New York State Police, Trooper Thomas S. Victor Letter of Censure, 2020
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4 w RK ATE State Police ANDREW M. CUOMO KEITH M. CORLETT Governor Superintendent September 11, 2020 Trooper Thomas S. Victor New York State Police Middletown, NY LETTER OF CENSURE Dear Trooper Victor: On April 7, 2020, you were operating your assigned Division vehicle when you were involved in a troop car accident. This accident has been reviewed at Troop Headquarters and it was determined to have been preventable on your part. On September 11, 2020, you appeared before me, executed a waiver, and requested that I adjudicate the disciplinary action. The accident occurred when you were traveling on East Main Street in the Town of Wallkill behind another Division vehicle, 2F70, and another vehicle in front of that. The front car stopped abruptly for a squirrel crossing the road. You braked but your vehicle, 2F60, struck the rear of 2F70, subsequently pushing it into the car in front of him. Fortunately, there were no mJunes. However, as professional driver, you are expected to drive more carefully. It is my decision that you receive a letter of censure for your actions. Additionally, I have determined that you would benefit from instruction with our Troop Safety Officer. I trust that you will drive more cautiously in the future. ;;;/-C,#~ James C. Michael Major Troop F Commander Building 22, 1220 Washington Avenue, Albany, NY 12226 I www.troopers.ny.gov NEW YORK STATE POLICE MEMORANDUM Troop F Station SP Middletown Date To: Major James C. Michael, Troop F Commander From: Trooper Thomas S. Victor Subject: DISCIPLINARY ACTION June 3, 2020 /73.V I hereby request to have the above-captioned investigation adjudicated by the Troop Commander pursuant to Rule 3, Disciplinary Action, of the New York State Police Manual. I waive the following: 1. The right to have this matter disposed of by the Superintendent or by a formal hearing. 2. Any right to appeal the Troop Commander's adjudication, which may be a determination of unfounded or, upon a finding of guilt, the imposition of the following penalties: 1. A letter of censure and/or 11. An intra-troop transfer and/or m. A fine to be expressed in the loss of no more than five vacation days to be worked by me with no additional compensation or overtime. TB-1SA PREVENTABLE TROOP VEHICLE ACCIDENT-REPORT OF ADJUDICATION (8/07) DATE OF ACCIDENT/INCIDENT VAN 1170169 104/ 07/20 TIME OF ACCIDENT/INCIDENT VEHICLE PLATE NUMBER 19:40 am 12F60 DRIVER'S NAME (FIRST, MI, LAST) !Thomas S. Victor SHIELD NUMBER STATION lsPMiddletown ~283 I. ORIGINAL FILE 3# IAMSP169BQ2GJ9 Type(s) OF Adjudication v7 01 - Clinical Phase 02 - Instruction - Troop Safety Officer or Traffic Supervisor 03 - EVOC assignment 04 - NO disciplinary action --"-✓ - OS - Counselling 06 - Censure 07 - Vacation Days (number) _ _ __ 08 - Probation 09 - Suspension without pay 10 - Termination 11 - Other (specify) _ _ _ _ _ _ _ _ __ II. Date of Adjudication APPROVED BY _i_1_LL1cJ (J RANK INSP-8 (Rev 12/16) PC # Administrative Investigation Report RCN, 9518721 SJS# 1 p age . New York State.Police Date: 2ooo(lS2'I 04/07/2020 TvDe of lnvestiaation □ □ □ Member Receivina Initial ComDlaint Incident Review Level 1 PC Injury/Illn ess to Person Prior to Custody Injury/Illness to Person Being Taken Into Custody Division Vehicle PDAA Division Vehicl e PIAA □ □ [l] Name (Last, First, Ml) Rank Prestigiacomo, Mark A. Sergeant/SC Reported By: Field Generated Date Occurred: 04/07/2020 Place of Occurrence: County: I Ti me Occurred: 9 :40 am Damage/Loss of Division Property - 04/07/2020 TZS Shield F221 5022 I Time Reported: 9 :40 am East Main St. Orange Synopsis: lnjurynllness to Person While in Custody Emp loyee ID # Date Reported: □ □ □ On-Duty lnjurynllness cJTN: I T/Wallkill CTV Code: F3666 Three car PIAA involving 2F60 and 2F70 . Member(s) Involved Name (Last, First, Ml} Rank TZS Sh ield Victor, Thomas S. Trooper F221 0283 White Mozer, Thomas J. Trooper F221 3611 White - Race Involved Person #1 - N/A Name (Last, First, Ml) DOB Address City Employee ID # Rank Race State TZS Shield If Member: How Occu rred: Cl) ~ ...0 ~ :::, £ Name of Hospital/EMS: Treated by: Treatment Refusal Witnessed by: If Prisoner - Charges: Use of Force: Zlp Phone Duty Time Lost ARS # hrs Nature: en en Sex I Type of Force: 1) 2) Page . New York ~ate Police INSP-8 (Rev 11/16) 2 PC# Administrative Investigation Report 9518721 SJS# 04/07/2020 Date: Person Interviewed #1 Name (Last, First, Ml) Race Sex Scott, Chelsea A. Black F Name (Last, First, Ml) Race Se.ll M White Tonnesen, Eric State NY Operator (Last, First, Ml) Sex Race White Victor, Thomas S. M Make Model Year Color Reg. State Reg. # Ford Explorer 2017 Blue NY 2F60 Mileage \/AN# 63,887 170169 Division Vehicles : Vehicle #2 Operator (Last, First, Ml) Race Sex Mozer, Thomas J . White M Make Model Year Color Reg.State Reg.# Ford Taurus 2014 Blue NY 2F70 Division Vehicles : Mileage \/AN # 150,235 140365 N/A #1 Type Reason for Damage/Loss Make Model Property Description \/AN# Reg. # Cal/Ga Year Serial# Damage Description Property Val ue $ DOB Owner (Last, First. Ml) Address City Sex Race State Zip Phone Page New York State Police 3 04/07/2020 95'18721 ' Vehicle.# 3 'I ' I Sex Race Scott, Chelsea A. Black Make Model Year Honda Civic 2017 Mileage VAN# F Color· Reg. State Reg.# Blu,e NY HWT4495 Division Vehicles: NIA Vehicle# Operator (Last, First, Ml) DOB Sex Race 'l Make Model Year Color Mileage VAN# Reg.State Reg.# Division Vehicles: ·- Vehicle# NIA DOB Operator (Last, First, Ml) Make Color Model Year Mileage VAN# Sex Race Reg.State Reg.# . Dlvls)on Vehicles: NIA Vehicle# DOB Operator (Last, F~rst, Ml) Make , Model Year MIieage VAN# Sex Race Color Reg.State Reg.# Division Vehicles: NIA Vehicle# DOB Operator (Last, First, Ml) Make Division Vehicles: Model Year Mileage VAN# Sex Race Color Reg.State Reg.# . Page New York State Police INSP-8 (Rev 11/16) PC# Administrative Investigation Report. SJS# 9518721 Date: 4 04/07/2020 Enclosures Check:List {Check all that annlvl Last Name of Person(s) Submittlng Memo(s): Memo(s) [l] Victor, Mozer Last Name of Person(s) Signing DepositiOn(s) andlor Statement(s)~ Depositions andlor Statements [l] Scott, Tonnesen \ EMS-Service or Medical Facility Title and Last Name Oeposltlon(s) □ AMS Message [l] Medical IJ Portal Message GENL-34D Photo Record GENL--89 Use of Chemical Agent GENL-90 Use of Taser X26/X26P GENL-91 Vehicle Pursuit Report MV-104A Police Accident Report Non-SP Collisionnncldent Report (TRACS) Audio Recording Video Recording GENL-81 Medical Release GENL-81E Medical Release GENL-ll1M Medical Release Other Enclosures □ [l] □ □ □ [l] □ □ □ □ □ □ [l] #EncloSed: Transcript enclosed: Enter Source: #Enclosed: Transcript enclosed: Enter Source: Last Name(s): Records Enclosed: Yes Records Enclosed: Yes Records Enclosed: Yes Employee(s) Last Name: Member(s) Last Name_: Describe: SJS Report #9518721, Estimates 2F60 and 2F70 □ □ □ No No No □ □ □ INSP-8 (Rev 11/16) Page New York State Police 5 PC# Administrative Investigation Report 9518721 SJS# Re Date: 04/101,2020 rt of: Name Rank TZS Mark A . Prestigiacomo Sergeant/SC F221 Signature Date 04/21 /2020 Name Rank TZS Thomas J. Brozycki Lieutenant F200 Signature Date From: J' . DA-'°'~ ,r Signature. I concur with the findings of this In vestigation: Yes ~ Yes ~ Date: From: Si gnature : Date: If Division riate status: □ Non-Preventable Preventable riate status: If Personnel Com Founded Unsubstantiated Closed by Investigation D H Founded, complete the following: Ru le 3 Waiver Form attached Date: Disposition imposed under Rule 3: No Action Warra nted D Letter of Censure D □ Copy of Memoran dum of Disposition to Member Attachec~ Intra - Troop Transfer D Probation # of days: □ Loss of A.L. Days # of days: □ I INSP-8N (Rev 11/16) Page 1 of 1 New Yark State Police Administrative Investigation Report Narrative PC# , SJS # 9518721 Date: 04/07/2020 On April 7, 2020 at approximately 9:40 PM, Trooper THOMAS S. VICTOR (SP Middletown 1 shift) operating 2F60 and Trooper THOMAS J. MOZER (SP Middletown 1 shift) operating 2F70 were involved in a three car PIAA on East Main Street in the Town of Wallkill. Sergeant/Station Commander THOMAS A. FORTUNA, Sergeant LEE C. GUAGENTI and I, Sergeant/Station Commander MARK A. PRESTIGIACOMO, were advised and responded to investigate. Investigation revealed that 2F60 (V-1 ), 2F70 (V-2), and a 2017 Honda Civic bearing NY registration HWT4495 (V-3) operated by CHELSEA A. SCOTT were traveling eastbound on East Main Street T/Wallkill when V-3 came to a sudden stop for an uninvolved vehicle ahead which stopped abruptly for a squirrel crossing the road . Troopers VICTOR and MOZER also braked, at which time 2F60 struck the rear of 2F70 subsequently pushing 2F70 into the rear of V-3 . I interviewed Troopers VICTOR and MOZER who stated that they were both traveling eastbound when V-3 came to a sudden stop causing them to brake. Trooper VICTOR stated that he attempted to brake and veer to the right, but was unable to avoid 2F70. Members provided GENL-7 memoranda which are enclosures in this report. Sergeant GUAGENTI interviewed CHELSEA SCOTT who stated that she stopped suddenly for a vehicle ahead of her which stopped for a squirrel crossing the road. SCOTT stated that she believed her vehicle was struck by 2F70, but she did not observe any damage and was uninjured. A supporting deposition was secured from SCOTT which is an enclosure in th is report. ~ ant/Station Commander FORTUNA interviewed independent witness ERIC TONESSEN ~ ho corroborated the event as described above. A supporting deposition was secured from TONESSEN which is an enclosure in this report. Photographs of the scene and involved vehicles were secured, as well as an accident report completed , which are enclosures in this report. Estimates were received from T&C Auto Body in Middletown, NY in the amount of $6,908.66 for 2F60 and $13,590.64 for 2F70 which are enclosures in this report. Closed by investigation. NEW YORK STATE POLICE MEMORANDUM TROOP F DATE STATION Middletown June 1, 2020 TO: Deputy Superintendent Joseph A. Tripodo, Field Commander Attn: Major, Division Traffic FROM, Majfil J=~ C. Michool. Troop F Cnmmrnde, SUBJECT: TROOP CAR ACCIDENT- 04/07/20 TROOPER THOMAS S. VICTOR ;:f!l Reference is made to the attached self-explanatory investigative report regarding the abov~ subject. I have reviewed this accident and it is my opinion that it was preventable on the part of Trooper Thomas Victor. Member has consented to adjudication by the Troop Commander under the provisions of Article 3, Disciplinary Action, Rules of the New York State Police. Results of the adjudication will be forwarded to you upon completion of same. Attach. Genl. 7 NEW YORK STATE POLICE MEMORANDUM Troop_E_Station SP Middletown Date_ _ _ _ _~A'--=p=ri~l~7~,2""'0"-'2=0 To: Major James C. Michael, Troop Commander, Troop F From: Trooper Thomas S. Victor II Subject: DIVISION VEHICLE PIAA -----,.5. // On Tuesday, April 7, 2020, I was working a 1 shift out of SP Middletown operating marked New York State Division vehicle 2F60, a 2017 Ford Explorer. At approximately 9:40 a.m. I was driving eastbound on East Main St, in the Town of Wallkill. At that time, 2F70 operated by Trooper THOMAS J. MOZER was in front of me along with a blue 2017 Honda Civic bearing New York registration HWT4495 operated by CHELSEA A. SCOTT in front of him. I observed Trooper MOZER come to a stop due to SCOTT abruptly stopping. I attempted to avoid 2F70 by slowing down and moving onto the shoulder but was unable to avoid striking the rear passenger side bumper. Said collision caused damage to the front driver side bumper of 2F60 and rear passenger side bumper of 2F70. The collision subsequently caused the airbags to deploy in 2F60. Sergeant/Station Commander THOMAS A. FORTUNA and Sergeant LEE C. GUAGENTI responded to the scene for the investigation. Both 2F60 ~d 2F70 were towed from the scene. E-.;.. Genl. 7 NEW YORK STATE POLICE MEMORANDUM Troop_f_Station SP Middletown Date_ _ ___,A'--'-"'-pr,.,_i,_17'-''"-'2..,0ce2,,,_0 To: Major James C. Michael, Troop Commander, Troop F From: Trooper Thomas J. Mozer Subject: DIVISION VEHICLE PIAA l:JM I was advised by Sergeant/Station Commander THOMAS A. FORTUNA to compose a memorandum regarding a Division vehicle personal injury automobile accident involving marked Division vehicles 2F70 and 2F60. On April 7, 2020, I was working an assigned I shift out of SP Middletown operating marked Division vehicle 2F70. At approximately 9:40AM I was driving eastbound on East Main St, in the Town of Wallkill. A Vehicle ahead ofme came to a sudden stop at which time I braked. Marked Division vehicle 2F60 being operated by Trooper THOMAS S. VICTOR II, was traveling behind me. Trooper VICTOR was unable to stop in time, striking 2F70 in the rear. Due to the impact, 2F70 was pushed into the rear of the stopped vehicle in front of me, a blue 2017 Honda Civic bearing New York registration HWT4495 being operated by CHELSEA A. SCOTT. 2F70 sustained rear end damage as well as front end damage to the push bumper. 2F60 sustained front end damage. I did not incur any injuries resulting from the accident. Sergeant/Station Commander THOMAS A. FORTUNA and Sergeant LEE C. GUAGENTI responded to the scene for the investigation.·2F70 and 2F60 were towed from the scene. . GENL-4 (03105) New York State Police ' SUPPORTING DEPOSITION (CPL§ '100.20) PAGE OF THE PEOPLE OF THE STATE OF NEW YORK -vs. OEFENDANT(S) LOCATION OF INCIDENT: LOCATION OF DEPOSITION: STATE OF NEW YORK ----- ---COURT O~bQ.. COUNTY OF OF On I COUNTY OF _ _o=C2JlortJ=;;;;..;;:t.;..::~c------- II j, l-'o ro•.o~ I I--~---~-~-l'-__ F'Ul.l.NI\ME: TIME STARTED: at - OF l,..'.)M..L{L.I U.. DATE: 4 STAT E OF NEW YORK ~ I, 1,,.-$_~----~$£.u ~ _,r_...., state the following: ~ ~ .,. ..... I ,Y -TP -ntt,_ 5TbP A$ NOTICE (Penal Law§ 210.45) In a written instrument, any person who knowingly makes a false statement which such person does not believe to be true has committed a crime under the laws of the state of New York punishable as a Class A Misdemeanor. Affirmed under penalty of perjury this -i rt+. --- day of >rPa.. 1t.. (SIGNATURE OF OEPONENTI -OR- * Subscribed and Sworn to before me this day of - -- - fMTNESS) - ------ ---- • This form need be swom to only when specillcally ,vquired by Ille oourt Page 1 - ORIGINAL Page 2 - COPY TlME ENOED: lb~ 12- AJ.-< (NAME OF PERSON TAKING DEPOSITION) Page 3-COPY Page4-COPY £.3 - - . . GENL-4 (03105) - -- e-'-f New York State Polir.a SUPPORTING DEPOSITION (CPL§ 100.20) PAGE OF THE PEOPLE OF THE STATE OF NEW YORK -vs. DEFENDANT(S) LOCATION OF INCIDENT: STATE OF NEW YORK - - - - -- -COURT COUNTY OF _ _ __ OF On LOCATION OF DEPOSITION: _ _ _ STATE OF NEW YORK _ __ __ COUNTY OF _ at Dvbl¾J state the following: {h-"Y> M::f:i:< /# w+fUc.p(/ I, l'.Yt,-h;- 1r trl,u--, Pi'-'ft"::\, I ty-J C& O_fl-&;.__,___6..:.,&_ _ _ _ __ ruw/V oF - - - - - - - - -- I"Li(~ J2D I In"'s??'n-½ I _ t],,t( ( zt=,, l-1&:G'" N wk A; :r "~ [~Jew JXJ!. I\M ,IL> ltr: f4z h~ /uyvz NOTICE (Penal Law§ 210.45) In a written instrument, any person who knowingly makes a false statement which such person does not believe to be true has committed a crime under the laws of the state of New York punishable as a Class A Misdemeanor. Affirmed under penalty of perjury this 1~ day of ~{ • 2b ~t_) 2 ~ CP ~ -OR- * Subscribed and Sworn to before me this (WITNESS) - - - sworn - ta only..,~-specifically - -- - - - -- "This fonn oced required 1110 coun be TIME ENDED: o:DJ--1/ day of by Page 1 - ORIGINAL Page 2-COPY Page3 -COPY Page4-COPY 12. Div/Precinct I. Agency F2 TROOP F • ZONE 2 I F22 1 7,8,9. Date Reported (Day, Date, Time) TUESDAY 04/07/2020 09 :40 - Ne\\ York Staie- - INCIDENT REPORT 13· ORI NY l 350200 r 0,11,12. Occur red On/From (Day, Date, Twne) Is. Case No. 16. l_ncident No. 95 18721 113,14,15. Occurred To (Day, Date, T ime) T UESDAY 04/07/2020 09:40 11 '· Business Name 16. l ncident T ype ACCIDENT-PERSONAL IN JURY 19. Incid ent A ddress (S treet Nam e, Bl dg. No~ Apt. No.) EAST MA IN ST 20. City/State/Zip NEW YORK 21. Loc11tiou Code (TSLED) 123. No. of ~ic1ims 126. Victim also Compla.inant'! 1 24. No. of Susp~cts WALLKILL TOWN 3666 Location Type STREET ASSOCIATED PERSONS S. TYPE Name (Last, First, Middle, Title} DRIVER 3 SCOTT, C HELS EA. A LAW ENFORCEMENT MOZER, T HOMAS , J LAW ENFORCEME1'ff VlGTOR. THOMAS, S 1220 W ASHJNGTON AVE BLDG#22 A LBANY Y 12226 VEHICLE 59. Vehicle Status DESTROYED/DAMAGED/VANDALIZED 63. Pl ate Type LA W ENFORCEMENT 68. Stvle SEDAN. 4 DOOR 71a. Towed By 1-lOLLYWOOD 60. Licen se Plate No. 2F60 165. Year 66. Make 67. Model FORD EXPlORER 20 17 161.State 1:62. Exp. Yr. NY 2020 . 1 Vallue 170. Color(s) BLUE 169. VLN I FM5K8ATI HGC3501 4 7th. Towed To TROOP 72. Vehicle Notes 59. Vehicle Status DESTROYED/ DAMAGED/VA NDALIZED 63. Pl ate T ype LAW ENFORC EM ENT 60. License Plate No . 2F70 66. Make 67. Model 165. Year FORD TAURUS 20 14 16 1. State 1:62. Exp. Yr. NY 68. Stvle SEDAN. 4 DOOR 7la. Towed By 169. VIN IFAHP2MT6EGI72231 71b. Towed To ROCK BOTTOM TROOP j· VaJluc 2020 170. Color(s ) BLUE 72. Vehicle Notes 59. Vehicle Status OTH ER 63. Plate T ype PASSENGER AUTOMOBILE (REGULAR PLATES) 68. Style SEDAN, 4 DOOR 71a. Towed Ry DRIVEN FROM SCENE 60. License Plate No. HWT4495 161. State 1:62. Exp. Yr. NY 202 1 165. Year 66. Make 67. Model HONDA C IVIC , CIVIC DEL SOL 169. VIN . 1 Val!ue 170. Color(s) BLUE 7 th. Towed To DRJVEN FROM SC ENE 72. Vehicle Notes NO DAMAGE TO V-3 Page I of 2 4/2 1/2020 17:49: 52 NARRATIVE Date of Action !Date Written I 04107/2020 104107/2020 I PRESTIGIACOMO, MARK (SGT SIC) Officer Nam~-&"Ranir- •' Narrative Investigated a three car Division vehicle PIAA on East Main St. T/Wallkill. Refer to admin report for details. ADMINISTRATIVE 74, Inquiries 175. NYSPIN Message No. 77. Reporting Officer Signature (Include Rank) SGT SIC MARK PRESTIGIACOMO 81. Status CLOSED - NO MEDIA 76. Complainant Signature 78. ID No. 5022 182. Status Date 79. Supervisor Signature (Include Rank) SGT SIC MARK PRESTIGIACOMO 80. ID No. 5022 83. Notified/TOT 04/07/2020 I Solvability Total Page 2 of2 ---------- -- 0 -- - - - - - - - - 17:49:52 Administrative Message Report Print\Run Date °'4/07/2020 AMS# SJS # 9511721 AMSP169BQ2GJ9 Date\Time Reported\Discovered 04/07/2020 09:40 Agency ORI TZS NYSP MIDDLETOWN F221 Message DIVISION VEHICLE - PIAA, ON DUTY INJURY Investigated By Photos YES Units Responded Videotape NO UF LT. THOMAS BROZYCKI, SGT/SC MICHAEL BEERS, SGT/SC THOMAS FORTUNA, SGT/SC MARK PRESTIGIACOMO, SGT LEE GUAGENTI _tf!rrative TrooP.er Thomas Victor operating 2F60 (V-1 ), Trooper Thomas Mozer operating 2F70 (V-2), and V-3 operated by Chelsea A . Seo~ are traveling eastbound on East Main Street T /Wallkill when OP V-3 brakes suddenly for a squirrel crossing the road. Troopers Victor and Mozer also brake. t which tim 2F trik he rear of 2F70 subse uentl ushin 2F70 into the rear of V-3. Troo er Victor sustained Lt Thomas J . Brozycki was notified and responded. Major James C. Michael notified by Captain Peter J. Cirigliano. # Injured #Vehicles 3 # Deceased 1 County ORANGE 0 Apparent Cause PENDING INVESTIGATION CfTNName Location\ Street Name \ Mile Post Marker WALLKILL, TOWN OF - 3666 EAST MAIN STREET Weather Conditions Road Conditions 1-DRY 1 -CLEAR Description of Damage V-1 FRONT DRIVER SIDE, V-2 REAR PASS SIDE/PUSH BUMPER, V-3 NO DAMAGE Criminal Actio n N/A Sent By FORTUNA THOMAS Sent Date \ Sent Time 04/07/2020 13:40 Notification Auth;;a•d I LT. THOMAS J. BROZYCKI TROOP, ZONE Driv r Information 1 Driver Name DOB VICTOR, THOMAS S ------------Address 1220 WASHINGTON AVE Gender M License State Chemical Test NO Driver Charged NO - - - - - - - - - State - - - - - -Zip -City ALBANY NY 12226 Violations Driver Member? YES Member Rank TROOPER Date of Entry 05/27/2018 Page 1 of 3 Member Shield 283 Member Shift 1 OWner lnfo.fm!tion Name (exactly as printed on registration) NYS POLICE, Address City ALBAN Y 1220 WASH AVE BLOG 22 Insurance Company and Code 994 - GOVERNMENT OWNED Vehicle Information 1 License Plate # State POLICE NY Vehicle Year 2017 State NY Make FORD Van# 170169 Zip 12226 VIN# 1FM5K8AT3HGC35014 Mileage 63887 School Bus NO Front Airbags Deployed YES Comm. Veh. NO Side Airbags Deployed NO NYSPVeh. YES Fire Suppression Deployed NO Equipment NO Damage Driver Information 2 Equipment Damage Description Driver Name DOB MOZER, THOMAS J Gender M License State Chemical Tent NO Driver Charged NO ------------------------State Zip - -Address -------------- City 1220 WASHINGTON AVE ALBANY NY 12226 Violations Driver Member? YES Member Rank Date of Entry Member Shield 3611 Memb1er Shift Owner Information 2 Name (exactly as printed on registration) NYS POLICE, A ddress City 1220 WASH AVE BLDG 22 ALBA NY State NY Zip 12226 Insurance Company and Code 994 - GOVERNMENT OWNED Vehicle Information 2 License Plate # State POLICE NY Vehicle Year 2014 Van# 140365 Make FORD VIN# 1FAHP2MT6EG172231 Mileage 150235 School Bus NO Front Airbags Deployed NO Comm. Veh . NO Side Airbags Deployed NO NYSPVeh. YES Fire Suppression Deployed NO Equipment NO Damage Driver Information 3 Equipment Damage Description Driver Name Gender SCOTT, CHELSEAA F Page 2 of 3 License State Chemical Te5rt Driver Charg,ed NO NO =A_d_d_re_s_•=====-------------'----------·-~-~-------=-=ip===----Violations Driver Member? NO Member Rank Date of Entry Member Shield Member Shift Owner Information 3 Name (exactty as printed on registration) SCOTT, CHELSEA A State NY Insurance Company and Code 678 - PROGRESSIVE ADVANCED INS Vehicle Information 3 License Plate # State HWT4495 Vehicle Year 2017 NY VIN# Make HOND Van# Mileage School Bus Comm. Veh. NO Front Airbags Deployed Side Airbags Deployed NO NO NYSPVeh. NO Fire Suppression Depluyed NO Equipment Damage NO Injured 1Dt '8as~ erso~tion 1 Equipment Damage Description INJURED Injured \ Deceased Injured \ Deceased Name VICTOR, THOMAS S Ftace Gender M Address 1220 WASH AVE BLDG 22 City A LBANY State NY Injured Taken To (Medical Facility) Position in Vehicle ORANGE REGIONAL MEDICAL CENTER 01 -DRIVER ln Custody NO Driver Member? YES NO Seat Belt NO Ejected Relative Notified NO YES Member Rank TROOPER Date of Entry 05/07/2018 Page 3 of 3 ME1mber Shield 283 Zip 12226 ARS# 006 24382 __..,. c-7 PeQe 1 of 3 New York State Department of Motor Vehicles Pages Local Codes POLICE ACCIDENT REPORT 9518721 ear Day or Week VEHICLE No. of Vehldes Military Time Tuesday 2020 VEHICLE 1- Driver License ID Number nve r ame - exactly es printed on rocense MV-104A (6/04) □ AMENDED REPORT SPP169BQ2BD1 09:40 ~~t ~n~~t~g~t~ _a~ 5:-:n~ _ O Left Scene D Police Photos D ~ Ye$ No □BICYCLIST □PEDESTRIAN 0 0TH ER PEDESTRIAN 0 Accident Reconstructed ~ VEHICLE 2 Slate of Lie. State of Lie. NY NY nver ame - exa as printed 011 license VICTOR II, THOMAS S Apt. 1220 WASH AVE BLDG 22 NY 01 City or T<Mn State ALBANY NY r-·---·----. Dato I Birth □ · DamS!)ed ... ear Day : Sex ~ Unlicensed □ Zip Code Vehicle Year & Make VehidefYPe 2017 FORD POLI S8X Cate Of Bir1h Oay Ontll Apt No. City or Town Stal♦ ALBANY NY Ins. Code Plat• Number 994 POLICE Stare of Reg. Velliele Year & Mal<e NY ~ic Prope:1)1 DamagM 01 1220 WASH AVE BLDG 22 12226 NY 12226 No•. of Occupants □ M ,stration , R818!1$8d Address (Include Number and Strool) State al Reg. Zip Code NY NYS POLICE, Apt.No•. 1220 WASH AVE BLDG 22 State ALBANY Public Propeny onth NYS POLICE, Address (lnc!IJde Number and Street) City or Town oa,a or Birth sex Nam9 - exac11y 8$ pdnted on registradon Apt No. 1220 WASH AVE BLDG 22 12226 o. of Occupal\ls MOZER, THOMAS ,T Address (Jndude Number and Street) No. Zip Code State 1 1 1 Address (Include Number and Street) 5 No. Injured No. Kiled 3 2014 FORD ~. □ eer , Re!eased ~J- □ Z.,Ccc!e 12226 Vehicle Type POLI Ins. Code 994 1ick8t!All'8SI Num!>el(s) Violalion Sec6on(s) s: ide; Circle the diagram below that describes the accident, or draw your own diagram In space #9. Number the vehicles. ide; feet tong; lghlpermit; Ill an overweight permit; t:::2~Ell~~r:1:J~~~g~~~Q:~~~::j L Box 1 • Point of Impact Box 2 - Most Damage Enter up to three more damago codes 1 E Vehlele By: Towed To: 12 3 1 4 2 I 2 L Box 1 - Point of Impact E Box 2 - Mo~t Damage Enter up to three 5 2 more damage codes l:IOLLYWOOD SP MIDDLETOWN 7 4 3 6 7 2 8 2 5 ACCIOE:NT DIAGRAM Vehlcle By; ROCK BOTTOM Towed To: SP MIDDLETOWN See the last page of the MV-1 04A for the accident diagram. VEHICLE DAMAGE CODING: 1-13 SEE DIAGRAM ON RIGHT. 14. UNDERCARRIAGE 15. TRAILER 16. OVERTURNED Refe~nce Marker 9. 17. DEMOUSHED 18. NO DAMAGE 19. OTHER Cost or repaiss to any one vehlde Will be more than $1000. D Unknown/Unable to determine Coordinates (if available) Latitude/Northing Place Where Ac:cldent Occurred: 4588301 Road on which accident occurred County ORANGE □ City □ Village ~ Town EAST MAIN ~ Yes of WALLKILL STREET """'~"-""""""""a....;;..;.;c==------.(R'"'c""u"'te""N"'u""m"' tier =oc""s"1re""e""t°"Na ~m=o~i- - 1---,.---.---i---l Longitude/Easting 551607 al 1) intersecting street .3 or 2) -1ee,......,.t- mlles 0N Os oe ~w (Route Numbei or Sireet Name) of DUNNING ROAD (Milepo$~ Nearest iltersecting Rout• Number or Street Name) Accident Description/Office(s notes V-1, V-2, and V-3 were traveling eastbound on East Main Street T/Wallkill when OP v- 3 b~aked suddenly for a squirrel crossing the road. OPS V-1 and V-2 also braked, at which time 'V- 1 struck the rear of V-2 subsequently pushing V- 2 into the rear of V-3. WITNESS #1 ERIC TONNESEN 153 RIDGEBURY ROAD NEW HAMPTON, NY 10958 (845) 820- 7092 NCICNo, 2752 14301 PrecinllPost StationlBe11t Troop/Zone Sector Reviewing Officer Dato/Time Reviewed BELGIOVENE, F2 MICHAEL 4/10/2020 09:45 41 N New York State Oepartment of Motor Vehicles Pages of 3 Local Codes POLICE ACCIDENT REPORT 9518721 SPP169BQ2BD1 □ i:,.::a;;;:;;:::..:;,=.------~.-a-r ......i Day of Week 2020 Military Time Tuesday VEHICLE VEHICLE 3- Driver License ID Number Driver Name - exactly as printed on license MV-104A (6/04) AMENDED REPORT 09:40 No. of Vehicles No. Injured No. Killed 1 3 Nol lnveMigated at Scene 0 3 Stale of Lie. NY SCOTT, CHELSEA A State NY nlicensed □ Vehicle Year & Make 2017 HOND . '..-: .. ,,, ; ·· · Circle the diagram below that deseribes the accident, or draw your cwn · /'i/.1,.' diagram In space #9. Number the vehicles, V •:jiff, ,,- ., 1:+--~ E H t'-a U1A Tutro l. I =:.&'..11o111 C ~---- Head On RlglltAAgle _J 1. ~ L Box 1 - Point of Impact . 2 L o . E Box 2 - Most Damage 9 1 I:! E ~x· Enter up 10 three - -3- +---4+---1 5 .. · ' ·" 3 more damage codes i'°"'":~r--:~~·:~· ::,;,·,~' -.;:15 ACCIDENT DIAGRAM f{t· Vehicle By: Towed To: VEHICLE·DAMAGE CODING: MS SEE DIAGRAM ON RIGHT. 14. UNDERCARRIAGE 17. DEMOLISHED U. TRAILER 11;, OVERTURNED 18. NO DAMAGE 19. OTHER 9. Cost of repairs to any one vehicle will be more than $1000, 11 Reference Marker Coordinates (if available} Latitude/Northing D Unknown/Unable to determine " · D Yes O No Place Where Accident Occurred: County D City D ORANGE Village D Town o! Road on whidl accident occurred (Route Numter or S1r8el Name) ~-.--.----.---1 Longijude/EasUng at 1) intersecling street or.2) -~,e-e~IAccident Description/Officer's notes 0 D NE B SW (Route Ni.rn6ar or Stroot Name) of -.,.,.,,,--,-,.,..,.,.,..,,.-.,-,,....,.,..,,..,.,..,.,.,...,.~==.c:::==:;-(Milepcsl Nearest interseCling Route Nuinber ~r Street Name) of 3 Page 3 Pages New York State Department of Motor Vehicles Local Codes POLICE ACCIDENT REPORT 9518721 SPPl69BQ2BDl □ AMENDED REPORT ~•"="'~"'~~J!.~e!Dae,to,___,,----,-"-__JDay of Week 0 4 7 2020 Military Time Tuesday 09:40 MV-104A (6/04) No. of Vehicles 3 No. Injured No. Killed l East Main St T/Wallkill 0 Not Investigated at Scene D Lett Scene D A~cid;nt Re-~n;t~cie"°d - - -□ Police Photos ~ Yes D No CD New York State Department of Motor Vehicles REPORT OF MOTOR VEHICLE ACCIDENT POLICE LINE OF DUTY ACCIDENT □ Page 1 AMENDED REPORT Panes of Precinct 'E'241 IMPORTANT: If you are the officer in charge, complete and sign this form, and attach it to the MV-104A or MV-104AN. Local Accident Number 951 8721 SPP1 69BQ2BD1 Accident nme Accident Date 4 Month I 7 Day / 2020 In Military Year Time County 09:40 ORANGE NAMES OF DRIVERS: {Please Print or Type) Driver Driver ofVeh. Plate License. M.I. Reg~ 'Number State License Number · Stat~ ... 'First Last VEH 1 □ VICTOR II THOMAS s NY POLI CE NY MOZER THOMAS J NY POLICE NY SCOTT CHELSEA A NY HWT4 495 NY VEH 2 □ VEH 3 □ VEH4 VEH 5 VEH 6 Pursuant to Section 605 of the New York State Vehicle and Traffic Law, the attached Police Acddent Report is also the motorist report for vehicle number(s) 1, 2 * Pursuant to Section 605(a)(4) of the Vehicle and Traffic Law, check only the box for each police officer operating a police vehicle (as defined by V & T Section 132-a) during emergency operation (as defined by V&T Section 114-b) when the accident occurred. Date 04/1 0/2020 MV-104L (4/07) --- -- ---- Signature of Owner or Police Vehicle/Police Agency Representative 09:45 - - - www.nysdmv.com NCIC# 14301 New York. State Department of Motor Vehicles REPORT OF MOTOR VEHICLE ACCIDENT POLICE LINE OF DUTY ACCIDENT □ of Page 1 AMENDED REPORT Pages Precinct F241 Local Accident Number .9518721 IMPORTANT: If you are the officer in charge, complete and sign this form, and attach it to the MV-104A or MV-1 04AN. SPP169BQ2BD1 Accident Date 4 Month I 7 Accident Time / 2020 Military Year Day County In nme ORANGE 09:40 NAMES OF DRIVERS: (Please Print or Type) $tale ofVeh. * L~st F.i.t st . M.I. Driver RetJ. Plate Nurnber .License State Driver · .License Number VEH 1 □ VICTOR II THOMAS s NY POLICE NY MOZER THOMAS J NY POLICE NY SCOTT CHELSEA A NY HWT4495 NY VEH 2 □ VEH 3 □ VEH4 VEH S VEH6 Pursuant to Section 605 of the New York State Vehicle and Traffic Law, the attached Police Accident Report is also the motorist report for vehicle number(s) 1, 2 • Pursuant to Section 605(a)(4) of the Vehicle and Traffic Law, check only the box for each police officer operating a police vehicle (as defined by V & T Section 132-a) during emergency operation (as defined by V&T Section 114-b) when the accident occurred. Date 04/10/2020 MV-104L (4/07) Signature ol Owner of Police Vehicle/Police Agency Representative 09:45 ✓-- - -~ - www.nysdmv.com NCIC# 14301 £6 - GENL. 340 /Rev 05/151 INSTRUCTIONS: ,DIGITAi- PHOTO RECORD STATION CASE NUMBER Sp Middletown FlU LEAD NUMBER INCIDENT DATE 9518721 • Complete a separate fonn for each Investigation • Print or hlne all enbies PHOTO DATE TIME 04/07/2020 INVESTIGATING MEMBER 04/07/2020 /0'. /1,,,IJM Sgt/Sc Thomas Fortuna CASE TYPE COMPLAINANT - DEFENDANT - OPERATOR- DECEASED Troop car PIAA/Member OD! NYSP COUNTY ADDRESS OR LOCATION Orange East Main St Mjddletown NY 10940 GENERAL DESCRIPTION OF SCENE/ ITEM($) I IMAGE TYPE OR FILE FORMAT 0 JPEG O TIF O Raw ' ACTION REQUESTED 0 Troop Car PIAA Fuji COMPLETED PHOTOGRAPHER'S NAME Sgt/Sc Thomas Fortuna CAMERA BEGAN ' ~ JO './0 I PAGEO 1 OF 1 ll?l Retain 04/07/2020 ll?J CD/DVD O E-MAIL O Other _ _ IMAGE# 1 DSCF1348 View of east main St facing east 39 2 1349 Rear of2F26 40 41 IMAGE# 3 1350 4 1351 Drivers side 2F26 Rear2F26 5 1352 Drivers side 2F60 43 6 1353 Pass side 2F60 44 7 1354 45 8 1355 Front of2F60 POI 2F60 . 9 1356 Rear2F70 47 10 1357 PO_l2F70 48 11 1358 POl2F70 49 12 1359 Pass side 2F70 50 13 1360 Front2F70 51 42 46 14 1361 Drivers side 2F70 52 15 1362 Rear of Honda Civic HWT4495 53 16 1363 54 17 1364 " " 18 " " O Print MANNER SUBMITTED: (Check one) CAMERA PHOTO 10# DESCRIPTION: Bum To CD/DVD DATE SUBMITTED TO FIU 55 1365 Inspection/ Reg 2F70 56 19 1366 Inspection/Reg 2F60 57 20 1367 2F70 Push guard 58 21 1368 Front QP of2F70 59 22 1369 Pass side QP of2F70 60 23 61 24 62 25 63 26 64 27 65 28 66 29 67 30 68 31 69 32 70 33 71 34 72 35 73 36 74 37 75 38 76 CAMERA PHOTO 10# DESCRIPTION: INSP-8PS (Rev 11/16) New York State Police Photo 1 of 6 Photo Sheet Case# 9518721 INSP-8PS (Rev 11 /16) New York State Police Photo 2 of 6 Photo Sheet Case# 9518721 INSP-8PS (Rev 11/16) New York State Police Photo 3 of 6 Photo Sheet Case#. 9518721 INSP-8PS (Rev 11/16) New York State Police Photo 4 of 6 Photo Sheet Case # 9518721 INSP-8PS (Rev 11/1 6) New York State Police Photo 5 of 6 Photo Sheet Case# 9518721 INSP-BPS (Rev 11 /16) New York State Police Photo 6 of 6 Photo Sheet Case# 9518721 .' T & C AUTO BODY, INC. 770 Rt 17 M, Po Box 2164, MIDDLETOWN, NY 10940 Phone: (845) 343-3443 FAX: (845) 342-4330 Workfile ID: PartsShare: 6153a430 5P6BSF State ID: 7000221 Preliminary Estimate Customer: New York State Police 2F60 Job Number: Written By: Courtney Tava, IA-941110 Insured: New York State Police 2F60 Type of, Loss: Policy#: Claim#: Date of Loss: Days to Repair: O Point of Impact: Owner: New York State Police 2F60 Inspection Location: T & C AUTO BODY, INC. 55 Qystal Run Rd 770 Rt 17 M Middletown, NY 10941 Po Box 2164 (845) 344-5300 Day Insurance Company: MIDDLETOWN, NY 10940 Repair Facility (845) 343-3443 Business VEHICLE. 2017 FORD Police Interceptor Utility Vehicle AWD (Fleet) 4D UTV 6-3.SL Turbocharged Gai;oline Gasoline Direct Injection Blue VIN: 1FM5K8AT3HG05014 Interior Color: License: 2F60 Exterior Color: Blue Mileage Out: State: NY Production Date: 3/2017 Condition: TRANSMISSION · Mileage In: ., Privacy Glass 63,887 Vehicle Out: Good Job#: AM Radio Head/Curtain Air Bags FM Radio SEATS CONVENIENCE Stereo Cloth Seats Air Conditioning Search/Seek Bucket Seats Power Steering Intermittent Wipers CD Player Redining/Lounge Seats Power Brakes TIit Wheel SAFETY WHEELS Styled Steel Wheels Automatic Transmission overhead Console 4 Wheel Drive POWER Power Windows Cruise Control Drivers Side Air Bag Power Locks Rear Defogger Passenger Air Bag PAINT Power MirTors Message Center Anti-Lock Brakes (4) Clear Coat Paint Power Driver Seat Steering Wheel Touch Controls 4 Wheel Disc Brakes OTHER Power Adjustable Pedals Rear Window Wiper Traction Control Rear Spoiler DECOR Backup camera Stability Control Dual Mirrors RADIO Front Side Impact Air Bags 4/.8/2020 3:58:26 PM 002479 ,)·.•· ':· ( Preliminary Estimate Customer: New York State Police 2F60 lob Number: 2017 FORD Police Interceptor Utility Vehide AWD (Fleet) 4D lJTV 6-3.5L Turbocharged Gasoline Gasoline Direct Injection Blue Line 1 2 3 4 Oper Description Part Number Qty Extended Price$ Labor Paint FRONT BUMPER O/H front bumper 3.8 * Repl # R&I Bumper cover (installl on parts 5 * Repl LI Side Sl!Pt!Qrt (SP ~UQQligd) 6 # R&I LT Side support (installl on parts vehicle) Bumi;ier cgver (SP ~ui;i:i;i:l!eQ) FB5Zl7D957EB 1 l!..O.Q Ind. 0.0 2.0 vehide) 7 FB5Zl7E8148 1 0 00 2 1 0.00 Repl LT Side support rivet W702852S300 8 * Repl Abs!lc:b!ilr (SP suggligd) FBSZ17C882C 9 # R&I Absorber (installl on parts vehide) 10 • Repl ~O!tier molding (SP SYRPlied) 11 # R&I Lower molding (installl on parts vehicle) 12 * LT Valgnce (SP sugglh~d) 14 # R&I LT Valance (installl on parts vehicle) 15 • Repl LT Side trim (SP suggll~) 16 # R&I LT Side trim (installl on parts vehide) 17 * Repl LI Side trim nut 18 # Repl Push bar (SP supplied) 19 # R&I Push bar (installl on parts vehicle) 20 GRILLE 21 * Repl l!lct. FBSZ8419APTM 1 lLlll! FB5Zl7626DA 1 0.00 Ind • 0.0 G[illg POUCE l!'!I!;8~~EIOR (SP 0.3 0.2 FB5Zl78968CA 1 l!.l1!! Ind • l!lct. W7042775439 1 1 2.0 1.0 FBSZ8200GB 1 l!.QQ W709367S439 1 l!..O.Q FB5Zl3008AF 1 0.00 Ind. supplied) # R&I Grille (installl on parts vehicle) 23 * Repl Grille 1:;lig (SP supplied) 24 FRONT LAMPS 25 * Repl LT Headlamg supplied) Repl Aim headlamps R&I LT Headlamp housing (installl on parts vehicle) 26 Ind. 0.2 • 22 1.12 R&I License plate Repl 13 Ind. hgysj □ g (SP 27 # 28 HOOD 29 * * Repl 30 31 It Repl Hood (installl on parts vehicle) 32 * Repl BI tlinge (SP supglied) l:fQQd (ALU) (SP sugglied) !ash 1 Ind. 0.5 lad. FB5Zl6612A 1 l)._QQ 1.1 Add for Underside(Complete) !l.l! 0.0 1 BB5Zl6796A 1 0.6 l!..O.Q 0.3 0.0 Note: lABOR: lime is after hood and cowl grille are removed. 33 # 4/8/2020 3:58:26 PM Repl RT Hinge (installl on parts vehicle) 1 002479 0.3 Page 2 Preliminary Estimate Customer: New York State Police 2F60 Job Number: 2017 FORD Police Interceptor Utility Vehide AWD (Fleet) 4D UTV 6-3.SL Turbocharged Gasoline Gasoline Direct Injection Blue Note: LABOR: Time is after hood and cowl grille are removed. 34 • Repl LI Hi □9f (SP suggljgr;!) BBSZ16797A Note: LABOR: Time is after hood and cowl grille are removed. 1 35 # Repl LT Hinge (install! on parts vehicle) 1 36 • Repl Late□ 37 # Repl Latch (install! on parts vehicle) 3B COWL R&I Cowl grille R&I Cowl grille (from parts car) 0.3 ILlill 0.3 Note: LABOR: Time ls after hood and cowl grille are removed. 39 40 # 41 FENDER (Se SYtmlied) • • 44 # Repl LT Fender (install! on parts vehicle) 45 • Repl LI Wbeel tll;!t:e (SP su1212!iei;!) 46 # R&I LT Flare (install! on parts vehicle) 47 • Repl LT Frgnt braQ;gt (Se sum;ilied} 48 # Repl LT Front bracket (install! on parts vehicle) Repl LT Upper rail (HSS) Rpr LT Apron/rail assy (HSS) 49 so • Repl LI Fendgr 1 lLl!Q 0.3 1 0.3 Incl. 43 42 BBSZ16700A (Se SUIJR!ied) 0.5 FBSZ16006A 1 2.3 1 1.2 Add for Edging 51 FBSZ16039AB I 2.QQ BBSZ16A143A 1 0.00 0.3 0.3 0.1 1 BBSZ16155A 1 0.1 806.63 s 3.5 s JJ! Overlap Minor Panel 52 Repl 53 LT Upper inner rail (HSS) # 55 RESTRAINT SYSTEMS 56 Rpr Repl BBSZ16B04SA 1 105.56 s 4.2 0.8 -0.2 Wire harness Driver air bag w/o PLATINUM u -0.2 Overlap Minor Panel 54 0.8 1.0 FBSZ78043B13AA I 435.85 m Ind. Note: FRONT DEPLOYMENT Deployed air bag module(s) Clockspring if driver air bag has deployed Control Module (RCM) Front impact sensors Deployed seat belt assemblies Height adjuster Occupant module if DTC B1231 can't be deared SIDE DEPLOYMENT Deployed air bag module(s) Control Module (RCM) Side impact sensors Deployed seat belt assemblies 4/8/2020 3:58:26 PM 002479 Page 3 Preliminary Estimate Customer: New York State Police 2F60 Job Number: 2017 FORD Police Interceptnr Utility Vehide AWD (Fleet) 4D UTV 6-3.SL Turbocharged Gasoline Gasoline Direct Injection Blue Height adjuster Occupant module if DTC B1231 can't be deared Seat back pad Seat back trim cover ROOF DEPLOYMENT Deployed air bag module(s) control Module (RCMJ Side impact sensors Occupant module If DTC B1231 can't be deared Headliner Windshield pillar trim Upper center pillar trim Pillar trim Rear pillar trim SEAT BELT DEPLOYMENT Deployed seat belt assemblies Control Module (RCM) OCtllpant module If DTC B1231 can't be deared INSPECTION COMPONENTS Undeployed air bag module(s) Steering wheel Steering column Instrument panel and mount points Instrument panel knee bolsters and mounts Impact sensor mount points Seat belts and mounts points Seats and mount points Seat back frame Wiring harness Occupant sensor 57 Air bag system diagnosis pinpoint test m 2.1 58 Air bag system diagnosis ck system operation m 0.5 59 Repl RT Ft impact sensor FR3Z14B004A 1 149.23 m 0.3 60 Repl LT Ft impact sensor FR3Z14B004A l 149.23 m 0.3 61 Repl Clockspring w/o heated steering wheel GB5Z14A664E 1 207.47 m 1.2 62 Repl control module HBSZ14B321A 1 476.87 m 0.3 Repl Note: LABOR: lime is after front center console is removed. LT Side impact sens rear FR3Z14B004A 1 149.23 m 0.3 63 4/8/2020 3:58:26 PM 002479 Page 4 Preliminary Estimate Customer: New York State Police 2F60 Job Number: 2017 FORD Police Interceptor Utility Vehide AWD (Fleet) 4D UTV 6-3.SL Turbodharged Gasoline Gasoline Direct Injection Blue 64 Repl LT Head air bag 65 Repl LT Side impact sens front DB5Z78042D95A 1 648.29 m 0.6 GN1Z14B345A 1 43.84 m 0.3 Note: LABOR: Time is after front door trim panel is removed. 66 Repl LT Seat belt assy DB5Z78611B09AD 1 67 Repl LT Height adjuster BB5Z78602B82AA 1 47.30 68 Repl LT Tensioner FB5Z78610E45A 1 109.48 0.3 69 Repl LT Budde end w/POUCE INTERCEPTOR EB5Z7861203AB 1 137.18 0.2 216.88 0.3 Note: LABOR: Time is after seat is removed. 70 CONSOLE R&I 71 R&I frt console assy 0.7 72 PILLARS, ROCKER &. FLOOR 73 • Repl LT Wodshld 121[ tdm ebO □¥ w[o PLATINUM (Se sugglied) 74 # R&I LT Windshld pillar trim (installl on parts vehicle) R&I LT Scuff plate front, w/o illumination ebony 0.1 R&I LT Scuff plate frcnt (frcm parts car) 0.1 R&I LT Lwr ctr plr trim ebony 0.3 75 76 # 77 FB5Z7803599AA 1 Incl • Iill:!., Note: LABOR: Time Is after front and rear scuff plates are remoVed. 78 # R&I LT Lwr ctr plr trim (from parts car) 79 • Repl LI UQ[ ci;r g!r bi[!) ebooy (SP supplied) 80 # R&I LT Upr ctr plr trim (installl on parts vehicle) R&I LT Scuff plate rear ebony 0.1 R&I LT Scuff plate rear (from parts car) 0.1 R&I LT R&I front seat 0.5 R&I LT R&I trim panel 0.5 R&I LT Qtr trim panel w/o inflatable 2nd row seat belts w/6 speaker audio-ebony 0.5 0.3 BB5Z7824347AC 1 lLllQ Ind. Note: LABOR: Time is after lower center pillar trim panel Is removed. 81 82 # 83 SEATS &. TRACKS 84 85 FRONT DOOR 86 87 Iill:!., QUARTER PANEL 88 89 # R&I LT Qtr trim 90 • Repl LI R~gr Qillar tdm '.!J.1.9 12 s12eaker eudiQ eba □¥ (SP 0.5 FB5Z7831011AA 1 lLl)Q 0.2 supplied) 91 # 92 ROOF 93 • 4/8/2020 3:58:26 PM R&I LT Rear pillar trim (installl on parts vehicle) • Repl t:lei:!dli□er '!:!.I.SJ. Cf2r AC. tamellgca:,: 0.2 FBSZ7851944FE 002479 1 4.7 Page 5 • Preliminary Estimate Customer: New York State Police 2F60 Job Number: 2017 FORD Police Interceptor UHlity Vehide AWD (Fleet) 4D UlV 6-3.SL Turbocharged Gasoline Gasoline Direct InjecHon Blue (SP supplied} 94 # R&I Headliner (insralll on parts vehide) 4.7 95 # Rpr Prepull left apron 96 # Repl Weld thru primer 1 8.50 0.3 97 # car Cover 1 8.00 0.3 98 gg # Rpr Disable SRS # Rpr De Nib &. Polish 2.0 F 0.6 1.0 SUBTOTALS 3,700.66 54.4 2.4 ESTIMATE TOTALS Category Basis Rate Parts Cost$ 3,700.66 Body Labor 52.4 hrs @ Paint Labor 2.4 hrs @ Frame Labor 2.0 hrs @ $ 55.00 /hr $ 55.00 /hr $ 55.00 /hr Paint Supplies 2.4 hrs @ $35.00/hr Subtotal 2,882.00 132.00 110.00 84.00 6,908.66 Grand Total 6,908.66 DeducHble 0.00 CUSTOMER PAY 0.00 INSURANCE PAY 6,908.66 MyPriceLink Estimate ID / Quote ID: 677151577802285056 / 65977278 ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR OTHER PERSON FILES AN APPLICATION FOR COMMERCIAL INSURANCE OR A STATEMENT OF CLAIM FOR ANY COMMERCIAL OR PERSONAL INSURANCE BENEFITS CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, INFORMATION CONCERNING ANY FACT MATERIAL THERETO, AND ANY PERSON WHO, IN CONNECTION WITH SUCH APPLICATION OR CLAIM, KNOWINGLY MAKES OR KNOWINGLY ASSISTS, ABETS, SOLICITS OR CONSPIRES WITH ANOTHER TO MAKE A FALSE REPORT OF THE THEFT, DESTRUCTION, DAMAGE OR CONVERSION OF ANY MOTOR VEHICLE TO A LAW ENFORCEMENT AGENCY, THE DEPARTMENT OF MOTOR VEHICLES OR AN INSURANCE COMPANY, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME, AND SHALL ALSO BE SUBJECT TO A CIVIL PENALlY NOT TO EXCEED FIVE THOUSAND DOLLARS AND THE VALUE OF THE SUBJECT MOTOR VEHICLE OR STATED CLAIM FOR EACH VIOLATION. You are entitled to the return of all replaced parts, except warranty and exchange parts, but you must ask for them in writing before any work is done. If you authorize work by phone, the shop must keep any replaced parts, and make them available when you pick up the vehicle. 4/8/2020 3:58:26 PM 002479 Page 6 .. ,. ;) :r,:ii,. ·c fil'tg::~{):QYi l~P. , VD,Rt17Mi·P.o;Box,tf64, ' MIDD(l:rOWN>NY. ,_ •. -.,~"'~••-'--~· ~ Wor1<file'ID: :7f•M~~, •StateID; ,7000221 1/iartisshane\ -~ .1Q!,!40J 5~6hjf- Ph9n~;,CE!45) ~4;i.;;Hit'.{ 'FAX: (~45)T312Sf330 .....- .. . P~llirii!lary ~sl:im.ite .-- - --· ,._ t:ustomer:,NeW,York'state'l:fol.i.~:2fJO' l11S)Jred:. N"'v York State ~olice 2FZO 'fype ~fL"55: Point of Impact: Owri,,i-:. ,eoi,ci:#: 'Dale ofl.oss:• Oaifn./1; to Repair: oays o; i,;,,pectk,!' l~~t.icifri New.'York Stife ~ohteslf,'Q 55 try,iraiRun Rd: 'J.& cAiJto BODY, iiiJt: ;1 ?JO:~UZM' ,Po lioxziM Miqq/_2towy,, NY'1G9-1J (845):~:s~oo·o;,y: l,IIDDLETDW~~NH@:!jl Rell.air Faq_l)!Y \845) 343·3'!4:i 'ilusmess i 20i 4 FORD· ecili~ •i:r1terC~l'!9r,,~'@.. (l;leetJ't\D _SEQ lic.J.Slf;Turtiocrfai~ed:Gasoline ,Gasofine~Dlrecffnji,ction'Bftl_e_ VIN:. License: iFAHP2MT6EGi7izii: 2F70 1~1:§ji<jr;~gl()i;: Extelior-Cofor: state: ~)' ,pij:,giiction'Date: .Mllea9e'fn:• 'Mii~_ageo_utj 'Condition: ·liiue TRAN~lSSIOf:1 Automatic Tiansnifssfon. ifli]te<l'Glais' Clverheact'tonsoteJ ~~--t .,.,,_T' S~f,jg 4.Wtieel Dnve' CONVENIENCE Sean':iiis.eii: CD'Player. POWE~ Pf?wer:s~erin~. po_~er~~rj~es Power Windo.W • "'! I- J)ir\conalti<irtinir J~ri\11\\,en\ \O!i~if 'r.l1o\Nheei . tiulse ConWi ~pwerJ~, .n -D~ --·-Ilea[ . ogger P,OWe1\MiITOl"S M~~ge,cente_r sleering'Wh~J{o_ug:]'.9'~ 1sq;;z3s; FMilAaio. §ll_c_kl,t,Se~ts ~ems- . SA!;EJ,Y Redini')9i!:D'!.~ge '.wi:IEEis Drtv~.~~~~r,e.@: i51:y1ea•§lii.e\ \'iJieeis, Passef!ger.wr Bag, ,Aiiti;Lock Brakes (4) ,,:i:wfie_elpis(BraK~ fi:QiJL~ld~J111tiact1lir ijag~- PowerDriver Seai f'oWeT~AdJustable Pedals. 'i'e1e;;copicWli'!!'I i'ieai!7Curtajn Air Bags DECOR '!lcllPIO rn1_iJR:espot:~~9'f:i ,AM'Racf<9 ·LaneDeparture.Wamlng .4]1i/2D2<f2:2B:46 PM sEJiTs oath,seats OQJ'_IZ.9; W!!ii ,oear,toat'Palnt1 f9THE!f 'Tracaao:cantrol'• •Stabillty,C6ntrol ~·11.···--·-· -~ . . ,, . 'iireliminafy'Estimate -··,. .-e<, ··~··LJ·'"-·1.f 1_--· l.......J '""-'-' CU$mer: New:\'orkstate P.olice 2f70. •;t_l)_j:4' FOl!p_Poii[!! _lnten;elltQf AW.P'"(Aeet).'IQSED:6:,3:sL Turiioiliar~ed~Gasoiine.Gasoiine,Direct-liiJect)on Bl~l a. · Part Number· ,J..in0. 11:xtendac ;tabor. . :~~-$, l R_l;AR BUMl'E~' Pm{eiir 5umQ!!f' ·RetiP Bumper cover w'[park ~ f 2 3 ~ 2;~ ,DG1Z17K835GAITTM AddfortiearCoai; 'f.3 J@il/m teverse ~ rR,;pl jj;t SJ~e ~!(iflReP,l Buf11pe'r_cover retainer; ~""' Clf.~ ¥e'~roil. Repi ~f~~eetpt "kepi Ldwer-.cover '{leiil Rr §# q,vei ri_,#;, :RePI: Ct ul~ef~9)Ver. liv~ ,Repl Rf.Lowe, cover reia[nen .ReP! -Absorber, ;;·:.~~-"" '" 'Rejli RTAbsorberretaini;r' ;Rep! Jinpacrban Jt_epl F?afKS'ehsor •Rep! 'Wire:hamesswt.o.passive entry ')'foparl< seiisa"i= ' - _, • -- PGtZl~.":4'198 {iGjl1t~t~Ai\1 O,~ ·ri.i . 17.42, rAG'fzi'l_CfflSl\1 13M§46N629 i1&0 1 1, 1, N80434:is •Ind. 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