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~ (~ S~Dr ~~ 9nc. <br />CapttaQ CQu~ms ~envice. <br />~ ~~~ T pOS7 OFFICE 90X 265 • SALEM, OREGON 97308 <br />~ ,; phone~ {503)399-8366 • Fax: (503)399-8366 <br />\ I <br />Service Billing <br />~ <br />~J ~f ~~ <br />Billing Date: 12/30/98 1 ~ `~~ <br />~~~~ <br />Our File Number: <br />To: Ms. Valerie Saiki k Insured: <br />M~°~~ ; Cla+mant: <br />~ on C~n~thouse C~a+m #; <br />~~G~jp H~g}rS~eet N.E. - Sth Floor pate of toss: <br />~~_`~0 Saler~s f~R 97 ~~'~ IRS#: <br />wtC'~ <br />y~ <br />/, . ' ~ <br />e~~ S~c~ <br />/ <br />, <br />~ ~ ! <br />W <br />l~-1~~"I ~Y <br />:.'~~~ ~ ~ <br />RISK ~ ~ ~ <br />D80245F <br />Marion County <br />Wilkes, Ryan <br />8/13/97 <br />93-0842926 <br />~~~ QP~~v <br />/ ' <br />" " a ~ 3s.oo ~ <br />2 s~.ao <br />Adjusters Hours . <br />-------- ------ - ----------------- <br />- - - - - <br />--------- <br />--------------------------------- --- <br />0.00 $ <br />0.0 C~ 0.00 <br /> <br />--- <br />Mileage - ---- <br />------------------- <br />------- -------- ------ -- <br />---------- <br />-------------------------------- ----- <br />~ @ p.00 $ 0.00 <br />---- <br />Photo -------------- <br />- -------- <br />----------------- - -------- <br />- ----- <br />- -------- <br />$ 0.00 <br />Adjusters Expense --------- <br />- <br />--------------------------- -- <br />---- ------ ------ <br />- --------------- <br />------- - ---- <br />~ a,oo <br />Total Loss 1 Salvage <br />Evaluation / Condition <br />- ------------ <br />----------------- - ---- ------ <br />- ----------- <br />_ --------- <br />$ 0.00 <br />hoto Copy ------------------ <br />--------------------- ------- ------ <br />- ---------- <br />- - -•- --------------------- - ---------- <br />$ p.90 <br />Phone <br /> <br />--------- <br /> <br /> <br /> <br />------ <br /> <br /> <br /> <br /> <br />------ - _ <br />----'$ <br />------------ <br />----------- <br />----- - --""~----~ <br /> <br /> <br /> <br /> <br /> <br />.5 <br />FNe Set-up Charge - ----- <br />-- <br />- -------------- - <br />----------- - -------------- <br />- ---------- ----- <br />----- ~ 1.b8 <br />Postage <br />--- <br />---- ------- --- ------ - - ----------- <br />- - - - --------------- <br />----- -------- <br />~ 15.00 <br />Office Expense <br />~i <br />~ ~ <br />~r ~ <br />l~ - <br />Total $ 110.08 <br />