Document 8

Toll Free: (800) 435-7764
Fax: (877) 217-1389

Email: myclaim@farmersinsurance.com
National Document Center
P.O. Box 268994
Oklahoma City, OK 73126-8994
November 21, 2021
JOSE VIRAMONTES
12224 NORLAIN AVE
DOWNEY CA 90242-3312
Delivered by email to: deliaviramontes@yahoo.com
RE: Insured: Jose Viramontes

Claim Number: 7003631361-1-1
Policy Number: 0922589808
Loss Date: 10/21/2021
Location of Loss: 12224 Norlain Ave, Downey, CA
Subject: Claim Outcome Letter
Dear Mr. Viramontes:
Thank you for choosing us to provide for your insurance needs. We value you as a customer and appreciate
the opportunity to be of service. You’ll receive payment separately from this email for the needed and related
repairs to your home.
The attached loss worksheet and estimate explains your settlement in more detail. Please note that we have not
included the flooring material costs in the estimate. We will address this portion of the claim upon receipt of the
report from ITEL.
As we discussed, this payment is for the actual cash value of your claim less your deductible. Actual cash value
is based on replacement cost less any applicable depreciation for age, useful life and condition. Labor, taxes
and other fees and expenses have also been depreciated if not prohibited by your state. To recover depreciation,
please send me a copy of any invoices or receipts that demonstrate replacement or repairs. We believe our
estimate reflects the reasonable cost necessary to repair or replace the covered damages. Please let me know
immediately if you disagree. I'll reimburse you for the full replacement cost reasonably paid to repair or replace
the covered damages or any applicable policy limits. If you intend to recover withheld depreciation, you must
submit a copy of your invoices or receipts within 365 days from the date of our first Actual Cash Value payment,
or by November 19, 2021. While some policies may provide less than 365 days to submit a copy of your
invoices or receipts, we are extending this time period to 365 days from the date of the first ACV payment.
Any deductible amount will be applied according to policy provisions.
You may request a six-month extension to submit your claim to recover withheld depreciation if you provide an
explanation that shows good cause as to why repairs or replacement can’t be completed within 365 days of our
first actual cash value payment. Please contact your claims representative if you can’t submit your replacement
cost claim within that time, so we can help you finalize your claim. If the loss or damage relates to an event for
CCJ0421W3
which a state of emergency was declared, as defined in Section 8558 of the California Government Code, you’ll
have 36 months from the date of our first actual cash value payment to make a claim for replacement cost.
I've attached a detailed estimate for the scope of the covered damage and reasonable repair costs. I have
estimated that a general contractor may be needed to manage the repairs, so I've included general contractor
fees as part of your actual cash value settlement. If you do not actually hire a general contractor, these amounts
will be deducted from any replacement cost settlement. You may choose any repair company you wish to
complete repairs. If the repair company you choose will charge more than my estimated amount, please contact
me before work begins. I'll review your repairer’s recommendations and help reach an agreement.
Your policy requires I include your mortgage company as a payee. To minimize delays in your home repairs,
you may want to contact your mortgage company to find out their requirements for endorsing the payment
and releasing the funds. During this contact, the mortgage company may request a copy of the building repair
estimate, which they may refer to as the "adjuster’s worksheet" or similar term.
The policy provides that after a loss, you should protect your property from further damage. Please keep all
receipts for emergency repairs or other expenses related to minimizing further damage.
We do not know of any party legally responsible for causing or contributing to this loss, therefore we are unable
to pursue recovery of the amounts paid, including your deductible, if applicable. In the absence of additional
information, the pursuit of any recovery is your responsibility. However, if you have additional information that
would identify a responsible party, please contact me.
We did not include drying charges in your building estimate. Since you chose a local mitigation contractor,
we’ll need a copy of their invoice. After we receive the invoice, we will review and contact you about settlement.
We reserve all rights and defenses under the policy and law and no activity on our part should be construed as
a waiver. Even though only parts of the policy may be mentioned or quoted in this letter, additional portions if
found to be relevant will be applied.
California law and regulations require that we provide you with written notice of any limitation period upon
which we may rely to deny a claim.
Please refer to the Conditions part of your policy, which states:
CONDITIONS
...
11. Suit Against Us. No action shall be brought unless there has been compliance with the policy
provisions and the action is started within one year after the loss.
In addition, we may deny a claim based on the applicable California statute of limitations.
We encourage you to visit www.farmers.com to learn more about our self-service options available to you,
including the ability to view your claim status, upload documents and photos and find local service providers.
CCJ0421W3
If you have any questions, or additional information you think may affect your coverage, please contact me at
(562) 208-1809.
Thank you.
Farmers Insurance Exchange
Bernard Biscocho
General Claims Adjuster
bernard.biscocho@farmersinsurance.com
(562) 208-1809
At this time, I can be reached by telephone and e-mail; my phone number and email address have not changed. Email
communications are preferred to avoid any potential delays caused by mailing. If you are unable to use email and
hard copies of communications are required, they may be sent to our National Document Center at P.O. Box 268994,
Oklahoma City, OK 73126-8994. We are unable to receive deliveries at any office location from FedEx, UPS or any other
courier at this time.
CC: D
Check(s): 1631559586
Enclosure(s):
General Supporting Documents -
Estimate/Invoice -
CCJ0421W3
Claim #: 7003631361-1 Farmers Insurance Exchange
Insured: JOSE VIRAMONTES

SPECIAL FORM DWELLING
Adjuster: Bernard M. Biscocho, CPCU, GCA 983
DOL: 10/21/2021 DP-3 ISO
Saturday, November 20, 2021

BUILDING STATEMENT OF LOSS
Key Policy Description: Policy Limits:
Coverage "A" (primary BLDG): $337,000.00
Building Repairs $33,256.40
Pack Out, Storage and Pack Back $6,337.26
Coverage "A" (total ): $39,593.66
Limited Lead and Asbestos Coverage: n/a

Asbestos & Lead Testing Not Additional Coverage $850.00
Abatement $13,251.20
Clearance Testing
Limited Lead and Asbestos Coverage (total ): $14,101.20
Trees, Shrubs, Plants & Lawns: $0.00
Trees, Shrubs, Plants & Lawns (total ): $0.00
Total Replacement Cost $53,694.86
<Less Coverage "A" Recoverable Depreciation> $177.38

<Less Coverage "A" Non-Recoverable Depreciation>
Actual Cash Value $53,517.48
<Less Deductible> -$500.00
Total Amount Due: $53,017.48
Description of Payment Date of Payment Amount of Payment

Asbestos and Lead Test 10/28/2021 $780.00
Balance of Testing fee 10/28/2021 $70.00
Pack Out 11/1/2021 $6,337.26
Abatement 11/5/2021 $13,251.20
Building Repairs 11/20/2021
< Total prior payments :> $20,438.46

This payment: $32,579.02
1

PO Box 268994
Toll Free Fax 1-877-217-1389
myclaim@farmersinsurance.com
Insured: JOSE VIRAMONTES

Property: 12224 NORLAIN AVE
DOWNEY, CA 90242-3312
Home: 12224 NORLAIN AVE
DOWNEY, CA 90242-3312
Claim Rep.: Bernard M. Biscocho, CPCU, GCA Business: (562) 208-1809

Company: Fire Insurance Exchange E-mail: myclaim@farmersinsurance.com
Business: P.O. BOX 268994
OKLAHOMA, OK 73126
Claimant: JOSE VIRAMONTES

Property: 12224 NORLAIN AVE
DOWNEY, CA 90242-3312
Estimator: Bernard M. Biscocho, CPCU, GCA Business: (562) 208-1809

Company: Fire Insurance Exchange E-mail: myclaim@farmersinsurance.
Business: P.O. BOX 268994 com
OKLAHOMA, OK 73126
Claim Number: 7003631361-1 Policy Number: 0922589808 Type of Loss: Water
Date Contacted: 10/22/2021 8:00 AM

Date of Loss: 10/21/2021 12:00 AM Date Received: 10/22/2021 1:10 AM
Date Inspected: 11/1/2021 11:00 AM Date Entered: 11/1/2021 11:01 AM
Price List: CALA8X_OCT21

Restoration/Service/Remodel
Estimate: JOSE_VIRAMONTES3
2

PO Box 268994
Toll Free Fax 1-877-217-1389
We appreciate the opportunity to serve your insurance needs and we want to make sure you have a clear understanding of how
your claim will be processed.
Attached is the estimate for the repairs of the damages to your property, also called the Replacement Cost Value of your loss. If
depreciation was applied to the estimated repair costs, then the Replacement Cost Value less the depreciation is the Actual Cash
Value of your loss. Depreciation is based on the average quality, age, condition and useful life of the damaged property, unless
otherwise noted. The applicable policy deductible(s) will be deducted from these amounts.
If it appears reasonably likely that a general contractor will be needed to coordinate and supervise the repairs, the estimate also
includes an amount for general contractor overhead and profit, unless your policy provides that general contractor overhead and
profit will only be paid if incurred. In addition, if your policy provides that any amounts for the matching of undamaged
materials will only be paid if incurred, then those estimated amounts will be shown under a section of the estimate labeled
Matching of Undamaged Property.
Please note this estimate reflects the extent of known covered damages to the property referenced above. No supplemental or
additional payments will be issued for repairs that have not been included in this estimate, without prior approval. This approval
must be obtained prior to replacement or repair. We must have the opportunity to view and inspect any proposed changes or
additional work.
Should you receive an estimate of repairs that exceeds this estimate, or if you wish to send us any other information related to
your claim, please include “Attention Claim # 7003631361-1” and forward this information to us by:
1. E-mailing to myclaim@farmersinsurance.com or
2. Faxing to 877-217-1389, or
3. Mailing to National Document Center, P.O. Box 268994, Oklahoma City, OK 73126-8994.
Once you have completed the repairs to your property, you may make a Replacement Cost claim for up to the amount of the
recoverable depreciation withheld. Any depreciation shown as “non-recoverable” does not qualify for reimbursement. Please
refer to the Conditions section of your policy for specific time limits within which you must claim the recoverable depreciation.
Once you complete the repairs, please send your supporting documentation to us as outlined above. In any case, your total claim
will not exceed the amount you actually spent making the repairs, minus your policy deductible. Estimated costs not actually
incurred, like general contractor overhead and profit, will offset recoverable depreciation.
If your policy provides for Building Ordinance or Law coverage, any known covered costs resulting from ordinance or law
upgrades are itemized in this estimate or contained in a separate estimate we will provide to you. However, these costs are not
included as part of the Actual Cash Value of this estimate. Ordinance or law costs will be paid under your policy when incurred
by you, subject to your deductible.
We wish to inform you there are time limits set forth in the Conditions section of your policy which may affect the time within
which you may pursue your claim. We suggest that you review the Conditions section of your policy, as may be endorsed,
particularly noting the 'Suit Against Us' or 'Legal Action Against Us' provision.
Although as a service we may refer contractors or repairmen to you, it is your decision to hire the contractor of your choice. We
neither direct or manage the activities nor guarantee the work of any contractor, whether referred or not. It is up to you to make
sure the work is completed to your satisfaction.
We encourage you to visit www.farmers.com to learn more about our self-service options available to you; including the ability
to view your claim status, upload documents and photos and find local service providers.
Thank you for the opportunity to serve your insurance needs. If you have any questions regarding this claim, please feel free to
JOSE_VIRAMONTES3 11/20/2021 Page: 2
3

PO Box 268994
Toll Free Fax 1-877-217-1389
contact us.
Bernard M. Biscocho, CPCU, GCA

(562) 208-1809

4

PO Box 268994
Toll Free Fax 1-877-217-1389
JOSE_VIRAMONTES3
Pack Out Storage and Pack Back
QUANTITY UNIT TAX O&P RCV AGE/LIFE COND. DEP % DEPREC. ACV
***PACK OUT***
***STORAGE***
***PACK BACK***
Totals: Pack Out Storage and 0.00 0.00 0.00 0.00 0.00
Pack Back
Main Level
Main Level
**** GENERAL ITEMS ****
12. Temporary toilet (per month)
2.00 MO 161.50 0.00 64.60 387.60 0/NA Avg. 0% (0.00) 387.60
13. Single axle dump truck - per load - including dump fees
2.00 EA 277.61 0.00 111.04 666.26 0/NA Avg. NA (0.00) 666.26
14. Final cleaning - construction - Residential
2,289.00 SF 0.34 0.00 155.66 933.92 0/NA Avg. 0% (0.00) 933.92
15. Residential Supervision / Project Management - per hour
1.00 HR 0/NA Avg. 0% NEED SUPPORT
Construction costs related to supervisor hours will be considered on an incurred basis upon receipt of supporting documentation. Documentation to
support what these hours entail such as walking and submitting plans to city, meeting with city inspectors for inspections, initial and final walk
through with customers, etc.
Total: Main Level 0.00 331.30 1,987.78 0.00 1,987.78
1' 10" 2' 3'

Hall Bath Height: 8'
1' 8" 2' 10"
Vanity (B3) Shower (B2)
191.94 SF Walls 51.68 SF Ceiling
5' 1"
5' 10"
B Closet (1)
8' 1"
8' 3"
Hall Bath
2' 5"
243.63 SF Walls & Ceiling 39.82 SF Floor
Bedroom 2
2' 1" 7"
4.42 SY Flooring 21.92 LF Floor Perimeter

2' 3"
FH Cab (B1)
3" 2' 4" 3' 11" 34.00 LF Ceil. Perimeter
4' 3"
Window 2' X 3' Opens into Exterior

Door 2' 4" X 6' 8" Opens into HALLWAY
**** FLOORS ****

5

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - Hall Bath
16. Tile floor covering - per specs from ind. tile analysis
39.82 SF 9.14 2.35 73.28 439.58 0/100 yrs Avg. 0% (0.00) 439.58
17. 1/2" Cement board
39.82 SF 5.52 6.45 45.26 271.52 0/100 yrs Avg. 0% (0.00) 271.52
18. Grout sealer
50.78 SF 1.73 0.81 17.74 106.40 2/18 yrs Avg. 11.11% (0.99) 105.41
includes tile base
19. Underlayment - 1/4" lauan/mahogany plywood
39.82 SF 2.15 4.18 17.96 107.75 0/150 yrs Avg. 0% (0.00) 107.75
20. Additional charge for screwing down underlayment/subfloor
39.82 SF 0.96 0.00 7.64 45.87 0/150 yrs Avg. 0% (0.00) 45.87
screw down diagonal sheathing that would have come loose during underlayment removal
21. Tile base
21.92 LF 20.86 8.90 93.24 559.39 0/100 yrs Avg. 0% (0.00) 559.39
**** WALLS ****
22. Detach & Reset Door opening (jamb & casing) - up to 32"wide - paint grade
1.00 EA 0/150 yrs Avg. 0% INCLUDED
included in hallway
23. Interior door - Detach & reset
2.00 EA 0/NA Avg. 0% INCLUDED
included in hallway
24. Paint door/window trim & jamb - 1 coat (per side)
1.00 EA 26.97 0.36 5.48 32.81 6/15 yrs Avg. 40% (1.56) 31.25
25. Ceramic/porcelain tile
13.38 SF 15.14 6.22 41.76 250.55 0/150 yrs Avg. 0% (0.00) 250.55
26. Add-on for tile backsplash installation
13.38 SF 19.65 0.00 52.58 315.50 0/150 yrs Avg. 0% (0.00) 315.50
27. Seal grout on tile wall
13.38 SF 1.89 0.21 5.10 30.60 7/10 yrs Avg. 70% (1.65) 28.95
28. Ceramic tile - bullnose - 3/4" x 6"
14.92 LF 10.56 3.72 32.26 193.54 0/150 yrs Avg. 0% (0.00) 193.54
29. Two coat plaster over 1/2" gypsum core blueboard
60.00 SF 11.46 11.04 139.72 838.36 0/150 yrs Avg. 0% (0.00) 838.36
30. Tape joint for new to existing drywall - per LF
7.50 LF 11.73 0.22 17.64 105.84 0/150 yrs Avg. 0% (0.00) 105.84
Allowance to tie in new plaster with existing
31. Texture drywall - smooth / skim coat
60.00 SF 1.82 0.66 21.98 131.84 0/150 yrs Avg. 0% (0.00) 131.84

6

PO Box 268994
Toll Free Fax 1-877-217-1389
32. Seal/prime then paint the surface area (2 coats)

60.00 SF 1.20 1.14 14.62 87.76 6/15 yrs Avg. 40% (5.02) 82.74
for all new plaster
33. Paint part of the walls and ceiling - one coat
183.63 SF 0.84 2.57 31.38 188.20 6/15 yrs Avg. 40% (11.31) 176.89
34. Paint door or window opening - 1 coat (per side)
1.00 EA 26.97 0.36 5.48 32.81 6/15 yrs Avg. 40% (1.56) 31.25
35. Mask and prep for paint - tape only (per LF)
36.63 LF 0.79 0.15 5.82 34.91 0/15 yrs Avg. 0% (0.00) 34.91
protect trims and tile surround
36. Detach & Reset Light bar - 3 lights
1.00 EA 62.90 0.00 12.58 75.48 0/20 yrs Avg. 0% (0.00) 75.48
37. Towel bar - Detach & reset
1.00 EA 20.48 0.00 4.10 24.58 0/NA Avg. 0% (0.00) 24.58
38. Toilet paper holder - Detach & reset
1.00 EA 21.60 0.00 4.32 25.92 0/NA Avg. 0% (0.00) 25.92
39. Bathroom mirror - Detach & reset
6.00 SF 11.30 0.00 13.56 81.36 0/NA Avg. 0% (0.00) 81.36
**** VANITY AND TOILET ****
40. Toilet - Reset
1.00 EA 152.71 0.62 30.66 183.99 0/NA Avg. 0% (0.00) 183.99
41. Vanity - Reset
4.75 LF 39.44 0.00 37.46 224.80 0/NA Avg. 0% (0.00) 224.80
42. Paint vanity - faces only
4.75 LF 18.42 1.30 17.76 106.56 6/15 yrs Avg. 40% (5.73) 100.83
Allowance for touch up painting from finish damage from counter removal
43. Install Plumbing fixture supply line
3.00 EA 13.99 0.00 8.40 50.37 0/20 yrs Avg. 0% (0.00) 50.37
44. P-trap assembly - Detach & reset
0.50 EA 61.58 0.00 6.16 36.95 0/NA Avg. 0% (0.00) 36.95
45. Sink - single - Detach & reset
1.00 EA 154.54 0.05 30.92 185.51 0/NA Avg. 0% (0.00) 185.51
includes faucet
46. Countertop subdeck - plywood
9.50 SF 4.09 1.83 8.14 48.83 0/150 yrs Avg. 0% (0.00) 48.83
47. Countertop - Tile
9.50 SF 30.61 6.36 59.44 356.60 0/150 yrs Avg. 0% (0.00) 356.60

7

PO Box 268994
Toll Free Fax 1-877-217-1389
48. Tile/stone sealer

9.50 SF 1.15 0.31 2.24 13.48 7/10 yrs Avg. 70% (2.41) 11.07
9.50 SF 5.38 1.41 10.50 63.02 0/150 yrs Avg. 0% (0.00) 63.02
50. Tile / Cultured Marble Installer - per hour
1.00 HR 120.75 0.00 24.16 144.91 0/NA Avg. 0% (0.00) 144.91
Allowance for additional labor to work around angled corners and curved sink
**** TUB AND SHOWER ****
51. Tile tub surround - up to 60 SF
1.00 EA 1,394.97 40.07 287.02 1,722.06 0/150 yrs Avg. 0% (0.00) 1,722.06
48.74 SF 5.38 7.21 53.88 323.31 0/150 yrs Avg. 0% (0.00) 323.31
53. Seal grout on tile wall
48.74 SF 1.89 0.78 18.58 111.48 7/10 yrs Avg. 70% (6.01) 105.47
54. Shower curtain rod - Detach & reset
0.50 EA 19.45 0.00 1.94 11.67 0/NA Avg. 0% (0.00) 11.67
55. Tub/shower faucet - Detach & reset
1.00 EA 214.15 0.00 42.84 256.99 0/NA Avg. 0% (0.00) 256.99
56. Tile jamb - wrap around
6.00 LF 33.92 5.24 41.74 250.50 0/150 yrs Avg. 0% (0.00) 250.50
Totals: Hall Bath 114.52 1,345.34 8,071.60 36.24 8,035.36
Hallway Height: 8'

B Closet (1)
Hall Bath
Bedroom 2 2' Bedroom
2' 1"
2' 8"
2' 6"
B2 Closet (1) 2' 4" FH Cab (B1)

2' 3"
6' 6" 2' 4"

11" 3'
5"
2' 4"
2' 10"
Master Entry (1) Hallway 7.58 SY Flooring 34.33 LF Floor Perimeter

3'
6' 5" 2' 2"

1' 11" 6' 1" 2' 1" 49.00 LF Ceil. Perimeter
Shower Fireplace (B4)
Door 2' 4" X 6' 8" Opens into BEDROOM

Door 3' X 6' 8" Opens into LIVING_ROOM_
Door 2' 4" X 6' 8" Opens into BEDROOM_3
Door 2' 4" X 6' 8" Opens into BEDROOM_2
Door 2' 4" X 6' 8" Opens into HALL_BATH

8

PO Box 268994
Toll Free Fax 1-877-217-1389
Subroom: Master Entry (1) Height: 8'

4' 4"
6" 2' 4" 3"
4' 8"
3' 5"

3' 3"
Master Entry (1)

4' 4" 4"
8.08 LF Ceil. Perimeter
2"
Missing Wall 3' 3" X 8' Opens into Exterior

Missing Wall 4' 4" X 8' Opens into Exterior
Door 2' 4" X 6' 8" Opens into HALLWAY
**** FLOORS ****
83.38 SF 9.14 4.92 153.40 920.41 0/100 yrs Avg. 0% (0.00) 920.41
83.38 SF 5.52 13.51 94.76 568.53 0/100 yrs Avg. 0% (0.00) 568.53
83.38 SF 2.15 8.76 37.62 225.65 0/150 yrs Avg. 0% (0.00) 225.65
83.38 SF 0.96 0.00 16.00 96.04 0/150 yrs Avg. 0% (0.00) 96.04
61. Grout sealer
83.38 SF 1.73 1.33 29.12 174.70 2/18 yrs Avg. 11.11% (1.63) 173.07
62. Remove End molding - for wood flooring
7.00 LF 0.47 0.00 0.66 3.95 0/25 yrs Avg. NA (0.00) 3.95
63. Install End molding - for wood flooring
7.00 LF 0.96 0.00 1.34 8.06 0/25 yrs Avg. 0% (0.00) 8.06
64. Remove Carpet - metal transition strip
3.08 LF 0.93 0.00 0.58 3.44 0/10 yrs Avg. NA (0.00) 3.44
65. Install Carpet - metal transition strip
3.08 LF 1.58 0.00 0.98 5.85 0/10 yrs Avg. 0% (0.00) 5.85
66. Baseboard - Detach & reset
40.08 LF 3.16 0.08 25.36 152.09 0/NA Avg. 0% (0.00) 152.09
67. Paint baseboard - one coat
40.08 LF 1.23 0.36 9.94 59.60 6/15 yrs Avg. 40% (1.58) 58.02
**** WALLS ****
6.00 EA 142.39 0.37 170.94 1,025.65 0/150 yrs Avg. 0% (0.00) 1,025.65
sits on top of flooring
5.00 EA 92.49 0.45 92.60 555.50 0/NA Avg. 0% (0.00) 555.50
6.00 EA 26.97 2.13 32.78 196.73 6/15 yrs Avg. 40% (9.37) 187.36

9

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - Hallway
71. Paint the walls - one coat

343.33 SF 0.84 4.81 58.64 351.85 6/15 yrs Avg. 40% (21.15) 330.70
finish will be damaged during baseboard and casing removal
151.76 LF 0.79 0.61 24.10 144.60 0/15 yrs Avg. 0% (0.00) 144.60
protect ceiling and trims
73. Dust control barrier per square foot
113.36 SF 0.83 1.59 19.14 114.82 0/NA Avg. NA (0.00) 114.82
Protect unaffected bedrooms and built in cabinet
Totals: Hallway 38.92 767.96 4,607.47 33.73 4,573.74
Bedroom
B2 Closet (1) FH Cab (B1)
3' 2' 11' 3"
Living Room/Kitchen Height: 8'
1' 1"
Master Entry (1)

Hallway
3'
7" 2' 2" 11' 5"

3'
9' 3" 10'

10' 6"
Fireplace (B4)
12' 11"
Shower Bedroom 3
B3 Closet (1)
7" 1210.80 SF Walls & Ceiling 469.25 SF Floor
4' 5" 3'
L Bathroom 11' 6" 4 ' 9"

Living
7" Room/Kitchen
3' 11"
"
B Cab1 2"Cab (B3) 4' 1' 6
16'FH
(B2)
2' 6"
Laundry Room10' 1" 6 " 1'

15' 10" 1' 3' 3' 3"
2' 2"
4' 10"(B1)
B Cab 3' 3' 5' 2' 6" 110.60 LF Ceil. Perimeter
5' 2" 2' 10" 5"
4'
10' 5" 16' 2"
16' 6" 10' 11"
Window - Goes to Floor 1' X 6' 8" Opens into Exterior
Door 3' X 6' 8" Opens into Exterior
Window - Goes to Floor 1' X 6' 8" Opens into Exterior
Door 3' X 6' 8" Opens into HALLWAY
Missing Wall - Goes to Floor 2' 6" X 6' 8" Opens into LAUNDRY_ROOM
**** FLOORS ****
469.25 SF 9.14 27.69 863.34 5,179.98 0/100 yrs Avg. 0% (0.00) 5,179.98

10

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - Living Room/Kitchen

469.25 SF 5.52 76.02 533.26 3,199.54 0/100 yrs Avg. 0% (0.00) 3,199.54
76. Grout sealer
517.05 SF 1.73 8.27 180.56 1,083.33 2/18 yrs Avg. 11.11% (10.11) 1,073.22
includes tile base
469.25 SF 2.15 49.27 211.64 1,269.80 0/150 yrs Avg. 0% (0.00) 1,269.80
95.60 LF 3.16 0.19 60.46 362.75 0/NA Avg. 0% (0.00) 362.75
95.60 LF 1.23 0.86 23.70 142.15 6/15 yrs Avg. 40% (3.78) 138.37
**** WALLS ****
1.00 EA 0/150 yrs Avg. 0% INCLUDED
included in hallway
81. Exterior door - Detach & reset
1.00 EA 161.41 0.51 32.38 194.30 0/NA Avg. 0% (0.00) 194.30
included in hallway
1.00 EA 26.97 0.36 5.48 32.81 6/15 yrs Avg. 40% (1.56) 31.25
734.80 SF 0.84 10.29 125.50 753.02 6/15 yrs Avg. 40% (45.27) 707.75
226.59 LF 0.79 0.91 35.98 215.90 0/15 yrs Avg. 0% (0.00) 215.90
protect fireplace, ceiling and trims
85. TV Brackets - Wall or ceiling mounted - Detach & reset
1.00 EA 58.10 0.00 11.62 69.72 0/NA Avg. 0% (0.00) 69.72
**** CABINETS AND COUNTERTOP ****
86. Cabinetry - lower (base) units - Reset
14.50 LF 46.09 0.00 133.66 801.97 0/NA Avg. 0% (0.00) 801.97
87. Paint cabinetry - lower - faces only
14.50 LF 20.33 4.03 59.76 358.58 6/15 yrs Avg. 40% (17.73) 340.85
Allowance for touch up painting from finish damage from counter removal
88. Cabinetry - full height unit - Reset
2.50 LF 45.92 0.00 22.96 137.76 0/NA Avg. 0% (0.00) 137.76
89. Install Crown molding - 3 1/4" stain grade
5.50 LF 3.17 0.00 3.48 20.92 0/150 yrs Avg. 0% (0.00) 20.92

11

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - Living Room/Kitchen
for full height cabinet

90. Paint cabinetry - full height - faces only
2.50 LF 22.24 0.78 11.28 67.66 6/15 yrs Avg. 40% (3.43) 64.23
Allowance for touch up paint
**** PLUMBING AND APPLIANCES ****
91. Remove Plumbing fixture supply line
2.00 EA 6.13 0.00 2.46 14.72 0/20 yrs Avg. NA (0.00) 14.72
2.00 EA 13.99 0.00 5.60 33.58 0/20 yrs Avg. 0% (0.00) 33.58
93. P-trap assembly - Detach & reset
0.50 EA 61.58 0.00 6.16 36.95 0/NA Avg. 0% (0.00) 36.95
94. Install Garbage disposer
1.00 EA 115.38 0.00 23.08 138.46 0/12 yrs Avg. 0% (0.00) 138.46
95. Install Refrigerator - bottom freezer - 18 to 22 cf
1.00 EA 26.96 0.00 5.40 32.36 0/14 yrs Avg. 0% (0.00) 32.36
96. Install Range - freestanding - gas
1.00 EA 155.18 0.00 31.04 186.22 0/15 yrs Avg. 0% (0.00) 186.22
97. Install Sink - double
1.00 EA 119.94 0.00 23.98 143.92 0/50 yrs Avg. 0% (0.00) 143.92
98. Install Sink faucet - Kitchen
1.00 EA 80.31 0.00 16.06 96.37 0/15 yrs Avg. 0% (0.00) 96.37
Totals: Living Room/Kitchen 179.18 2,428.84 14,572.77 81.88 14,490.89
L Bathroom
2' 6" 2' 8" Laundry Room Height: 8'

1' 11"
1' 9"
2' 4"

2' 6"
2' 6"
Laundry Room
2' 9"
3' 1"
2' 2"
2' 4"

5' 2"
B Ca
5' 6"
Door 2' 6" X 6' 8" Opens into Exterior

Missing Wall - Goes to Floor 2' 6" X 6' 8" Opens into LIVING_ROOM_
Door 2' X 6' 8" Opens into L_BATHROOM

12

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - Laundry Room
**** FLOORS ****

36.17 SF 9.14 2.13 66.54 399.26 0/100 yrs Avg. 0% (0.00) 399.26
100. R&R 1/2" Cement board
36.17 SF 6.54 5.86 48.50 290.91 0/100 yrs Avg. 0% (0.00) 290.91
36.17 SF 2.15 3.80 16.32 97.89 0/150 yrs Avg. 0% (0.00) 97.89
36.17 SF 0.96 0.00 6.94 41.66 0/150 yrs Avg. 0% (0.00) 41.66
103. Grout sealer
36.17 SF 1.73 0.58 12.64 75.79 2/18 yrs Avg. 11.11% (0.70) 75.09
104. Door threshold - Detach & reset
1.00 LF 12.01 0.00 2.40 14.41 0/NA Avg. 0% (0.00) 14.41
17.33 LF 3.16 0.04 10.96 65.76 0/NA Avg. 0% (0.00) 65.76
17.33 LF 1.23 0.16 4.30 25.78 6/15 yrs Avg. 40% (0.68) 25.10
**** WALLS ****
1.00 EA 142.39 0.06 28.50 170.95 0/150 yrs Avg. 0% (0.00) 170.95
108. Exterior door - Detach & reset
1.00 EA 161.41 0.51 32.38 194.30 0/NA Avg. 0% (0.00) 194.30
2.00 EA 26.97 0.71 10.92 65.57 6/15 yrs Avg. 40% (3.12) 62.45
148.00 SF 0.84 2.07 25.28 151.67 6/15 yrs Avg. 40% (9.12) 142.55
111. Paint door or window opening - 1 coat (per side)
1.00 EA 26.97 0.36 5.48 32.81 6/15 yrs Avg. 40% (1.56) 31.25
55.49 LF 0.79 0.22 8.80 52.86 0/15 yrs Avg. 0% (0.00) 52.86
protect ceiling and trims
**** APPLIANCES ****
113. Dryer - Remove & reset - gas
1.00 EA 141.88 0.00 28.38 170.26 0/NA Avg. 0% (0.00) 170.26

13

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - Laundry Room
114. Washer/Washing machine - Remove & reset

1.00 EA 48.55 0.00 9.72 58.27 0/NA Avg. 0% (0.00) 58.27
Totals: Laundry Room 16.50 318.06 1,908.15 15.18 1,892.97
Shower
1' 10" 2' 6" 10" L Bathroom Height: 8'

2' 2"
2'

4' 9"
4' 5"
L Bathroom 132.82 SF Walls & Ceiling 22.82 SF Floor

2'

2' 6" 2' 8"
5"
Door 2' X 6' 8" Opens into BEDROOM_3

Door 2' X 6' 8" Opens into LAUNDRY_ROOM
Missing Wall - Goes to Floor 2' 6" X 6' 8" Opens into SHOWER1
**** FLOORS ****
22.82 SF 9.14 1.35 42.00 251.92 0/100 yrs Avg. 0% (0.00) 251.92
116. R&R 1/2" Cement board
22.82 SF 6.54 3.70 30.60 183.55 0/100 yrs Avg. 0% (0.00) 183.55
22.82 SF 2.15 2.40 10.30 61.76 0/150 yrs Avg. 0% (0.00) 61.76
22.82 SF 0.96 0.00 4.38 26.29 0/150 yrs Avg. 0% (0.00) 26.29
119. Grout sealer
22.82 SF 1.73 0.37 7.98 47.83 2/18 yrs Avg. 11.11% (0.45) 47.38
**** WALLS ****
2.00 EA 142.39 0.12 56.98 341.88 0/150 yrs Avg. 0% (0.00) 341.88
2.00 EA 92.49 0.18 37.04 222.20 0/NA Avg. 0% (0.00) 222.20

14

PO Box 268994
Toll Free Fax 1-877-217-1389
CONTINUED - L Bathroom

2.00 EA 26.97 0.71 10.92 65.57 6/15 yrs Avg. 40% (3.12) 62.45
110.00 SF 0.84 1.54 18.78 112.72 6/15 yrs Avg. 40% (6.78) 105.94
65.83 LF 0.79 0.26 10.46 62.73 0/15 yrs Avg. 0% (0.00) 62.73
protect ceiling, trims and tile surround
**** PLUMBING ****
125. Toilet - Detach & reset
1.00 EA 250.26 0.62 50.18 301.06 0/NA Avg. 0% (0.00) 301.06
126. Pedestal sink - Detach & reset
1.00 EA 292.02 0.00 58.40 350.42 0/NA Avg. 0% (0.00) 350.42
127. Remove Plumbing fixture supply line
3.00 EA 6.13 0.00 3.68 22.07 0/20 yrs Avg. NA (0.00) 22.07
3.00 EA 13.99 0.00 8.40 50.37 0/20 yrs Avg. 0% (0.00) 50.37
Totals: L Bathroom 11.25 350.10 2,100.37 10.35 2,090.02
Total: Main Level 360.37 5,541.60 33,248.14 177.38 33,070.76
Line Item Totals: JOSE_ 360.37 5,541.60 33,248.14 177.38 33,070.76

VIRAMONTES3
[%] - Indicates that depreciate by percent was used for this item
[M] - Indicates that the depreciation percentage was limited by the maximum allowable depreciation for this item
Additional Charges Charge

California Lumber Assessment Fee 6.88
Additional Charges Total $6.88

15

PO Box 268994
Toll Free Fax 1-877-217-1389
Grand Total Areas:

2,892.30 SF Walls 1,108.02 SF Ceiling 4,000.32 SF Walls and Ceiling
1,089.41 SF Floor 121.05 SY Flooring 352.10 LF Floor Perimeter
0.00 SF Long Wall 0.00 SF Short Wall 454.85 LF Ceil. Perimeter
1,089.41 Floor Area 1,214.74 Total Area 2,968.97 Interior Wall Area
1,170.40 Exterior Wall Area 151.38 Exterior Perimeter of
Walls
0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length
0.00 Total Ridge Length 0.00 Total Hip Length

16

PO Box 268994
Toll Free Fax 1-877-217-1389
Summary for Building

Line Item Total 27,346.17
California Lumber Assessment Fee 6.88
Material Sales Tax 360.37
Subtotal 27,713.42
Overhead 2,771.49
Profit 2,771.49
Replacement Cost Value $33,256.40

Less Depreciation (177.38)
Actual Cash Value $33,079.02

Less Deductible (500.00)
Net Claim $32,579.02
Total Recoverable Depreciation 177.38
Net Claim if Depreciation is Recovered $32,756.40
Bernard M. Biscocho, CPCU, GCA

17

PO Box 268994
Toll Free Fax 1-877-217-1389
Recap by Category with Depreciation
O&P Items RCV Deprec. ACV

APPLIANCES 487.95 487.95
CABINETRY 1,009.31 1,009.31
CLEANING 778.26 778.26
GENERAL DEMOLITION 746.28 746.28
DOORS 970.25 970.25
DRYWALL 197.18 197.18
FLOOR COVERING - CARPET 4.87 4.87
FLOOR COVERING - CERAMIC TILE 11,236.01 12.62 11,223.39
FLOOR COVERING - WOOD 6.72 6.72
FINISH CARPENTRY / TRIMWORK 1,782.46 1,782.46
FINISH HARDWARE 121.92 121.92
FRAMING & ROUGH CARPENTRY 1,575.50 1,575.50
LIGHT FIXTURES 62.90 62.90
INTERIOR LATH & PLASTER 687.60 687.60
PLUMBING 1,437.43 1,437.43
PAINTING 2,775.97 139.50 2,636.47
TOILET & BATH ACCESSORIES 67.80 67.80
TILE 3,074.76 9.15 3,065.61
TEMPORARY REPAIRS 323.00 323.00
O&P Items Subtotal 27,346.17 161.27 27,184.90
Permits and Fees 6.88 6.88
Material Sales Tax 360.37 16.11 344.26
Overhead 2,771.49 2,771.49
Profit 2,771.49 2,771.49
Total 33,256.40 177.38 33,079.02

18
Main Level
10' 10" 6' 10" 2' 4" 11' 9"

10' 4" 3' 2" 2' 4" 2' 11' 3"
4' 10"
Vanity (B3)6' Shower

6"
4' 9"
8' 1" 10"
5' 1"
(B2)
5' 10"
B Closet (1)
6'
8' 3"
4' 8" Hall Bath
10' 4"
11' 5"
4' 4" Bedroom 2
7"
3' Bedroom
2'
2' 1"
2' 3"
5' 6"
FH Cab (B1)
6'
B2 Closet (1)
5' 5"
5' 3"
2' 1"
2' 3"
6' 10"
10' 8" 5' 11"
25' 5"
3' 5"
3' 1"
3' 3"
Master Entry (1) 17' 2"

2' 10"
Hallway
3'
4' 4" 4" 10' 6"

10" 2' 3"
8"
2" 10' 4"

3'
1' 2' 1"

5' 6"
13' 2"
5' 2"
3' 11"
3' 5"
4' 6"
Shower Fireplace (B4)
11' 2"
10' 6"
Bedroom 3 B3 Closet (1)

12' 11"
1' 9"
4' 9"
4' 5"
L Bathroom
3'
2'
11' 6" Living Room/Kitchen 9"

9' (B2) 2' 6"(B3)
3' 11"
B Cab1 FH Cab 4' 5"
11' 8"
7' 6"
3'
7'
Laundry Room
8' 7"
3' 3"
6'
8"
5'
5' 6"(B1)
1' 4"
B Cab
2'
1' 6"
23' 8"
24' 4"
Main Level

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Toll Free: (800) 435-7764

Fax: (877) 217-1389

RE: Insured: Jose Viramontes

Dear Mr. Viramontes:

Any deductible amount will be applied according to policy provisions.

Please refer to the Conditions part of your policy, which states:

Farmers Insurance Exchange

Insured: JOSE VIRAMONTES

Saturday, November 20, 2021

Coverage "A" (total ): $39,593.66

Limited Lead and Asbestos Coverage: n/a

Limited Lead and Asbestos Coverage (total ): $14,101.20

Trees, Shrubs, Plants & Lawns: $0.00

Trees, Shrubs, Plants & Lawns (total ): $0.00

Total Replacement Cost $53,694.86

<Less Coverage "A" Recoverable Depreciation> $177.38

Actual Cash Value $53,517.48

<Less Deductible> -$500.00

Total Amount Due: $53,017.48

Description of Payment Date of Payment Amount of Payment

< Total prior payments :> $20,438.46

Farmers Insurance Exchange

Insured: JOSE VIRAMONTES

Claim Rep.: Bernard M. Biscocho, CPCU, GCA Business: (562) 208-1809

Claimant: JOSE VIRAMONTES

Estimator: Bernard M. Biscocho, CPCU, GCA Business: (562) 208-1809

Claim Number: 7003631361-1 Policy Number: 0922589808 Type of Loss: Water

Date Contacted: 10/22/2021 8:00 AM

Price List: CALA8X_OCT21

Farmers Insurance Exchange

Farmers Insurance Exchange

Bernard M. Biscocho, CPCU, GCA

JOSE_VIRAMONTES3 11/20/2021 Page: 3

Farmers Insurance Exchange

Pack Out Storage and Pack Back

Total: Main Level 0.00 331.30 1,987.78 0.00 1,987.78

1' 10" 2' 3'

4.42 SY Flooring 21.92 LF Floor Perimeter

Window 2' X 3' Opens into Exterior

JOSE_VIRAMONTES3 11/20/2021 Page: 4

Farmers Insurance Exchange

CONTINUED - Hall Bath

JOSE_VIRAMONTES3 11/20/2021 Page: 5

Farmers Insurance Exchange

CONTINUED - Hall Bath

32. Seal/prime then paint the surface area (2 coats)

JOSE_VIRAMONTES3 11/20/2021 Page: 6

Farmers Insurance Exchange

CONTINUED - Hall Bath

48. Tile/stone sealer

Totals: Hall Bath 114.52 1,345.34 8,071.60 36.24 8,035.36

Hallway Height: 8'

B2 Closet (1) 2' 4" FH Cab (B1)

6' 6" 2' 4"

Master Entry (1) Hallway 7.58 SY Flooring 34.33 LF Floor Perimeter

6' 5" 2' 2"

Door 2' 4" X 6' 8" Opens into BEDROOM

JOSE_VIRAMONTES3 11/20/2021 Page: 7

Farmers Insurance Exchange

Subroom: Master Entry (1) Height: 8'

64.22 SF Walls & Ceiling 15.11 SF Floor

Master Entry (1)

Missing Wall 3' 3" X 8' Opens into Exterior

FLOORS