Total Logic Valuation Inspection Worksheet

1 Page 1 of 4 Inspection Worksheet (800) 710-2451 (Service Center)(858) 530-8904 (Fax)Claim and Admin InformationInspected ByNameCompanyPhoneInspection SiteDateClaimClaim-Suffix IDPolicy NumberInsurance CarrierLoss DateSettlement Offer DateClaim RepresentativeFirst Name Last NameClaim Representative IDOwnerFirst Name Last NameInsuredClaimant AddressHome PhoneCityStateWork PhoneZIPFaxLien HolderNameLoss TypeDeductibleVehicle IdentificationVINV ehicle TypeYe a rM a k eM o d e lSub-ModelBody StyleExterior ColorEngineTransmissionDrive TrainLicense PlateState RegisteredRegistration ExpiresMileageVehicle Location ZIP** Denotes a required field*Page 2 of 4

2 Inspection Worksheet (800) 710-2451 (Service Center)(858) 530-8904 (Fax)Vehicle EquipmentExteriorInteriorFog LampsAir Bags - dual frontLuggage RackAir Bags - frontMirrors - powerAir Bags - front & rearMirrors - power & heatedAir ConditioningRear SpoilerAM/FM Stereo/CassetteSun RoofAM/FM Stereo/Cassette/CD (single)Wheels - alloyAM/FM Stereo/CD (multi)Wheels - premiumAnti-theft Deterrent SystemWheels - steelCruise ControlPowertrainDVD Entertainment System___ Engine Size (liters)Leather Seats4WD or AWDN avigational SystemABS (4-wheel)Power Door LocksAutomatic TransmissionPower Seats - dualDiesel EnginePower WindowsManual TransmissionPremium Sound SystemPower BrakesRear DefoggerPower SteeringRoof - flip upTraction ControlRoof - moonTruck/SUVRoof - slidingAuxiliary Fuel TankSeat - heatedBedliner - rigidSeat - power driverBedliner - spay onTilt SteeringDual Rear WheelsFiberglass CapRear Air ConditioningRunning BoardsThird Row SeatTowing/Camper PackageWinchWork Truck PackagePoints of ImpactPrimary POIS econdary POIPage 3 of 4 Inspection Worksheet (800) 710-2451 (Service Center)(858) 530-8904 (Fax)

3 Vehicle ConditionExcellentVery GoodGoodFairPoorUnknownInteriorSeatsCarp etHeadlinerDoors/Interior PanelsDash/ConsoleGlassExteriorBodyPaint Tr i mVinyl/Convertible TopMechanicalEngineTransmissionTiresCond ition CommentsPage 4 of 4 Inspection Worksheet (800) 710-2451 (Service Center)(858) 530-8904 (Fax)Aftermarket Parts (Description and adjustment amount)CategoryDescriptionDepreciationPu rchase DateAmount PaidAdjustmentPrior Damage Adjustments (Description and negative adjustment amount)DescriptionAdjustment $ (Negative Amount Only) Valuation Notes