Name*
Home Phone:
Cell Phone:
Address:
Email*
City
State:
Zipcode:
Vehicle Year:*
Make:*
Model*:
Work Authorization
I authorize Unlimited Collision & RV to perform the repair work described on the repair estimate form, utilizing necessary labor, parts and materials. I agree that Unlimited Collision & RV is not responsible for loss or damage to the vehicle, articles left in the vehicle, in case of theft, fire, or any other cause beyond our control. I agree that Unlimited Collision & RV is not responsible for delays caused by unavailability of parts, or delay in parts shipments by the supplier or transporter. I grant Unlimited Collision & RV employees permission to operate my vehicle for the purpose of testing and/or inspection. I understand if any closer analysis finds additional labor, parts or materials are necessary to complete the repair, I will be contacted for authorization, only if the amount of repairs that I will pay will be increased.
Please Note: a daily storage charge may be applied up to $75.00 per day for vehicles that have not been picked up after 3 working days from the date of notification that repairs have been completed.
Old parts removed from cars will be junked unless otherwise instructed.
Owner must pay any core charges before returning.
I acknowledge that this work authorization approved supplemental estimates. I agree that if I should halt repairs for any reason I will be responsible for the cost of any and all repairs completed to that point, as well as the cost of parts, which are not returnable, or restocking fees charged to Unlimited Collision & RV. If I chose not to purchase said parts outright, I am entitled to retain any parts I pay for that are not returnable to their vendors.
Power of Attorney
I appoint Unlimited Collision & RV as my attorney in fact, to accept on my behalf all checks, drafts, or bills of exchange, and to endorse all such checks, drafts, or bills of exchange for deposit to the Unlimited Collision & RV account, as credit on my account for repairs on my vehicle.
Mechanics Lien
I expressly acknowledge a mechanics lien on my vehicle to secure the amount of the repairs. I agree to pay reasonable attorneys fees, fees and court costs in the event legal action is necessary to enforce this contract.
Payment Policy
Upon completion of the vehicle, any deductible, betterment or customer pay items must be paid for in full and in cash, certified funds, or credit card. Credit cards are not accepted for the insurance portion of the repair bill. I understand the vehicle will not be released to me until payment is received or arrangements have been made for payment with the primary payee. The insurance check(s) can simply be endorsed by all parties directly to Unlimited Collision. herein after referred to as “Repair Center”. It is the customer’s responsibility to secure the third party endorsements. Vehicle owner will be responsible for any attorney fees, collection and or court cost related to collections of payments.
Accepted By:*
Date:*
BY CLICKING SUBMIT I AM DIGITALLY SIGNING THIS FORM AND GIVING AUTHORIZATION AND POWER OF ATTORNEY TO UNLIMITED COLLISION & RV AS STATED FORTH IN THIS DOCUMENT.
