Transcription of Automotive Repair Reinspection Form - Dashboard
1 Automotive Repair Reinspection FormWestern DivisionEastern Division3817 W. Magnolia41 Lundlam , CA 91505 Bayville, NY 11709 Tel: (800) 572-8010 Tel: (800) 856-4353 Fax: (800) 544-1332 Fax: (800) No:Carrier: SCA File No: REINSPECTING APPRAISERORIGINAL APPRAISERDATE ASSIGNEDDATE ORIGINAL OFWRITTENREINSPECTIONVEHICLE OWNERINSTYPE OF LOSSBEFORE REPAIRREPAIR REPAIRAFTER REPAIRVEHICLE YEAR/MAKE/MODELLOCATION OF INSPECTION ADDRESSREINSP. MADESHOPNAMEW/ ORIGINAL APPRAISERSTREETCITY STATEW/O ORIGINAL APPRAISERN A123456789101112 Page 1Do repairs seem excessive to damage?Evidence of old damage not related to this claim ?Any evidence of improper / unacceptable repairs?DATE OF LOSSS tate Bureau of Automotive Repair ?General Comments and / or Recommendations of Reinspector:Were panels blended [ref] W/O R/I trim [Estimate shows R/l trim]?Quality repairs made ?Any evidence of fraudulent repairs?
2 Based on the Reinspection results, should this Repair be reported to theWere AM / LKQ parts used but the estimate listed OEM?Repairs being completed according to scope of estimate?Damage logical according to facts of accident?Estimate correlates with damages?Betterment applied where needed?LIC. CheckAREA CODEPHONEVIN # YES NOREINSPECTORORIGINALORIGINAL ORIGINALORIGINAL ADJUSTED ADJUSTED ADJUSTED ADJUSTEDNOMISSEDREF LABORPARTSBDY, MECH,SUBLETREFPARTSBDY, MECH,SUBLETVISIBLEDMGHOURSCOSTFRAME HRSCOSTHOURSCOSTFRAME HRSCOSTDMG#SATUN- IDENTIFICATIONBODY =+/1 $_____2 ESTIMATE SEQUENCEPAINT =+/1 $_____3 STRAIGHTENINGFRAME =+/1 $_____4 PLASTIC REPAIRMATERIAL_____ _____ _____ =+/1 $_____5 Repair VS. REPLACE_____6 PARTS NOT INCLUDED_____7 RECONDITIOND/REBUILT/USED_____8 PAINTINGPARTS $ +/- $ = $_____9 GLASSSUBLET $ +/- $ = $_____10 TOW AND STORAGETAX $ +/- $ = $_____11 FRAME (CONVENTIONAL) BETTERMENT $ +/- $ = $_____12 STRUCTURAL (UNIBODY)OTHER $ +/- $ = $_____13 STEERING & ALIGNMENT_____14 COOLING & AIR COINDITIONING TOTAL ADJUSTMENT.
3 +/- = $_____15 OLD DAMAGE ORIGINAL APPRAISAL .. = $_____16 BETTERMEN/DEPRECIATION TOTAL REVISED ESTIMATE AMOUNT ..+/- = $_____17 CASH ALLOWANCE_____18 TECH. ERROR_____19 MECHANICAL AGREED ADJUSTMENT BY:_____20 SUSPENSIONAPPRAISERPHONE:_____21 MISSED PARTS/DAMAGE_____22 AFTER MKT. PARTS Repair SHOP_____23 % MARK UP MANAGERDATE:_____24 OTHER _____25 CONCESSIONS AMOUNT, IF ANY $(EXPLAIN CONC. IN COMMENTS SECTION) Automotive Repair Reinspection FormEXCEPTION BASISORIGINAL APPRAISERSUGGESTED ESTIMATE CHANGESTOTAL APPRAISER'S TRENDRATE CHANGESORIGINALADJUSTED$
