated by the repair businesses providing the appraisals.
Furthermore, I have provided a diagram clearly identifying the exact parked position of my vehicle and the point of impact, along with multiple photographs documenting the damage and scene conditions. Taken together, these materials substantiate the location, mechanism, and extent of the collision and resulting property damage.
Accordingly, this summary is submitted as part of my formal claim for property damage reimbursement related to this incident.
Geraldo Rodriguez
2/13/26
FREE
ESTIMATES
ESLAS
AUTO BODY
Manager
(951) 334-4192 (951) 565-7660
300 S Sycamore Ave. Building B Rialto CA 92376
Islas Auto Body Estimate ID
300 S Sycamore Ave Building B, Rialto, CA 92376-6579 26696165 Office: (951) 904-0479 Original
ESLAS
AUTO BODY [email protected]
islasautobody.com
Owner Appraiser
GERALDO RODRIGUEZ Julio Islas
[email protected]
2026 FEB 13
Classification - Гт
None CITY OF RIALTO
Loss Type Deductible PH
Unknown Unknown
2013 Chevrolet Camaro LT 2 Door Coupe 3.6L 6 Cyl Gas Injected 6 Speed Auto Trans RWD VIN Drivable Mitchell Service Code
Unknown 911210
Options
Air Conditioning Alum/Alloy Wheels AM-FM Stereo Anti-Lock Brake Sys. (ABS) Automatic Headlights Auxiliary Input Bluetooth Wireless Cloth Seat Cruise Control Daytime Running Lights Connectivity
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 Driver Seat Power Passenger Seat Power Remote Mirror Power Steering Power Windows Rear Bench Seat Rear Spoiler Remote Decklid Or Tailgate Satellite Radio Release
Second Row Side Airbag With Side Airbags Steering Wheel Mounted Telematic Systems Tilt Steering Wheel Head Protection Audio Control
Systeressure Monitoring Traction Control/Electronic
GERALDO RODRIGUEZ | 2013 Chevrolet Camaro LT
Parts Profile Parts Profile Version
AM and QR Parts 2.0
LABOR PART
Line # Description Operation Type Total Units CEG Type Number Qty Total Price Tax Front Door
101137 L Frt Door Outside Blend Refinish 1.0C 2.3 Existing 101251 L Frt Rear View Mirror Remove Body INC# 0.8 Existing / Install
101253 L Frt Otr Door Belt Remove Body 0.9# 0.9 Existing Moulding / Install
4 103657 L Frt Otr Door Belt Remove Body INC# 0.2 New 20965831 $214.00° Yes Moulding / Replace
101148 L Fit Door Trim Panel Remove Body INC 0.4 Existing / Install
Committed On Version Mitchell Cloud Estimating ™M Printed On Profile Page 1 of4 titchell Estimating 25 Copyright 1994-2026 Mitchell International, Inc. 2/13/2026 System profile EM FEB_26. 01:25 PM Profile Version
All Rights Reserved 11.0
LABOR PART
Line # Description Operation Type Total Units CEG Type Number Qty Total Price Tax 101154 L Frt Otr Door Handle Remove Body 0.3 0.3 Existing / Install
Back Window
7 100195 Back Window Glass Remove Glass 2.5# 25 Existing / Install
Side Body
100884 L Side Body Panel Remove Body 20.1# 20.1 New 19370675 1 $2,455.87° Yes Assembly -S / Replace
L Side Body Panel Refinish Refinish 6.6C 6.6 Existing
Complete Only
L Quarter Panel Edge Refinish Refinish 0.5 C 0.5
Only
L Add For Pillar Refinish Refinish 0.5 C 0.5
Only
12 L Add To R&I/RER Side Remove Mechanical 0.8# 0.8
Curtain Air Bags-M / Replace
13 L Add To Ral/R&R Side Remove 0.4 0.4
Air Bag Sensor -M / Replace
14 L Cow/Dash Trim Panel Remove INCr 0.2 Existing
/ Install
15 L Frt Upr Quarter Trim Remove Body INCr 0.2 Existing Panel / Install
16 L Rear Upr Quarter Trim Remove Body INCr 0.2 Existing Panel / Install
17 L Lwr Quarter Trim Panel Remove Body INC# 0.3 Existing / Install
18 Rear Seat Assy Remove Body INC 0.5
/ Install
Luggage Lid
19 100004 Luggage Lid Outside Blend Refinish 0.9C 2.1 Existing 20 101127 Luggage Lid Spoiler Remove Body 0.5# 0.5 Existing / Install
Rear Bumper
21 101374 Rear Bumper Cover Repair Body 4.0*# 25 Existing 22 AUTO Rear Bumper Cover Refinish Refinish 2.9C 2.9 Existing Only
Additional Costs & Materials
23 AUTO Paint/Materials Additional $756.00 Yes
Cost
24 AUTO Shop Materials Additional $5.00° Yes
Cost
25 AUTO Hazardous Waste Additional $5.00° Yes
Disposal Cost
Additional Operations
26 AUTO Clear Coat Additional Refinish 3.9 0.0 $0.00
Operation
27 933003 Tint Color Additional Refinish 0.5 0.0 $0.00
Operation
28 933007 Feather, Prime & Block Additional Refinish 0.0 0.0 $0.00 Operation
29 933021 De-Nib And Finesse Additional Refinish 3.0° 0.0 $0.00 Operation
30 933018 Mask For Overspray Additional Refinish 1.0° 0.0 $10.00* Operation
* Judgment Item C Included in Clear Coat Calculation
Committed On Version Mitchell Cloud Estimating™ Printed On Profile Page 2 of4 Mitchell Estimating 25. Copyright 1994-2026 Mitchell International, Inc. 2/13/2026 System profile DEM FEB_26 01:25 PM Profile Version
All Rights Reserved 11.0
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 [I Verify the part number and price before ordering Estimate Totals
Labor Units Rate Sublet Add'l Amount Totals
Body Labor 25.8 $75.00 $1,935.00
Refinish Labor 20.8 $65.00 $10.00 $1,362.00
Glass Labor 2.5 $65.00 $162.50
Mechanical Labor 1.2$120.00 $144.00
Total Labor 50.3 $3,603.50
Taxable $3,603.50
Tax 0.0000% $0.00
Non-Taxable $0.00
Pre-Tax Discount 0.00% $0.00
Labor Total $3,603.50
Parts Amount
Taxable Parts $2,669.87 $2,669.87
Parts Adjustments $0.00
Tax 7.7500% $206.91
Non-Taxable $0.00
Pre-Tax Discount 0.00% $0.00
Parts Total $2,876.78
Costs Amount
Paint Materials $756.00 $756.00
Shop Materials $5.00 $5.00
Other Additional $5.00 $5.00
Costs
Paint Materials: Taxable $766.00
- Refinish Units: 16.8 units Tax 7.7500% $59.37
- Rate: $45.00 Non-Taxable $0.00
- Rate Max: 99.9 units Pre-Tax Discount 0.00% $0.00
- Additional Rate: $0.00 Costs Total $825.37
Shop Materials:
- Rate: $5.00
Gross Totals Amount
Gross Total $7,305.65 $7,305.65
Taxable $7,039.37
Tax $266.28
Non-Taxable $0.00
Pre-Tax Discount 0.00% $0.00
Gross Total $7,305.65
Adjustments Amount
Total Customer $0.00
Responsibility
Net Estimate Total $7,305.65
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.
Committed On Mitchell Cloud Estimating™ Printed On Profile Page 3 of4 Copyright 1994-2026 Mitchell International, Inc 2/13/2026 System profile 01:25 PM Profile Version
All Rights Reserved 11.0
Estimate Event Log
Job Created 2/13/2026 01:19 PM
Estimate Started 2/13/2026 01:20 PM
Estimate Printed 2/13/2026 01:25 PM
Estimate Committed Estimate Not Committed
Estimate Retrieval ID 1009251406
Version Printed On Profile Page 4 of 4
Mitchell Estimating 25.4 Copien Mishal Coute intermational, Inc. 2/13/2026 System profile OEM FEB_26_V 01:25 PM Profile Version
All Rights Reserved
11.0 Jose Sanchez ALLMAGIC PAINT & BODY
909-434-0500 / 800-61-Magic GOLD CLASS
FOR
[email protected] COLLISION REPAIR
FONTANA OFFICE www.AllMagicAuto.com
18150 Foothill Blyd Additional locations to serve you.
Fontana Ca 92335 Narco
909-434 0500 Moreno Valley
or 800-61 Magic Eastvale
• ALL MAGIC PAINT & BODY FONTANA Workfile ID: 7c32bdae
State ID: 264790144-00001
18150 Foothill Blvd, Fontana, CA 92335 Federal EPA: PT0040524 Phone: (909) 434-0500 State EPA: CAL000451880
FAX: (909) 822-1602 BAR: 296862
Preliminary Estimate
Customer: Rodriguez, Geraldo
Written By: Jose Sanchez
Insured: Rodriguez, Geraldo Policy #: Claim #: 200
- Г:
Type of Loss: Date of Loss: Days to Repair: 0 .. C
2026 FEB 13 PM 3: 53 CITY OF RIALTO
Point of Impact: 08 Left Qtr Post (Left Side)
Inspection Location: Insurance Company. e
Owner:
Rodriguez, Geraldo ALL MAGIC PAINT & BODY FONTANA CUSTOMER PAY 18150 Foothill Bivd
Fontana, CA 92335
Repair Facility
(909) 434-0500 Business
VEHICLE
2013 CHEV Camaro LT1 2D CPE 6-3.6L Gasoline Direct Injection RED VIN: Interior Color: BLK Mileage In: Vehicle Out:
License: Exterior Color: Mileage Out:
State: CA Production Date: 9/2012 Condition: Good Job #:
TRANSMISSION Air Conditioning Auxiliary Audio Connection Redlining/Lounge Seats 6 Speed Transmission Intermittent Wipers Satellite Radio WHEELS POWER Tilt Wheel SAFETY Aluminum/Alloy Wheels
Power Steering Cruise Control Drivers Side Air Bag PAINT Power Brakes Rear Defogger Passenger Air Bag Clear Coat Paint Power Windows Keyless Entry Anti-Lock Brakes (4) OTHER
Power Locks Message Center 4 Wheel Disc Brakes Fog Lamps Power Mirrors Steering Wheel Touch Controls Front Side Impact Air Bags Traction Control Power Driver Seat Telescopic Wheel Head/Curtain Air Bags Stability Control Power Passenger Seat RADIO Communications System Rear Spoiler DECOR AM Radio Hands Free Device Power Trunk/Liftgate
Dual Mirrors FM Radio SEATS
Console/Storage Stereo Cloth Seats
CONVENIENCE Search/Seek Bucket Seats
2/13/2026 2:22:02 PM 428433 Page 1
Preliminary Estimate
Customer: Rodriguez, Geraldo
2013 CHEV Camaro LT1 2D CPE 6-3:6L Gasoline Direct Injection RED Line Oper Description Part Number Qty Extended Labor Paint Price$
1 PILLARS, ROCKER & FLOOR
2 Repl LT Uniside assy 19370675 1 1,834.78 25.0 7.3
3 * Add for Clear Coat 2.9
4 R&I LT Rocker molding w/o ZL1 0.8
5 R&T LT Drip molding 0.4
6 Repl LT Drip molding rivet 11611651 7 55.23
Note: 7 of these are required. 1 TIME USE.
7 R&I LT W/S pillar trim black Incl.
8 R&I LT Cowl trim 0.1
9 R&I LT Wstrip on body Ind.
10 DOOR
11 * Bind LT Outer panel 1.1
12 R&I LT Belt molding 0.2
13 R&I LT R&I mirror .0.3
14 R&I LT Handle, outside 0.4
15 2&1 LT R&I trim panel 0.5
16 BACK GLASS
R&I Back glass GM 2.0
18 Repl Urethane Kit 1 60.00
19 QUARTER PANEL
20 R&I LT Pressure vent 0.1
21 R&I LT Wheelhouse liner Incl.
22 Repl Fuel pocket 22765851 1 43.47 0.3
Note: PARTS: Part cannot be reused/reinstalled.
23 R&I Fuel door painted 0.3
24 * Bind Fuel door painted 0.2
25 Repl LT Stone guard 20951963 1 12.88 0.2
26 R&I LT Quarter glass GM Incl.
27 # Subl Urethane Kit 1 30.00 X
28 R&I LT Upper gtr trim black Incl.
R&I LT Lower at trim Incl.
30 REAR BUMPER
31 O/H bumper assy 3.4
32 Deduct for Rear Bumper R&I -1.7
33 * Rpr Bumper cover w/o park sensor 6.0 3.2
34 Overlap Major Non-Adj. Panel -0.2
35 * Add for Clear Coat 0.6
36 VEHICLE DIAGNOSTICS
37 * Subl Pre-repair scan 1 22.00 Xm
38 * Subl Post-repair scan 1 72.00 Xm
* Subl DTC Reset 187.20 Xm
40 MISCELLANEOUS OPERATIONS
41 * Repl Cover car for Overspray 1 5.00 0.2
2/13/2026 2:22:02 PM 428433 Page 2
Preliminary Estimate
Customer: Rodriguez, Geraldo
2013 CHEV Camaro LT1 2D CPE 6-3.6L Gasoline Direct Injection RED 42 * Repl Cover car for Primer 1 5000 0.2
43 # Color Tint 1 0.5
44 # Color Sand and Buff 1 1.0
45 D&R Battery 1 0.2
46 # Cover for Interior 1 3.00 0.2
47 # Seam Sealer 1 25.00 1.0
48 # Weld thru Primer 1 10.00 0.5
49 # Flex Additive 1 8.00
50 # Restore Corrision Protection 1 10.00 0.3
51 # Mask Windshield 1 0.3
SUBTOTALS 2,433.56 42.7 15.1
ESTIMATE TOTALS
Category Basis Rate Cost $
Parts 2,072.36
Body Labor 42.7 hrs $90.00/hr 3,843.00
Paint Labor 15.1 hrs $ 90.00/hr 1,359.00
Paint Supplies 15.1 hrs $ 60.00 /hr 906.00
Miscellaneous 361.20
Subtotal 8,541.56
Sales Tax $2,978.36 8.7500% 260.61
Grand Total 8,802.17
MyPriceLink Estimate ID / Quote ID:
1451696769724325888 / 151069531
2/13/2026 2:22:02 PM 428433 Page 3
Preliminary Estimate
Customer: Rodriguez, Geraldo
2013 CHEV Camaro LT1 2D CPE 6-3.6L Gasoline Direct Injection RED 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.
THIS ESTIMATE IS FOR REPAIRS TO MEET VEHICLE MANUFACTURER AND INDUSTRY STANDARDS. AS THE
CUSTOMER, IT IS YOUR RESPONSIBILITY TO CONTACT THE THIRD-PARTY PAYOR FOR PAYMENT OF THE REPAIRS YOU HAVE AUTHORIZED.
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.
''''CURE TIME'' MEANS THE LENGTH OF TIME THAT, PER THE ADHESIVE
MANUFACTURER, THE WINDSHIELD ADHESIVE NEEDS TO CURE UNTIL THE
WINDSHIELD CAN PROPERLY FUNCTION AS A SAFETY DEVICE PURSUANT
TO THE FEDERAL MOTOR VEHICLE SAFETY STANDARDS AND THE
VEHICLE MANUFACTURER'S SPECIFICATIONS.
2/13/2026 2:22:02 PM 428433 Page 4
Preliminary Estimate
Customer: Rodriguez, Geraldo
2013 CHEV Camaro LT1 2D CPE 6-3.6L Gasoline Direct Injection RED Estimate based on MOTOR CRASH ESTIMATING GUIDE and potentially other third party sources of data. Unless otherwise noted, (a) all items are derived from the Guide DR1CD10, CCC Data Date 02/09/2026, and potentially other third party sources of data; and (b) the parts presented are OEM-parts. OEM parts are manufactured by or for the vehicle's Original Equipment Manufacturer (OEM) according to OEM's specifications for U.S. distribution. OEM parts are available at OE/Vehicle dealerships or the specified supplier. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships with discounted pricing. Asterisk (*) or Double Asterisk (**) indicates that the parts and/or labor data provided by third party sources of data may have been modified or may have come from an alternate data source. Tilde sign (~) items indicate MOTOR Not-Included Labor operations. The symbol (<>) indicates the refinish operation WILL NOT be performed as a separate procedure from the other panels in the estimate. Non-Original Equipment Manufacturer aftermarket parts are described as Non OEM, A/M or NAGS. Used parts are described as LKQ, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign (#) items indicate manual entries.
Some 2024 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The CCC ONE estimator has a list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership.
The following is a list of additional abbreviations or symbols that may be used to describe work to be done or parts to be repaired or replaced:
SYMBOLS FOLLOWING PART PRICE:
m=MOTOR Mechanical component. s=MOTOR Structural component. T=Miscellaneous Taxed charge category.
X=Miscellaneous Non-Taxed charge category.
SYMBOLS FOLLOWING LABOR:
D=Diagnostic labor category. E=Electrical labor category. F=Frame labor category. G=Glass labor category.
M=Mechanical labor category. S=Structural labor category. (numbers) 1 through 4=User Defined Labor Categories.
OTHER SYMBOLS AND ABBREVIATIONS:
Adj.=Adjacent. Algn.=Align. ALU=Aluminum. A/M=Aftermarket part. BInd=Blend. BOR=Boron steel.
CAPA=Certified Automotive Parts Association. CFC=Carbon Fiber.
D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel. Incl.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part.
O/H=Overhaul. Qty=Quantity. Refn=Refinish. Repl=Replace. R&I=Remove and Install. R&R=Remove and Replace. Rpr=Repair. RT=Right. SAS=Sandwiched Steel. Sect=Section. STS=Stainless Steel. Subl=Sublet.
UHS=Ultra High Strength Steel. N=Note(s) associated with the estimate line.
CCC ONE Estimating - A product of CCC Intelligent Solutions Inc.
The following is a list of abbreviations that may be used in CCC ONE Estimating that are not part of the MOTOR CRASH ESTIMATING GUIDE:
BAR=Bureau of Automotive Repair. EPA=Environmental Protection Agency. NHTSA= National Highway Transportation and Safety Administration. PDR=Paintless Dent Repair. VIN=Vehicle Identification Number. 2/13/2026 2:22:02 PM 428433 Page 5
CITY OF RIALTO
2026 FEB 13 PM 3: 53
CITY CLERK
Rialto Police Courtesy Notice
Date 2/12/26
Time Day of Week
Comment 932601882
Omar. /. HERRinA
Badge No.
CONTACT RIALTO P.D.-(909) 820-2550 FOR FURTHER INFORMATION (Over)
CITY OF RIALTO
7026 FEB 13 PM 3:53
RECEIVEL
CITY CLERK
Inswance.
104IDCD02
MARIA C TORRES RODRIGUEZ
NAIC# 22268 CALIFORNIA
CALIFORNIA EVIDENCE OF LIABILITY INSURANCE
Infinity Insurance Company
3760 River. Run Drive Birmingham, AL, 35243
(800) 782-1020
YEAR MAKE/MODEL VEHICLE ID NUMBER 0006185/15
5515846 2013 CHEVROLET/CAMARO
POLICY NUMBER NAME & ADDRESS OF INSURED
Company 10146233301 MARIA C TORRES RODRIGUEZ
Infinity Insurance Company
Policy Holder EFFECTIVE DATE
MARIA C TORRES RODRIGUEZ 01/28/2028
PoNcy Number EXPIRATION DATE DRIVER(S) MARIA C TORRES RODRIGUEZ 10146233301
07/28/2026 GERALDO RODRIGUEZ
Effective ANTHONY RODRIGUEZ
01/28/2026 FAVIOLA RODRIGUEZTORRES
This policy complles with Sections 16056 or 16500.5 of the Callfornia Vehicle Code.
CITY OF RIALTO
2026 FEB 13 PM 3:53
RECEIVLL
CITY CLERA Registration
STATE DE CAUFORNIA • DEPARTMENI OF MOTDR VEHICLES VALIDATED REGISTRATION CARD
LICENSE NUMBER REGISTRATION VALID FROM TYPE TYPE VEHICLE USE ENGINE NUMBER MISC 12/20/2025 TO 12/20/2826 KL7 40
DATE ISSUED PEEL.HERE
VEHICLE IDENTIFICATION NUMBER MAKE VLF GLASS VR MODEL TYPE VEH CHEV FH 2013 2013 12/05/2025
WC UNLADEN /G/ CGW TOTAL FEES PAID CE/ALCO STICKER INSTRUCTIONS BODY TYPE MODEL DATE FIRST SOLD 1) CLEAN SURFACE - SCRAPE 2012
LIENHOLDER 2) REMOVE DECAL BY BENDING
PAPER ALONG POTTED LINE
3) LIFT EORE OF DECAL AND
SLOWLY PEEL
₩ 00000 VEHICLES:
CALIFORNIM
REGISTERED OWNER R 00138 in Top Right Corner
RODRIGUEZ GERALDO L 00023
MOTORCYCLES ONLY:
Right Hail of This Well
130-
credit Cace Asruperta SaS IMPORTANT INSTRUCTIONS ON REVERSE SIDE Nissan Maxima or similar
"? Automatic
vehicle des carrental
CITY 7026 FEB 13 PH CITY OF RIALTO
+* It's not too late! You can still
Upgrade
upgrade to Luxury for only $136.78*
more. ($862.29 total)
Vehicle Edit
Time & Distance 2 Week(s) @ $ 324.58 / week $649.16*
Unlimited Mileage Included
Extras Add
-
Taxes and Fees $76.35*
Estimated Total $725.51*
#2 Vehide Car
rental
Full Size Elite CIT
CITY
CEED RECEI
Audi A5 Sportback or similar 126 FEB 13 PM 3:54
OLERK RIALTO
%. Automatic
Vehicie Edit
Time & Distance 2 Week(s) @ $ 375.56 / week $751.12*
Unlimited Mileage Included
Extras Add
-
Taxes and Fees $93.92*
Estimated Total $845.04
• Custom Rate
A3Venicle Cor
Standard Pickup rehta
Toyota Tacoma or similar
Automatic
2026 FEB
+* It's not too late! You can still CITY OF RIALTO
Upgrade
upgrade to 1/2 Ton Pickup for only
$4.62* more. ($865.27 total)
Vehicle Edit
Time & Distance 2 Week(s) @ $ 380.08 / week $ 760.16*
Unlimited Mileage Included
Extras Add
-
Taxes and Fees $100.49*
$8600.05
- ..
CITY OF RIALTO
3026 FEB 13 PM 3: 54
RECEIVED
CITY CLERK
RIA
1256929
parked