Filing Number: 786205
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| Filing Accepted: 10/8/2024 |
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BOYS & GIRLS CLUBS OF SARASOTA AND DESOTO COUNTIES, INC.
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First Name |
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3100 FRUITVILLE ROAD |
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SARASOTA,
FL
34237
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| Email Address
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JDTEAM@MERLINLAWGROUP.COM |
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Insured |
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| Last/Business Name* |
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BOYS & GIRLS CLUBS OF SARASOTA AND DESOTO COUNTIES, INC. |
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First Name |
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| Policy # * |
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3004633594 |
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Claim #* |
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05000001071 |
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Attorney is Applicable
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| Last Name* |
DELGADO
First Name *
JAVIER
Initial
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| Street Address* |
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777 S. HARBOUR ISLAND BLVD, SUITE 950 |
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TAMPA
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FLORIDA
33602
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JDELGADO@MERLINLAWGROUP.COM |
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| Insurer Type
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Authorized Insurer
Unauthorized Insurer
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| Insurer Name |
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| Insurer Name* |
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FRONTLINE INSURANCE UNLIMITED COMPANY
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NAIC Company Code 10074 |
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| Name of individual responsible for violation (if any):*
CAVIN CURTIS (FRONTLINE INDEPENDENT COMMERCIAL CLAIMS ADJUSTER); LORI MILAND (FRONTLINE SENIOR COMMERCIAL CLAIMS SPECIALIST); TED SMITH (FRONTLINE COMMERCIAL CLAIMS ADJUSTER); RON TATUM (PILOT CATASTROPHE SERVICES, INC. INDEPENDENT ADJUSTER), PILOT C
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| Type of Insurance
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Commercial Property & Casualty
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| Reason for Notice
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Claim Delay
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Unsatisfactory Settlement Offer
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Other
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Failure to Properly Investigate Claim with Due Regard to Insured’s Interest
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Statutory provision(s) which the insurer allegedly violated.
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| 624.155(1)(b)(1) |
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Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
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| 626.9541(1)(i)(3)(d) |
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Denying claims without conducting reasonable investigations based upon available information.
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Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
A. Coverage
We will pay for direct physical loss of or damage to Covered Property at the premises described in the Declarations caused by or resulting from any Covered Cause of Loss.
2. Property Not Covered
Covered Property does not include
q. The following property while outside the buildings:
(2) Fences, radio or television antennas (including satellite dishes) and their lead-in wiring, masts or towers, trees, shrubs or plants (other than “stock” of trees, shrubs or plants), all except as provided in the Coverage Extensions.
BUILDING AND PERSONAL PROPERTY COVERAGE FORM – CP 00 10 06 07
e. Increased Cost Of Construction
(1) This Additional Coverage applies only to
buildings to which the Replacement
Cost Optional Coverage applies.
(2) ln the event of damage by a Covered
Cause of Loss to a building that is Covered
Property, we will pay the increased
costs incurred to comply with enforcement
of an ordinance or law in the
course of repair, rebuilding or replacement
of damaged parts of that property,
subject to the limitations stated in e.(3)
through e.(9) of this Additional Coverage.
(3) The ordinance or law referred to in e.(2)
of this Additional Coverage is an ordinance
or law that regulates the construction
or repair of buildings or establishes
zoning or land use requirements
at the described premises, and is in force at the time of loss.
***
G. Optional Coverages
…
3. Replacement Cost
a. Replacement Cost (without deduction for
depreciation) replaces Actual Cash Value in
the Valuation Loss Condition of this Coverage
Form
b. This Optional Coverage does not apply to:
(1) Personal property of others;
(2) Contents of a residence;
(3) Works of art, antiques or rare articles, including etchings, pictures, statuary,
marbles, bronzes, porcelains and bric-a-brac; or
Under the terms of this Replacement Cost
Optional Coverage, personal property
Owned indivisibly by all unit-owners, and the
Property covered under Paragraph A.1.a.(6)
Of this Coverage Form, are not considered
to be the personal property of others.
c. You may make a claim for loss or damage
covered by this insurance on an actual cash
value basis instead of on a replacement
cost basis. In the event you elect to have
loss or damage settled on an actual cash
value basis, you may still make a claim for
the additional coverage this Optional Coverage
provides if you notify us of your intent
to do so within 180 days after the loss or damage.
d. We will not pay on a replacement cost basis
for any loss or damage:
(1) Until the lost or damaged property is
actually repaired or replaced; and
(2) Unless the repairs or replacement are
made as soon as reasonably possible
after the loss or damage.
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BUSINESS AND PERSONAL PROPERTY COVERAGE FORM
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E. Loss Conditions
The following conditions apply in addition to the Common Policy
Conditions and the Commercial Policy Conditions.
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3. Duties In The Event Of Loss Or Damage
a. You must see that the following are done in the event of loss or
damage to Covered Property.
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(6) As often as may be reasonably required, permit us to inspect
the property proving the loss or damage and examine your
books and records.
Also permit us to take samples of damaged and undamaged
property for inspection, testing and analysis, and permit us to make
copies from your books and records.
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(8) Cooperate with us in the investigation or settlement of the
Claim
(CP 00 10 06 07 p. 9-10 of 15)
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4. Loss Payment
a. ln the event of loss or damage covered by
this Coverage Form, at our option, we will
either:
(1) Pay the value of lost or damaged property;
(2) Pay the cost of repairing or replacing the
lost or damaged property, subject to b.
below;
(3) Take all or any part of the property at an
agreed or appraised value; or
(4) Repair, rebuild or replace the property
with other property of like kind and quality,
subject to b, below.
We will determine the value of lost or damaged
property, or the cost of its repair or
replacement, in accordance with the applicable
terms of the Valuation Condition in
this Coverage Form or any applicable provision
which amends or supersedes the
Valuation Condition.
b. The cost to repair, rebuild or replace does
not include the increased cost attributable
to enforcement of any ordinance or law
regulating the construction, use or repair of
any property.
c. We will give notice of our intentions within
30 days after we receive the sworn proof of
loss.
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g. We will pay for covered loss or damage
within 30 days after we receive the sworn
proof of loss, if you have complied with all
of the terms of this Coverage Part and:
(1) We have reached agreement with you
on the amount of loss; or
(2) An appraisal award has been made.
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BUSINESS INCOME (AND EXTRA EXPENSE COVERAGE FORM
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C. Loss Conditions
The following conditions apply in addition to the Common Policy
Conditions and the Commercial Policy Conditions.
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2. Duties In The Event Of Loss
a. You must see that the following are done in the event of loss.
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(5) As often as may be reasonably required, permit us to inspect
the property proving the loss or damage and examine your
books and records.
Also permit us to take samples of damaged and undamaged
property for inspection, testing and analysis, and permit us
to make copies from your books and records.
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(7) Cooperate with us in the investigation or settlement of the
Claim
(8) If you intend to continue your business, you must resume all
or part of your "operations" as quickly as possible.
(CP 00 10 30 06 07 p. 5 of 9)
CAUSES OF LOSS – WINDSTROM OR HAIL FORM
A. Covered Causes of Loss
When Wind is shown in the Covered Causes of Loss section of the Declarations, Covered Causes of Loss means the following:
Windstorm or Hail, but not including:
Loss or damage to the interior of any building or structure, or the property inside the building or structure, caused by rain, snow, sleet, sand, dust or by falling objects, whether driven by windstorm or not, unless the direct force of windstorm or hail first damages the building or structure causing an opening in the roof, walls, doors, or windows, and the rain, snow, sleet, sand, dust or falling objects enters through this opening.
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Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.
This Civil Remedy Notice is made on behalf of BOYS & GIRLS CLUBS OF SARASOTA AND DESOTO COUNTIES, INC (the “INSURED”). In consideration of premium paid to it by the INSURED, FRONTLINE INSURANCE UNLIMITED D/B/A FRONTLINE INSURANCE (“FRONTLINE”) issued a commercial policy, bearing policy number 3004633594, which provided coverage for the below premises (collectively referred to as the “Property”) as shown in the Declaration page:
Covered Premises Location Address Building Coverage Bldg. Deductible BPP – Contents
Limit of Liability BPP Deductible
Loc. 1 – Bldg. 1 3100 Fruitville Rd,
Sarasota, FL 34237 $4,877,016 $243,850.80 $520,741 $26,037.05
Loc.2 – Bldg. 1 3130 Fruitville Rd,
Sarasota, FL 34237 $381,685 $19,084.25 $153,656 $7,682.80
Covered Premises Location Address Building Coverage Bldg. Deductible BPP – Contents
Limit of Liability BPP Deductible
Loc. 3 – Bldg. 1 6851 S Biscayne Drive North Port, FL 34287 $769,080.00 $38,454.00 $39, 621 $1,981.05
Loc.3 – Bldg. 2 6851 S Biscayne Drive, North Port, FL 34287 $43,024 $2,151.20
Loc.3 – Bldg. 3 6851 S Biscayne Drive , North Port, FL 34287 (Gym) $1,310,400 $65,520.00 $13,168 $658.40
Loc.3 – Bldg. 4 6851 S Biscayne Drive , North Port, FL 34287 $439,370 $21,968.50 $22,286 $1,114.30
Covered Premises Location Building Coverage Bldg. Deductible BPP – Contents
Limit of Liability BPP Deductible
Loc. 4 – Bldg. 1 1790 21st Street
Sarasota, FL 34234 $2,990,000 $149,500 $222,031 $11,101.55
Covered Premises Location Building Coverage Bldg. Deductible BPP – Contents
Limit of Liability BPP Deductible
Loc. 5 – Bldg. 1 920 Gulf Coast Boulevard
Venice, FL 34285 $3,808,600 $190,430 $459,009 $22,950.45
Covered Premises Location Building Coverage Bldg. Deductible BPP – Contents
Limit of Liability BPP Deductible
Loc. 6 – Bldg. 1 18 School Avenue
Arcadia, FL 34266 $50,000.00 $2,500
Loc. 6 – Bldg. 2 18 School Avenue
Arcadia, FL 34266
(gymnasium) $1,000,000 $50,000
The policy was in full force and effect with an effective policy period of October 1, 202, to October 1, 2022. The policy provides coverage on a replacement cost basis, subject to a 5% deductible. The policy further provides coverage for Ordinance or Law and Additional Coverage for Fungus/Mold with a sublimit of $15,000. There is no dispute that the policy was in full force and effect at the time of the loss.
On September 28, 2022, the INSURED suffered damage to the Property as a result of Hurricane Ian. The windstorm caused direct physical damage to the Property including but not limited to, opening to the roofing systems, exterior walls, windows, and doors, which resulted in wind-driven rain entering the buildings causing damage to the interior units and common areas.
The Policy is an all-risk policy. This means the policy covers all direct physical loss to the Property unless otherwise excluded. Under an all-risk policy, once the covered Property suffers a loss and it is reported to the insurance company, the responsibility to determine the cause(s) of loss and the amount of damage falls to the insurer. If an exclusion in the Policy applies, it is up to the insurer to investigate and determine what specific damage is excluded from coverage and the balance of the claim should be paid timely.
The INSURED timely reported the damage to FRONTLINE. FRONTLINE acknowledged the claim and assigned claim number 05000001071 to the loss. On or about October 6, 2022, as part of its investigation, FRONTLINE engaged the services of an independent adjusting company, Pilot Catastrophe Services, Inc. (“Pilot”), to inspect the loss, photograph the damages, and write an estimate for repairs. Ron Tatum of Pilot Catastrophe Services, Inc. inspected the buildings on or about October 18, 2022. After his inspection, Mr. Tatum prepared a damage repair estimate dated December 29, 2022, for $187,734.71 replacement cost value (“RCV”) and $164,716.36 actual cash value (“ACV”).
On January 1, 2023, FRONTLINE informed the INSURED that it had completed the investigation and that it afforded coverage for wind related damage to three (3) buildings only. Based on its field adjuster’s estimate, FRONTLINE issued payment totaling $89,978.19, after the application of the deductible and recoverable depreciation. FRONTLINE’s coverage decision was as follows:
Building Coverage: Location 3 Building 1 (6851 Biscayne Dr., North Port, FL)
Replacement Cost Value $109,824.05
Less Depreciation ($17,018.41)
Less Deductible ($38,454.00)
Less Prior Payments (0.00
Net Claim $54,351.64
Building Coverage: Location 3 Building 4 (6851 Biscayne Dr., North Port, FL)
Replacement Cost Value $62,867.64
Less Depreciation ($5,274.59)
Less Deductible (21,968.50)
Less Prior Payments: ($0.00)
Net Claim $35,624.55
FRONTLINE also acknowledged wind damage to Location 5-Building 1 (920 Gulf Coast Blvd., Venice, FL), in the amount of $8,035.02 RCV, However, it determined that the damage to this location did not exceed the deductible.
Though FRONTLINE’s field adjuster observed interior water damage to the ceiling to Location 4-Building 1 (1790 21st Street, Sarasota, FL 34234), the field adjuster concluded that the damage was not the result of a storm created opening. Thus, FRONTLINE not only denied coverage for damage to the roofing system and the building’s exterior, but it also inaccurately determined that the interior ensuing water loss is not covered under the Policy’s Building and Personal Coverage Clause.
Moreover, FRONTLINE stated that its field adjuster did not observe storm related damages to: (1) Location 1- Building 1 (3100 Fruitville Road, Sarasota, FL); (2) Location 3-Building 2 (6851 S Biscayne Drive, North Port, FL 34287), and (3) Location 6-Building 2 (18 School Avenue, Arcadia, FL).
The independent adjuster’s estimate raises significant questions that the insurer and claim handler must address prior to relying on the estimate to determine all owed damages. FRONTLINE failed to hire qualified engineer(s) and/or building consultant(s) to evaluate the INSURED’s structures for wind related damage and to opine on the origin and causation of the damage. FRONTLINE further failed to address or adjust the INSURED’s claim for Business Personal Property. As a result, FRONTLINE made a coverage determination based on an incomplete investigation
The INSURED disputed FRONTLINE’s under-scoping and under-estimating of the damages and incurred the costs of retaining expert assistance and retained Phoenix Claims Consulting (“PHOENIX”) to assist in the further adjustment of the loss.
On February 14, 2023, PHOENIX on INSURED’s behalf requested that FRONTLINE provide the INSURED with its independent adjuster’s estimate, photographs taken during FRONTLINE’s inspection of the Property, copies of all correspondence between FRONTLINE and the INSURED, and all expert or third-party reports used by FRONTLINE in the investigation and determination of the claim.
On February 21, 2023, FRONTLINE acknowledged receipt of the INSURED’s public adjuster’s Letter of Representation advising FRONTLINE that there were damages at the various loss locations not previously addressed at the initial inspection.
FRONTLINE engaged the services of Signature Adjusting Services (“SAS”) to conduct a re-inspection. FRONTLINE further retained SDII Global Corporation (“SDII”) to determine if any of the buildings sustained structural damage from Hurricane Ian and to evaluate the damage to the roofs.
On May 4, 2023, the INSURED’s public adjuster provided FRONTLINE with an environmental report and assessment and requested that the INSURED be reimbursed for the costs incurred associated with this report. Additionally, the public adjuster confirmed the re-inspection requested from FRONTLINE.
On May 18, 2024, FRONTLINE stated that it would not issue a reimbursement for the invoice from ETA for $19,090.00 for the assessment at the loss locations because it was pending the results of the independent adjuster/engineer re-inspection at the property. A joint re-inspection by FRONTLINE’s field adjuster, SDII’s engineer, and the INSURED’s public adjuster took place on May 25, 2023.
FRONTLINE completed its investigation of the claim for coverage for water damage to Business Personal Property nearly 19 months after the claim was first reported. On June 7, 2024, FRONTLINE acknowledged that damages to the Business Personal Property at Locations 3 – 1 and 3 – 4 located at 6851 S Biscayne Drive, North Port, Florida was due to rainwater entering the roof through wind created openings and afforded coverage in the amount of $45,790.26 on actual cash value basis.
On August 8, 2023, after the joint reinspection of the property, FRONTLINE issued a supplemental payment for the buildings in the net amount of $21,957.34. Having received its engineer’s findings, the INSURED’s public adjuster again inquired about the reimbursement for the ETA invoice. FRONTLINE set the stage to deny these costs incurred by the INSURED asking if “anyone from Frontline request that the reports be done, or do you have any approvals from Frontline that the cost of the reports would be covered?”
Though the supplemental undisputed payment of $21,957.34 was still deficient, this is further evidence that FRONTLINE’s investigation was incomplete and inconsistent with the damage the Property sustained during Hurricane Ian.
FRONTLINE improperly delayed the INSURED’s insurance claim, improperly denied payments for the full amounts owed under the policy, and otherwise engaged in unfair general business practices in the handling of the INSURED’S claim. Even though FRONTLINE had not properly investigated and/or paid the loss, the INSURED agreed to participate in the appraisal process to its financial detriment.
FRONTLINE’s ultimate liability to the INSURED for the Hurricane Ian loss and the extent of damages were established the Appraisal Award as follows:
Appraisal Award
Type of Damage RCV Depreciation ACV
Location 3-3 - (6851 S Biscayne Dr Northport, FL) Gym $743,314.67 $21,805.00 $721,509.67
Location 5-1 (920 Gulf Coast
Blvd Venice FL) $785,574.04 $32,384.75 $753,189.29
Location 2-1 - (3130 Fruitville Rd., Sarasota, FL) $12,000.00 $0.00 $12,000.00
Location 1-1 - (3100 Fruitville Rd., Sarasota, FL) $916,675.60
$9,401.80 $907,273.80
Location 4-1 - (1790 21st St
Sarasota, FL) $607,738.39 $38,837.50 $568,900.89
Location - 6-2 (18 School Ave., Arcadia, FL) $71,419.96 $488.90 $70,931.06
Business Personal Property Loc 3-4 $37,393.04 $1,981.30 $35,411.74
Mold Remediation - Loc 3-4 $15,000.00 $0.00 $15,000.00
Location - 3-1 (6861 S Biscayne Dr, Northport, FL) Admin $459,912.82 $6,068.97 $453,843.85
Location -3-4 (6861 Biscayne Dr., Northport, FL) Teen $209,503.88 $9,028.67 $200,475.21
Business Personal Property Loc 3-1 $13,588.88 $115.01 $13,473.87
TOTALS $3,872,121.28 $120,111.90 $3,752,009.38
To date, the INSURED has done all things legally required of it, including, but not limited to providing access to the Property as often as FRONTLINE required, providing damage repair estimate, engineers’ reports, and responding to requests for information. Any further compliance with the policy provisions has been waived by FRONTLINE.
FRONTLINE failed to carry out its contractual, statutory, regulatory, and ethical duties in adjusting the INSURED’s claim. FRONTLINE violated §624.155(1)(b)(3), Fla. Stat., when it failed to promptly settle the claim when the obligation to settle had become reasonably clear. This is evidenced by the fact that FRONTLINE ignored covered damages based on the engineers’ reports, estimates, and photographs, the INSURED submitted to FRONTLINE to aid it in the adjustment of the claim.
On information and belief, FRONTLINE implemented a claims handling program that was designed to encourage FRONTLINE’s adjusters, investigators, and employees to delay and deny claims and to pay less than the value of the claim. FRONTLINE’s conduct was designed to obtain an unfair advantage over its insureds.
Had FRONTLINE done a proper investigation and had it hired qualified consultants from the inception of the claim, FRONTLINE would not have delayed claim resolution or ignored covered damages to the INSURED’s detriment. Pursuant to FRONTLINE’s demand, the INSURED was forced to retain the services of an attorney to protect its contractual right, engineer(s), and a public adjuster to provide details about material aspects of the claim, including cause of loss as well as claimed damages.
FRONTLINE violated section 624.155(1)(b)(1), Fla. Stat., when it failed to attempt in good faith to settle the claim when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its INSURED and with due regard for its interests. Specifically, had FRONTLINE acted fairly and honestly toward the INSURED and with due regard for its interest FRONTLINE would have attempted to settle the claim with the public adjuster and/or participated in appraisal pursuant to the terms of the policy. FRONTLINE has ignored covered damages during the investigation of the claim and refused to re-inspect the Property upon receiving additional information from its insured.
FRONTLINE engaged in the above-described conduct so often as to constitute a general business practice. FRONTLINE’s conduct was designed to enhance FRONTLINE’s profits to the detriment of FRONTLINE’s policyholders. All such actions were conducted intentionally, maliciously, or in reckless disregard of the rights of the INSURED’s and other policyholders.
Within every insurance policy is an implicit duty of good faith and fair dealing. This duty of good faith obligates the insurer to handle its insured’s claims with “the same degree of care and diligence as a person of ordinary care and prudence should exercise in the management of his own business.” Boston Old Colony Ins. Co. v. Gutierrez, 386 So.2d 783 (Fla. 1980). FRONTLINE had a duty to act in good faith and with due regard for the interests of the INSURED but failed to do so.
Even though the INSURED has complied with all other post loss obligations under the Policy, FRONTLINE continues to delay undisputed payment to the INSURED that is due and owing under the Policy.
To date, FRONTLINE has failed and/or refused to provide the INSURED with all the insurance benefits due and owing, despite knowing that the INSURED has sustained covered damages to the insured Property. Despite the INSURED’s repeated pleas, FRONTLINE has not paid any amount needed to repair the Property.
The adjusters assigned to this claim have a duty to adjust and treat all claims equally. Since the beginning of this claim, the representatives on behalf of FRONTLINE have approached this investigation in a manner prejudicial to the INSURED.
FRONTLINE has a contractual obligation not to make a perfunctory investigation, and to not ignore evidence that would support the INSURED’s claim. This is a breach of the Policy.
FRONTLINE has a contractual obligation not to look the other way when confronted with facts revealing the possibility of coverage and resisting reasonable interpretations of its policy. This is a breach of the Policy.
This notice is given in order to perfect the right to pursue the civil remedy authorized by Florida Statute, including any and all bad faith/extra contractual, should FRONTLINE fail to cure the violations set forth in this Civil Remedy Notice within the given cure period.
While no specific “cure amount” is required for this Civil Remedy Notice to be valid, the INSURED will consider the allegations contained herein “cured” if FRONTLINE issues the following payments without a request for release from the INSURED:
(1) Immediately tenders to the INSURED payment pursuant to the Appraisal Award for buildings and business personal property in the amount of $3,752,009.38 ACV, after application of the deductible and prior payment.
(2) Immediately tenders to the INSURED payment for recoverable depreciation for $120,111.90 as determined by the Appraisal Award.
(3) Immediately tenders to the INSURED payment for the actual costs incurred for the appraisal process in the amount of $225,659.94.
(4) Immediately tenders to the INSURED payment for public adjuster’s fee for $277,860.37.
(5) Immediately tenders to the INSURED payment for attorney’s fees and costs in the amount of $8,600.00
(6) Immediately tenders to the INSURED the amount of statutory interest pursuant to §627.70131(7)(a), Fla. Stat., for the undisputed payment of $21,957.34 issued on August 8, 2023.
(7) Immediately tenders to the INSURED the amount of statutory interest pursuant to §627.70131(7)(a), Fla. Stat., for the undisputed payment of $45,790.26 for Business Personal Property loss issued June 7, 2024.
INSURED continues to remain open to a fair and reasonable settlement offer from FRONTLINE in an effort to avoid additional delay, costs and expenses, and hereby requests the same prior to the expiration of the statutory “cure” period. FRONTLINE must act fairly and honestly in its response to the INSURED’s request for a prompt, fair and reasonable settlement offer and resolution of its claim.
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The submitter hereby states that this notice is given in order to perfect the rights of the
person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.
Before submitting a Notice using this system, please verify that all text has been entered
correctly and completely. Once the Notice has been submitted, the text cannot be changed
or deleted.
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DFS-10-363
Rev. 10/14/2008
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