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AUTHORIZATION FOR REPAIR
Ken's
Body Shop
5753 State Route 104 East Oswego, NY 13126
Phone(315)343-6611, Fax(315)342-1570
Name________________________________
Date_______________
Address_____________________________________________________
Home Phone____________________ Work Phone__________________
Year_________ Make_________________ Model_________________
I hearby authorize repair of the above vehicle. I agree that Ken's Body
Shop is not responsible for loss or damage to this vehicle and or loss
of articles left in the vehicle caused by fire, theft, or any other
cause beyond our control, or for delays caused by the unavailability
of parts or shipping delays. I also grant permission to Ken's Body Shop's
employees to operate the above stated vehicle for the purpose of testing
or inspection. I understand and agree that to secure payment for the
repairs thereto, an expressed mechanic's lien on the above vehicle is
acknowledged and I further agree to pay reasonable attorney's fees and
court costs in the event that legal action is required. I understand
that whenever a windshield or back glass are removed there is a chance
of breakage. I understand that Ken's Body Shop is not responsible for
the cost of replacement and that I must submit a glass claim to my insurance
company for payment of replacement glass. If supplemental damages, related
to this claim are found after commencement of repairs, I authorize Ken's
Body Shop to do those repairs with the understanding that the responsible
insurance company will bear the cost.
TERMS:
The total amount of the repair charges must be paid before release of
the above vehicle.
VEHICLE OWNER'S SIGNATURE:
___________________________________
DATE: _______________
DIRECT PAY AUTHORIZATION
I hearby authorize payment to be made directly to Ken's Body Shop for
repairs made to my vehicle.
VEHICLE
OWNERS SIGNATURE
___________________________________
DATE: _______________
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Repair Authorization