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Repair Authorization

Customer Information

Vehicle Information

Insurance Information

Repair Authorization

  1. Customer hereby authorizes the Insurance Company to pay the Companies directly for the repairs arising out of the above referenced loss including any additional supplements necessary to consummate the repair.
  2. Sublet Repairs. Customer acknowledges that portions of the repairs may be provided by a subcontractor hired by the Companies, or at another Collision Center facility controlled by the Companies, and Customer hereby authorizes all sublet repairs that the Companies (in its sole discretion) may deem necessary.
  3. Authorization to Operate Vehicle. Customer hereby authorizes the Companies, its employees and its subcontractors to operate the vehicle, including use on public streets, for the purposes of, including but not limited to, inspecting, testing, sublet services, pick-up and delivery, and facilitating repairs.
  4. Damage or Theft. The Companies do not accept any responsibility or liability for the theft of, or damage to, the vehicle, or any personal property left in the vehicle, that is not a direct result of its gross negligence. Customer acknowledges that said property is not insured or protected to the amount of the actual cash value thereof, or otherwise, against loss related to theft, fire or vandalism while the property remains in the Companies’ possession. Customer further acknowledges that all personal property has been removed from the vehicle, and that the Companies, its employees and its subcontractors are not responsible for inspection thereof.
  5. Payment upon Completion. Customer agrees that he/she will be jointly and severally responsible and liable for payment of all charges for labor, parts, material and accessories, sublet repairs to the vehicle, and any other charges in connection with the repair, and that payment in full (including the insurance deductible) shall be made prior to the release of the vehicle. To the extent that storage fees associated with this repair are not governed by a direct repair agreement with an insurance company, Customer hereby agrees that the Companies have the right to charge $20.00 per day storage for the vehicle if and only if the following limited circumstances are met: (1) the vehicle is a total loss and not removed from a Company facility within a reasonable time, (2) the vehicle sits “idle” at the repair facility without being actively repaired due to circumstances beyond the Companies’ control, (3) if after repairs are complete, the vehicle is not picked up after ten days.
  6. In addition to any and all other legal and equitable remedies available to the Companies, Customer acknowledges an expressed mechanics lien on his or her vehicle to secure the amount due for repairs thereto. Customer agrees to pay reasonable collection or attorney’s fees and court costs in the event those actions are necessary to collect payment for repair and/or enforcement of this contract.
  7. Customer acknowledges that the Companies are not responsible for any delays caused by the unavailability of parts or delays in the parts shipments by the supplier
  8. Entire Agreement, Headings, Validity. Customer acknowledges that he/she has not been induced to authorize repairs by any representation or warranty not set forth in this agreement. This is the entire agreement between Champ’s and Customer, and supersedes all existing agreements and all other oral or written communication between them concerning its subject matter. If any provision herein shall be held to be invalid, illegal or unenforceable, the validity, legality or enforceability of the remaining provisions shall in no way be affected or impaired. This agreement may only be modified in writing, signed by one of the Companies and the Customer.
I have read the above statement and agree to these terms.