Paul Nxxxxx
XXXXXXXXXX
XXXXXX, XX XXXXX
(XXX) XXX-XXXX
9 April 2004
John Cxxxxxxxx
Nationwide Mutual Insurance Company
Suite 214
3665 Bee Ridge Road
Sarasota, FL 34233
Mr. Cxxxxxxx:
The following is a list of items lost or damaged during the accident or expenses directly as a result of the accident. Thee items that require complete replacement are currently residing within the trailer. The trailer is being stored at a commercial outdoor storage facility at $50.35 per month. The storage is for the sole purpose of the eventual transfer to Nationwide Insurance after an agreed settlement as was communicated to me by you and your company. The cost will increase each month it remains stored at this location and added to the amount here until a transfer takes place. The trailer has a broken frame and should not be moved on its own.
There are a number of items still residing in the car and underneath the car, which is inside the trailer. Those items are not listed here but I reserve the right to add them at a later time before any settlement is made if they can be retrieved. Currently the car is in an unsafe position in the trailer and getting in the car to retrieve items is dangerous. Removal of the car would need to be done by qualified personnel. The cost of this would need to be made directly by your company.
There are several items, which I have retrieved from the trailer and documented but not included on this list. At this time I have elected not to include them as they have some value other than what a replacement could provide or I am pursuing possible repair. I reserve the right before any actual settlement to add the cost of repair or if needed, replacement.
|
# |
Quantity |
Item |
Damage/Comments |
Value |
|
1 |
1 |
1995 Ford Contour LX VIN # 1FALP66L4SK109135. 6 Cylinder-2.5Liter, 5 speed, Power doors/windows/locks/mirrors, Air Conditioning, Electric Moon Roof, Deluxe Sound System, Fog Lights, rear defroster, Cruise Control, Air Bags, Deluxe wheels. *New rear tires (purchase three days before accident), new brakes, rear taillights, Overall Mint condition. See attached receipts. |
Smashed in roof and moon roof, broken windshield, scratched paint, broken side mirrors, broken interior lights & moon roof control, scraped trunk lid and bumper, bent rear suspension. |
$3895.00 |
|
2 |
1 |
1992 Pace American 24’ Enclosed race Car Trailer. 10,000 pound GVW rating, dual 5K axles, 102” wide, 110 volt deluxe interior lights, 12 volt interior lights, 110 volt electrical service with 50 amp breaker box package, 4500# winch with remotes, roof vent, dealer customized wrap around cabinets with workbench, oversize side door, breakaway box. New brakes (see attached receipt) less than one month before accident, overall mint condition. |
Rear door has broken hinge and door no longer closes, Frame is broken in two places and entire frame has shifted, ramp is broken, roof of trailer is cracked in several places, rear ceiling collapsing, electrical wiring broken, 110 volt lights broken, 110 volt electric inlet box broken, trailer jack bent, coupler bent, cabinets broken apart, workbench broken off completely, winch not working. Frame is twisted and would require almost complete disassembly and then reassembly on a factory jig. |
$5650 |
|
3 |
2 |
Pit Pal Trailer Storage Racks |
Bent from impact of car |
150.00 |
|
4 |
1 |
½” Drive Professional Socket set |
Wrench bent, sockets lost during accident |
29.00 |
|
5 |
1 |
IBM ThinkPad Laptop Docking Station |
Damaged Speaker |
35.00 |
|
6 |
1 |
Four Shelf Heavy Duty PVC Cabinet |
Top two drawers and case completely broken off |
25.00 |
|
7 |
4 |
Dress Slacks |
Stained from car/trailer paint and leaked fluids during crash, some are torn as well. |
160.00 |
|
8 |
1 |
1985 Chevy G30 Van VIN # 1GCFG35L0F7134965. Full Ton Van, 5.7 Liter engine, 3 Speed Automatic Transmission, Rear Axle 3.73, Heavy Duty Chassis, Air Conditioning, Heavy Duty Shock Absorbers, Rear heat & AC, Power windows/door locks, full window package, optional rear bench seat, Transmission cooler, full tow package, Factory Class IV hitch, Rear defroster, 3.73 Rear end gear, 33 gallon tank, deluxe captains chairs, Delco Premium sound system, Electronic Speed Control, Gauge package, Auxiliary Lighting. |
Bent rear bumper, dented door & fender, scraped paint. |
1581.99 Amt. Agreed to previously by Nationwide to cover repairs; some repairs have since been performed. |
|
9 |
1 |
Equal-I-zerâ Sway control/weight distributing hitch Part #2332B. This was about one month old at time of accident - see attached receipt. |
Broken arm, bent arm, broken receiver, broken hitch arm brackets. |
600.00 |
|
11 |
1 |
Alternator/Battery & Load Tester |
Bent needle in gauge, gauge cover broken |
37.00 |
|
12 |
1 |
Century 6 & 12-volt automatic (2 & 10 amp) battery charger with 55-amp starter. |
Broken function and amp setting buttons, bottom & front of unit bent and wires hanging out. |
54.00 |
|
13 |
1 |
Rebco Deluxe Caster/Camber and spindle inclination gauge. |
Negative camber gauge tube is broken and fluid lost. Must be repaired at factory |
45.00 (145.00 – replacement) |
|
14 |
1 |
Storehouse 150 piece Locknut assortment |
Pieces lost during accident |
9.00 |
|
15 |
1 |
Storehouse 250 piece Flat and Lock Washer kit |
Pieces lost during accident |
8.00 |
|
17 |
1 |
Chicago Pneumatic Anti-Static Siphon Hose |
Hose portion is crimped and broken. |
12.00 |
|
18 |
1 |
Three ton hydraulic shop floor jack |
Bent pump and handle lost |
65.00 |
|
19 |
1 |
40 Piece socket set |
Missing nearly all its components rendering kit useless. |
5.00 |
|
20 |
1 |
½” Drive Professional Socket set |
Case is bent and missing nearly all components rendering kit useless |
29.00 |
|
22 |
1 |
Decal Set |
Torn and marked |
42.00 |
|
23 |
1 |
12 Volt, 850 amp Car battery |
Broken Case, leaking acid |
40.00 |
|
24 |
1 |
Sears Craftsman 2/6 amp 12 volt battery charger |
Wire leads broken off |
42.00 |
|
25 |
1 |
ProGen Pentium 4 Computer |
Broken System board, inoperable CD-ROM Drive, bent case |
500.00 |
|
26 |
1 |
IBM ThinkPad Pentium Laptop |
Broken Memory chip and service to diagnose and replace |
$94.00 See attached receipt |
|
27 |
1 |
Miscellaneous Food Products |
Packaging Broken |
80.00 |
|
28 |
1 |
Miscellaneous Cleaning supplies, lubes and oils |
Packaging Broken, contents missing |
110.00 |
|
29 |
1 |
Atlas Towing Service |
Towing of Trailer from crash site |
1182.40 |
|
30 |
1 |
Atlas Towing Service |
Repair of trailer tires after crash |
40.00 |
|
31 |
1 |
Home Depot – Tarps, rope |
To cover damaged trailer to keep from further damage |
85.00 |
|
32 |
1 |
Master’s Inn/Dennys |
Overnight stay after accident and dinner. |
85.00 |
|
33 |
1 |
Verizon Wireless |
Cell Phone calls made as of result of accident |
200.00 |
|
34 |
1 |
Pondella Storage |
Storage of Damaged Trailer, car and items inside. This will keep incrementing at $50.35/per month |
1057.35 |
|
35 |
1 |
Gary Shierling DDS |
Crown to fix broken tooth caused during accident. See
attached forms |
610.00 |
|
TOTAL AMOUNT: |
$16557.74 |
|||
Should you have any questions I can be reached at the above number.
Paul Nxxxxxx
