Liability Claims Committee (Meets as needed)

City Attorney’s Office Frog Prell, City Attorney Phone: (715) 395-7214 1316 North 14h Street, #300 Fax: (715) 395-7590 Superior, WI 54880 E-mail: attorney@ci.superior.wi.us MEETING NOTICE—Amended 10.18.2022 TO: Members of the Liability Claims Committee DATE: October 13th, 2022 RE: Agenda for the October 20, 2022 Liability Claims Committee Meeting Please be advised that there is a Liability Claims Committee meeting scheduled for October 20, 2022 at 4:00 p.m. in Conference Room 300, Government Center, 1316 N. 14th Street, Superior, Wisconsin. THE AGENDA IS AS FOLLOWS: 1. Call to Order 2. Roll Call 3. Approval of Minutes from the June 20, 2022 meeting 4. Claimants opportunity to speak to Committee 5. Pursuant to Wisconsin Statute 19.85(g), which states: “Conferring with legal counsel for the governmental body who is rendering oral or written advice concerning strategy to be adopted by the body with respect to litigation in which it is or is likely to become involved,” upon motion made and seconded, the Committee will go into Closed Session to discuss and/or act upon the following Items 6 through 9 of the Agenda 6. 22-11 Knauf 7. 22-12 Matson 8. 22-13 Hill 9. 22-14 Gee 10. 22-15 Harmon 11. 22-16 Olson 12. 22-17 Massengill 13. Reconvene into open session 14. 11. Adjournment cc. Mayor Paine, City Clerk, Finance, CVMIC, Matson, Hill, Gee, Harmon, Olson, Massengill The City of Superior complies with the Americans with Disabilities Act of 1990. If you are in need of an accommodation to participate in the public meeting process, please contact the City Attorney’s Office at (715)395-7521 by 4:30 p.m. on the day prior to the scheduled meeting. The City will attempt to accommodate any request depending on the amount of notice we receive. TDD (715)395-7521. IN COMPLIANCE WITH WISCONSIN OPEN MEETINGS LAW, THIS AGENDA WAS: -Posted: 10/13/2022 AMENDED 10.18.2022 and re-Placed: Government Center, Courthouse and Public Library The following media was notified on 10/13/2022: WDIO-TV, KDAL, KUWS, KBJR-TV, WEBC, Duluth News Tribune, Shockley Communications and Daily Telegram  PROCEEDINGS OF THE LIABILITY CLAIMS COMMITTEE MEETING CITY OF SUPERIOR June 20, 2022 ROLL CALL Members present: Chad Matushak, Amanda Foster and Tom Kurtz Members excused: Mike Hood and John Vaski Staff Present: City Attorney Frog Prell, Paralegal Heather Peterson, Russ Behlings, Darienne McNamara and Erin Abrahamson Staff excused: Human Resources Director Cammi Koneczny and Finance Director Ashley Puetz There being a quorum present, the meeting was called to order at 3:30 p.m. and the following items were discussed: MOTION by Matushak, seconded by Kurtz, to approve minutes of the May 4, 2022 meeting. Motion passes. Scott Carlson spoke to his claim, #22-07. Jessica Tapani spoke to claim #22-08, Mahkahta Consulting & Development. Felicia Swenson & Diane Brook spoke to claim #22-09. MOTION by Matushak, seconded by Kurtz to move into closed session under Wis. Stat. 19.85(g) at 3:54 p.m. Motion passes. MOTION by Kurtz, seconded by Matushak to reconvene in open session at 4:00 p.m. Motion passes. MOTION by Kurtz, seconded by Foster to pay claim #22-07, Scott Carlson, in exchange for Release of All Claims & W-9. Motion passes unanimously. MOTION by Matushak, seconded by Kurtz to receive and file claim #22-08, Mahkahta Consulting & Development Corp. Motion passes unanimously. MOTION by Foster, seconded by Matushak to deny claim #22-09, Michael & Felicia Swenson. Motion passes unanimously. Wis. Stat. 19.85(g) Exemptions (1) Any meeting of a governmental body, upon motion duly made and carried, may be convened in closed session under one or more of the exemptions provided in this section. The motion shall be carried by a majority vote in such manner that the vote of each member is ascertained and recorded in the minutes. No motion to convene in may be adopted unless the chief presiding officer announces to those present at the meeting at which such motion is made, the nature of the business to be considered at such closed session, and the specific exemption or exemptions under this subsection by which such closed session is claimed to be authorized. Such announcement shall become part of the record of the meeting. No business may be taken up at any closed session except that which relates to matters contained in the chief presiding officer’s announcement of the closed session. A closed may held for any of the following purposes: (g) Conferring with legal counsel for the governmental body who is rendering oral or written advice concerning strategy to be adopted by the body with respect to litigation in which it is or is likely to become involved. MOTION by Matushak, seconded by Foster to receive and file claim #22-10, Notice of Injury of Damian Cole. Motion passes unanimously. MOTION Matushak, seconded by Kurtz to pay claim #22-11, Monica Knauf, in exchange for Release of All Claims & W-9. Motion passes unanimously. MOTION by Matushak, seconded by Foster to pay claim #21-14, American Family on behalf of Eric Altman in exchange for Release of All Claims & W-9. MOTION by Kurtz, seconded by Matushak to adjourn at 4:10 p.m. Wis. Stat. 19.85(g) Exemptions (1) Any meeting of a governmental body, upon motion duly made and carried, may be convened in closed session under one or more of the exemptions provided in this section. The motion shall be carried by a majority vote in such manner that the vote of each member is ascertained and recorded in the minutes. No motion to convene in may be adopted unless the chief presiding officer announces to those present at the meeting at which such motion is made, the nature of the business to be considered at such closed session, and the specific exemption or exemptions under this subsection by which such closed session is claimed to be authorized. Such announcement shall become part of the record of the meeting. No business may be taken up at any closed session except that which relates to matters contained in the chief presiding officer’s announcement of the closed session. A closed may held for any of the following purposes: (g) Conferring with legal counsel for the governmental body who is rendering oral or written advice concerning strategy to be adopted by the body with respect to litigation in which it is or is likely to become involved. Date Submitted {;J_-{-d__ ~ Dept Claim Number tl- -o l 11 Liability Claims Cmt info given - - - - CITY OF SUPERIOR NOTICE OF CLAIM FORJri R-ECEIVED RETURN FORM TO: CITY CLERK'S O}"'FICE JUN 10 2022 1316 N. 14'" STREET City Clerk SUPERIOR, WI 54880 Superior, Wisconsin (715) 395-7200 (l'LEASE PRINT) I J ' v ,,.. 1'1 I I f\ NAME rvt-OI'll CQ I' r UA.-'-l \ ADDREss Po &JX ld-t / Lto ~ CJvu'OV\. ~1- S+ocKlor~t1 tA.tC ~~0~£ City ~g State Zip TELEPHONE(home) 90..0-l{1~-[~L(( er C(d.o- a~~- C)..C[..)-_3 ~ INCIDENT: DATE AND TIME: } - J~- ~~ ~ \ ':}_ ~ S' 0 f f4 LOCATION: C..O(n-er 0~ ~ M-otll AtJe. ~ u/l!tf /W~ f/J;)p {e~ ltir '"t- WAS POLICE REPORT FILED? ~e.) INJURED?(name) IV6 '1 n_~u,d6 . WHERE TREATED? TYPE OF INJURY?_---'NL.:...L-/.L-/\:-'-------'-------- ~AMAGE - circle one below) ~roperty-Personal-Injury(specify) e~-h'¥Yictt'f ct't-\«t..h-Qc{ ESTIMATEOFDAMAGE: $ '%0 [" "?:, ~ PROPERTY OWNERNAME: _ _ _ _ _ _ _----'---------- - - - <IF DIFFERENT than above) ADDRESS:.~----~--~----.,--~---'----- STATE BRIEFLY WHAT HAPPENED: ----------------- cJcu'\1\.ctvJ- U€-W'vle S-tru..c-t<- \oy In S.u.v~ u~lv'cl ~ , a~ ~ PI~'J..a. ~ seu~c0J ~~ ~'M_l~('~cr ttc!'~ wet~ -kJ~ CttAe. o~. tu~K~rt-L· Signature X ~~ ~ Date: LR -2- d-e>J.- ~ . cc: City Attorney; Tom Mrum, Cities & Villages Municipal Insurance ,Co.; Public Works_ Street Dept. _ Planning_ C.D, _ Police Chief_ Other -------------------------- Cowicil O(O{z_l/2-2  GRANO CHUTE POLICE DEPARTMENT 5GLOBNZM32 WISCONSIN MOTOR VEHICLE 1900 W GRAND CHUTE BLVD G22000923 \ CRASH REPORT GRAND CHUTE, WI 54913 (920) 832-1575 Document Number Override Primary Crash Document # Agency Crash Number Investigating Officer/Deputy CORPORAL L. VUE N Crash Date Crash Time Date Arrived Time Arrived ~ 01/14/2022 12:50 PM 01/14/2022 12:55 PM ~ Date Notified Time Notified Total Units Total Injured z 01/14/2022 12:50 PM 02 00 m O o on Emergency O Hitand Run o workZone D Reporting Threshold ..J Government ~ D Property 0 Active School Zone Crash Type Secondary ~ Reportable DT4000 (STANDARD CRASH) D Amended D Crash Description Diagram Reconstruction By Photos By Additional Information NONE NOT DRAWN TO SCALE ¢; ~ I, a sworn law enforcement officer, agree that I have not added any CJIS data In this report. VEH 1 AS T VE lNG S/B ON MALL DR IN TH MIDDLE LN J ST OF COLLEGE AVE. VEH 2 WAST VELING IN THE LEFT LE TUR ONLY ON MALL DR IN THE LOCATION. THE DRIVER OF VEH 2 STATED A TRUCK IN FRONT OF HIM JUST SUDDENLY STOPPED MAKING HIM WANT TO SWITCH INTO THE RIGHT LN NEXT TO HIM. HE MADE THE lANE CHANGE AND DID NOT SEE VEH 1 AND STRUCK HER. THE DRIVER OF VEH 2 STATED SHE WAS GOING STRAIGHT WHEN VEH 2 SWITCHED LN INTO HER. BOTH DRIVERS WERE ID'D BY THEIR WI PHOTO DLS. \_ Wisconsin Motor Vehicle Crash This report does not include any CJIS data. Crash Date 01/14/2022 Form DT4000 1 of 6 Crash Time 12:50 PM  GRAND CHUTE POLICE DEPARTMENT 5GlOBNZM32 W~SCONSIN MOTOR V'IEH~CLIE 1900 W GRAND CHUTE BLVD G22000923 CRASH REPORT GRAND CHUTE, Wl54913 (920) 832-1575 Location ON MALL DR Latitude Longitude 86FTN 44.262198828 -88.469419896 OF COLLEGE AVE/ CTHCA SB X Coordinate V Coordinate IN THE TOWN OF GRAND CHUTE 4902045 382710.28125 IN OUTAGAMIE COUNTY Structure Type NO STRUCTURE Crash Scene First Harmful Event First Harmful Event Location MOTOR VEH IN TRANSPORT ON ROADWAY Manner of Collision Light Condition 07 ·SIDESWIPE/SAME DIRECTION DAYLIGHT Road Surface Condition(s) Roadway Factor(s) DRY Environment Factor(s) NONE NONE Weather Condition(s) CLOUDY Animal Type Relation To Trafficway TRAFFICWAY· ON ROAD Crash Classification - Location Crash Classification - Jurisdiction PUBLIC PROPERTY NO SPECIAL JURISDICTION Tribal Land Access Control NO CONTROL I Special Study Within Interchange Area _I_ Junction Location 'Intersection Type NO NON-JUNCTION NOT AN INTERSECTION Unit Summary Unit Status Vehicle Operating As Classification Unit Type IN TRANSIT DCLASS AUTOMOBILE .... 0 Vehicle Type Operating As Endorsements (SPORT) UTILITY VEHICLE Total Occs Train/Bus# Recorded Total# Citations Issued Total Trailers Total HazMat Types 1 0 0 0 Insurance? Direction OfTravel Speed Limit Total Lanes Pre CrashTire .... YES SOUTHBOUND 0 Mark 25 5 2 Most Harmful Event: Collision With Special Function Emergency Motor Vehicle Use ::I NO SPECIAL FUNCTION NOT APPLICABLE MOTOR VEH IN TRANSPORT TrafficWay Traffic Control Traffic Control Inoperative/Missing DIVIDED HWY W/0 TRAFFIC BARRIER TRAFFIC SIGNAL NO Surface Type Road Curvature Road Grade BLACKTOP (BITUMINOUS) STRAIGHT LEVEL Trucl< Bus or HazMat NO Vehicle License Plate Number Plate Type St Country of Issuance 347VMJ AUT ·AUTOMOBILE WI UNITED STATES .... 0 .... Vehicle Q Identification Number 3GKALVEV9LL 113583 Make GENERAL MOTORS COR Year 2020 Model TERRAIN Color Body Style Bus Use GRY-GRAY UT ·SPORT UTILITY VEHICLE w Initial Contact Point VelliCie Damage 7 8 !l 10 11 -.1 1:: 0 10 ·LEFT SIDE FRONT z ::I s:lU Extent Of Damage 10 ·LEFT SIDE FRONT 6 5 4 3 2 1 112 I MINOR DAMAGE > Wisconsin Motor Vehicle Crash This report does not include any CJIS data. Crash Date 01/14/2022 Form DT4000 2 of 6 Crash Time 12:50 PM  GRAND CHUTE POLICE DEPARTMENT 5GlOBNZM32 W~SCONS~N MOTOR VEHIClE 1900 W GRAND CHUTE BLVD G22000923 CRASH REPORT GRAND CHUTE, Wl54913 (920) 832-1575 Towed Due To Damage Vehicle Removed By NOT TOWED OWNER What Driver Was Doing Vehicle Factors GOING STRAIGHT Driver Prior Action Other NOT APPLICABLE Driver Actions NO CONTRIBUTING ACTION Owner Name Owner Address MONICA KNAUF 403 UNION ST (920) 213-2953 STOCI{BRIDGE, WI 53006 , US sequence 0 f Events Event MOTOR VEH IN TRANSPORT N Event Q M Event 0 Event !:: Policy Holder z :':) Insurance Company Individual ERIE-INS-CO MONICA I{NAUF Individual Driver Citations Issued Sex MONICA KNAUF 0 FEMALE (920) 213-2953 Race Date of Birth 10/29/1942 WHITE Address Driver License Number 403UNION ST K5105404286902 STOCKBRIDGE, WI 53088 , US STATE: WISCONSIN COUNTRY: UNITED STATES J ~ On Duty Crash Safety Equipment Sa fety E.quipmen Row 01 ·FRONT ROW ISeat Position 07 ·LEFT SHOULDER & LAP BELT Helmet Use Helmet Compliance Eye Protection Tint Compliance • rrvj InjUry :>evency Alroag lnJU NO APPARENTINJURY Ejected NOT EJECTED I Ejection Path NOT EJECTED/NOT APPLICABLE NON DEPLOYED Trapped/Extricated NOT TRAPPED Medical Transport EMS Agency Identifier EMS Run# NOT TRANSPORTED Hospital Date of Death Time of Death -~ Distracted By Source Distracted 8 NOT APPLICABLE (NOT DISTRACTED) , Distracted By Action NOT DISTRACTED Wisconsin Motor Vehicle Crash This report does not Include any CJIS data. Crash Date 01/14/2022 Form DT4000 3 of 6 Crash Time 12:50 PM  GRAND CHUTE POLICE DEPARTMENT 5GLOBNZM32 WISCONSIN MOTOR VE II-D~CliE 1900 W GRAND CHUTE BLVD G22000923 CRASH REPORT GRAND CHUTE, W I 54913 (920) 832-1575 i~ Strildng Unit # Location Non Motoris Prior Action Action ..J <( ;::) !:: c z > ;::) c ~ Action Olher I To/From School Drug & A/coho NO )~ Suspected Alcohol Use I Suspected Drug Use NO Alcohol Test Given Alcohol Test Type Alcohol Test Results TEST NOT GIVEN Drug Test Given TEST NOT GIVEN Drug Test Type I Drug Test Results ..... .... C) Cl Drug Type C) Individual Condition I APPEARED NORMAL Unit Summary Unit Status Vehicle Operating As Classification Unit Type IN TRAN SIT DCLASS AUTOMOBILE Vehicle Type Operating As Endorsements N 0 PASSENGER CAR Total Occs Tram/Bus # Recorded Total #Citations Issued Total Trailers Total HazMatTypes 1 0 0 0 Insurance? Direction Of Travel Speed Limit Total Lanes Pre Crash Tire 1- YES SOUTHBOUND 0 Marlt 25 5 z Most Harmful Event: Collision With :;) Special Funct1on Emergency Motor Vehicle Use MOTOR VEH IN TRANSPORT NO SPECIAL FUNCTION NOT APPLICABLE TramcWay Traffic Control Traffic Control lnoperative/Missmg DIVIDED HWY W/0 TRAfFIC BARRIER TRAFFIC SIGNAL NO Surface Type Road Curvature Road Grade BLACKTOP (BITUMINOUS) STRAIGHT LEVEL Truck Bus or HazMat NO Vehicle License Plate Number Plate Type St Country of Issuance 782TWE AUT· AUTOMOBILE WI UNITED STATES Vehicle Identification Number Make Year Model N N C) CHEVROLET 201 2 IMPALA POL 0 2G1WD5E31 C1197843 Color Body Style Bus Use SIL · SILVER (ALUMINUM) 4D - 4DR w ..J Initial Contact Point Vehicle Damage 7 8 9 10 11 !:: 0 03 ·RIGHT SIDE MIDDLE z;:) i Extent Of Damage 03 · RIGHT SIDE MIDDLE G !. 1' 12 w 5 4 3 2 1 ,> MINOR DAMAGE I Vehicle Removed By Towed Due To Damage NOT TOWED OPERATOR Wisconsin Motor Vehicle Crash This report does not include any CJIS data. Crash Date 01/14/2022 Form DT4000 4 of 6 Crash Time 12:50 PM  GRAND CHUTIE POLICE DEPARTMENT 5GLOIBNZM32 W~SCONS~N MOTOIR VIE IHI~CliE 1900 W GRAND CHUTE BLVD G22000923 CRASIHI IREPOIRT GRAND CHUTE, \l\fl54913 (920) 832-1575 What Driver Was Doing Vehicle Factors CHANGING LANES Driver Prior Action Other NOT APPLICABLE Driver Actions FAILED TO KEEP IN DESIGNATED LANE, LOOKED B UT DID NOT SEE Owner Name Owner Address SUPERIOR CITY 1316 N 14TH ST (715) 395-7234 SUPERIOR, WI 54880 , US sequence OfEven ts Event MOTOR VEH IN TRANSPORT N Event 0 Event Event Policy Holder Insurance Company Government CITIES·&-VILLAGES-MUTUAL-INS-CO SUPERIOR CITY Individual Driver Citations Issued Sex ADAM DAVID JOHNSON 0 MALE (218) 428-8509 Race Date of Birth 04/14/1989 WHITE Address Driver License Number 5508 OAKES AVE J5250048913408 SUPERIOR, WI 54080 , US STATE: WISCONSIN COUNTRY: UNITED STATES ~ On Duty Crash Sa feijf Equ/pmen1 Safety Equipment Row 01 • FRONT ROW I Seat Position 07 ·LEFT SHOULDER & LAP BELT Helmet Use Helmet Compliance Eye Protection Tint Compliance lnju1 '!'1 InJUry :::>evemy NO APPARENT INJURY Alroag Ejected NOT EJECTED I Ejection Path NOT EJECTED/NOT APPLICABLE NON DEPLOYED Trapped/Extricated NOT TRAPPED Medical Transport EMS Agency Identifier EMS Run# NOT TRANSPORTED Hospital Date of Death Time of Death ,, Distracted By Source Disiracted I3J1 El<TERNAL {TO VEHICLE/NON-MOTORIST AREA) Distracted By Action OTHER ACTION (LOOKING AWAY FROM TASK ETC) f\lon'/VJotoris ~~ Stril<ing Unit t1 I Location Wisconsin Motor Vehicle Crash This report does not Include any CJIS data. Crash Date 01 /14/2022 Form DT4000 5 of 6 Crash Time 12:50 PM  GRAND CHUTE POLICE DEPARTMENT 5GlOBNZM32 WISCONSIN MOTOR VEHI~CliE 1900 W GRAND CHUTE BLVD G22000923 CIRASH IRIEI?ORT GRAND CHUTE, Wl54913 (920) 832-1575 Prior Action Action Action Other I To/From School )~ Suspected Alcohol Use -~ Suspected Drug Use Drug & A/coho NO NO Alcohol Test Given Alcohol Test Type -r Alcohol Test Results TEST NOT GIVEN Drug Test Given TEST NOT GIVEN Drug Test Type I Drug Test Results Drug Type Individual Condition APPEARED NORMAL Wisconsin Motor Vehicle Crash This report does not include any CJIS data. Crash Date 01/14/2022 Form DT4000 6 of 6 Crash Time 12:50 PM  Workflle ID: d77f3f21 BERGSTROM BODY SHOP - PartsShare: 6BrX5J APPLETON CHEVY FederaiiD: 391430055 2245 W. COLLEGE AVE., APPLETON, WI 54914 ( /) Phone: (920) 749-5800 AI:·· \ 1?'f' FAX: (920) 749-5817 '1l ~\' cJeliminary Estim~ Customer: Knauf, Monica Job Number: Written By: Troy Solberg Insured: Knauf, Monica Policy#: Claim#: Type of Loss: Date of Loss: Days to Repair: 0 Point of Impact: 11 Left Front Owner: Inspection Location: Insurance Company: Knauf, Monica BERGSTROM BODY SI-IOP - APPLETON Erie CHEVY PO Box 128 2245 W. COLLEGE AVE. Stockbridge, WI 53088 APPLETON, WI 54914 (920) 213·2953 Cell Repair Facility (920) 749-5800 Business VEHICLE 2020 GMC Terrain SLT AWD 4D UW 4-1.5L Turbocharged Gasoline Direct Injection Grey VIN: 3GKALVEV9LL113583 Interior Color: Mileage In: 24,873 Vehicle Out: License: 347VMJ Exterior Color: Grey Mileage Out: State: WI Production Date: 7/2019 Condition: Job#: TRANSMISSION Air Conditioning Stereo Xenon or L.E.D. Headlamps Automatic Transmission Intermittent Wipers Search/Seek Lane Departure Warning 4 Wheel Drive Tilt Wheel Auxiliary Audio Connection ROOF POWER Cruise Control Satellite Radio Luggage/Roof Rack Power Brakes Keyless Entry SAFETY SEATS Power Windows Alarm Drivers Side Air Bag Reclining/Lounge Seats Power Locks Message Center Passenger Air Bag Leather Seats Power Mirrors Steering Wheel Touch Controls Anti-Lock Brakes (4) Heated Seats Heated Mirrors Telescopic Wheel 4 Wheel Disc Brakes WHEELS Power Driver Seat Climate Control Traction Control Aluminum/Alloy Wheels DECOR Backup Camera Stability Control PAINT Dual Mirrors Remote Starter Front Side Impact Air Bags Clear Coat Paint Privacy Glass RADIO Head/Curtain Air Bags OTHER Console/Storage AM Radio Communications System Fog Lamps CONVENIENCE FM Radio Hands Free Device Signal Integrated Mirrors 1/14/2022 2:32:26 PM 044206 Page 1  Preliminary Estimate Customer: Knauf, Monica Job Number: 2020 GMC Terrain SLT AWD 40 UTV 4-1.5L Turbocharged Gasoline Direct Injection Grey Line Oper Description Part Number Qty Extended Labor Paint Price$ 1 ** Sub I A/M Four wheel alignment 1 79.95 T Note: per dealer Invoice -·~ ...... --~ 2 FRONT BUMPER &. GRILLE 3 * <> Rpr Bumper cover wjo park sensors 1..Q 3.0 4 Add for Clear Coat 1.2 5 0/H bumper assy 3.8 6 Rep I Lower cover black, wjfog lamps 84248519 1 384.72 Incl. 7 R&l Grille assy SLT Incl. -----------·-·- 8 FRONT LAMPS 9 ** Rep I Opt OEM LT Headlamp assy 84815558 1 1,055.96 0.3 10 Aim headlamps 0.5 11 HOOD 12 * Rpr Hood u 3.0 13 Overlap Major Non-Adj. Panel -0.2 14 Add for Clear Coat . 0.6 -·-···--P---·----·-·--· --------------------- · ------· 15 FENDER 16 ** Rep I A/M CAPA LT Fender 84278262 1 330.00 2.0 1.8 17 Overlap Major Adj. Panel -0.4 18 Add for Clear Coat 0.3 19 Add for Edging 0.5 20 Add for Clear Coat 0.1 21 Repl LT Wheel opng mldg black 84579557 1 115.62 Incl. 22 R&I LT Trim molding wjo Midnight Incl. Edition 23 R&I LT Fender liner Incl. ·- · ~---- ---- 24 WHEELS 25 Rep I LT/Front Wheel, alloy 18" code: 22968932 1 464.95 m 0.3 RV6 ·--·-· ·------- - - · - - ·---·------ 26 PILLARS, ROCI<ER &. FLOOR 27 R&l LT Rocker molding 0.6 ·-----· 28 FRONT DOOR 29 * Rpr LT Outer panel 1...Q 2.1 30 Overlap Major Non-Adj. Panel -0.2 31 Add for Clear Coat 0.4 32 R&l LT Belt molding black 0.3 33 Rep I LT Nameplate "TERRAIN" chrome 23255004 1 51.95 0.2 34 R&I LT R&I mirror 0.3 35 R&I LT Handle, outside wjo chrome 0.4 36 R&I LT R&I trim panel 0.5 37 # RepI Hazardous waste removal 1 5.00 T 38 # Repl Cover Car 1 10.00 T 0.2 39 # Repl Corrosion protection primer 1 T 0.3 40 # Rep I Flex additive 1 8.00 T 1/14/2022 2:32:26 PM 044206 Page 2  Preliminary Estimate Customer: Knauf, Monica Job Number: 2020 GMC Terrain SLT AWD 4D UTV 4-1.5L Turbocharged Gasoline Direct Injection Grey SUBTOTALS 2,506.15 19.9 12.5 ESTIMATE TOTALS Category Basis Rate Cost$ Parts 2,403.20 Body Labor 19.9 hrs @ $ 68.00 lhr 1,353.20 Paint Labor 12.5 hrs @ $ 68.00 lhr 850.00 Paint Supplies 12.5 hrs @ $ 48.00 lhr 600.00 Miscellaneous 102.95 Subtotal 5,309.35 Sales Tax $5,309.35 @ 5.5000% 292.01 Grand Total 5,601.36 Deductible 0.00 CUSTOMER PAY o.oo INSURANCE PAY 5,601.36 MyPricelink Estimate ID I Quote ID: 911350178835865600 1 99211294 The above Estimate is based upon the visible damage at the time of initial inspection. This initial ~stimate doesn't cover additionaiParts, Labor, or Material that may be necessary to restore the vehicle to pre loss condition that are discovered after dissembly. Because of vehicle complexity, parts that are worn, broken, or damaged are not always visible during the initial inspection. The Parts and Labor pricing on this Estimate are current and SUBJECT TO CHANGE. The deductible portion of all collision repairs must be paid, and the release signed when the vehicle is delivered. MOTOR VEHICLE REPAIR PRACTICES ARE REGULATED BY CHAPTER ATCP 132, WIS. ADM. CODE, ADMINISTERED BY THE BUREAU OF CONSUMER PROTECTION, WISCONSIN DEPT. OF AGRICULTURE, TRADE AND CONSUMER PROTECTION, P.O. BOX 8911, MADISON, WISCONSIN 53708-8911. THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF ONE OR MORE REPLACEMENT PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE REPLACEMENT PARTS RATHER THAN BY THE MANUFACTURER OF YOUR MOTOR VEHICLE. 111412022 2:32:26 PM 044206 Page 3  Preliminary Estimate Customer: Knauf, Monica Job Number: 2020 GMC Terrain SLT AWD 4D UTV 4-l.SL Turbocharged Gasoline Direct Injection Grey Estimate based on MOTOR CRASH ESTIMATING GUIDE and potentiplly other third party sources of data. Unless otherwise noted, (a) all items are derived from the Guide DR1FJ18, CCC Data Date 01/10/2.022, 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 (N) 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 LI<Q, 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 2022 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=Eiectrical labor category. F=Frame labor category. G=Giass 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.=Aiign . ALU=Aiuminum. A/M=Aftermarket part. Blnd=Biend. BOR=Boron steel. CAPA=Certified Automotive Parts Association. D&R=Disconnect and Reconnect. HSS=High Strength Steel. HYD=Hydroformed Steel. Inci.=Included. LKQ=Like Kind and Quality. LT=Left. MAG=Magnesium. Non-Adj.=Non Adjacent. NSF=NSF International Certified Part. 0/H=Overhaul. Qty=Quantity. Refn=Refinish. Repi=Replace. R&I=Remove and Install. R&R=Remove and Replace. Rpr=Repair. RT=Right. SAS=Sandwiched Steel. Sect=Section. Subi=Sublet. UHS=Uitra High Strength Steel. N=Note(s) associated with the estimate line. CCC ONE Estimating - A product of CCC Intelligent Services 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. 1/14/2022 2:32:26 PM 044206 Page 4  Preliminary Estimate c ustome1·: l<nauf, Monica Job Number: 2020 GMC Terrain SLT AWD 4D UlV 4-1.5L Turbocharged Gasoline Direct Injection Grey PARTS SUPPLIER LIST Line Supplier Description Price 9 Rydell Chevrolet #84815558-N $ 1,055.96 1324 E SAN MARNAN DR Opt OEM LT Headlamp assy WATERLOO lA 50702 Quote : 1112766961 (888) 462-1197 Expires: 01/21/22 16 Keystone #GM1240408C. $330.00 5050 N WREN DRIVE A/M CAPA LT Fender APPLETON WI 54913 Quote: 1139531285 (920) 731-3030 Expires: 02/28/22 1/14/2022 2:32:26 PM 044206 Page 5 8/2/2022