• OUR ADDRESS: 610 E County Road 7300, Lubbock TX 79404

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  • CUSTOMER INFORMATION

  • DAMAGE TYPE

  • Rental Car coverage on Insurance policy?

  • VEHICLE IFORMATION

  • INSURANCE NFORMATION

  • PRIOR DAMAGE

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  • WORK / PAYMENT AUTHORIZATION

  • I authorize for this to serve as my direction of pay and grant the company permission to get paid for repairs. I agree that Global Auto Hail & Dent Repair, inc. is not responsible for loss or damage to this vehicle and/or articles left in the vehicle due to fire, theft, or any other causes beyond it's control. I also hereby grant permission to this company's employees to operate the vehicle for the purpose of testing and/or inspection. Further, I acknowledge that if closer analysis reveals additional repairs are necessary, either I or my insurance company will be contacted for authorization of any additional repair charges. If new parts listed in attached repair order are not available, I authorize Global Auto Hail & Dent Repair, inc. to repair such damaged or worn parts when possible. Old parts will be thrown away unless otherwise instructed. Global Auto Hail & Dent Repair, inc. authorize to manufacture access to dents that may not be accessible due to their location on the vehicle. The total amount of the repair charges must be paid before the attached vehicle can be released for delivery. If insurance coverage pays either a portion of or total amount due, I acknowledge that the insurance check/draft must be obtained by me or sent in advance by the insurance company. I also acknowledge that I must make arrangements with my lien holder or other payees to endorse the insurance check and/or draft prior to the release of the above repaired vehicle. I authorize any and all supplements payable to Global Auto Hail & Dent Repair, inc. for the consideration of repairs made to the vehicle. I hereby authorize Global Auto Hail & Dent Repair, inc. to act as power of attorney to sign or endorse any checks and/or drafts make payable to me and any release there to, as settlement for any claim for damage to this vehicle. Global Auto Hail & Dent Repair, inc. is not responsible for prior damage listed on vehicle diagram to the right. To secure payment in amount of repairs, an expressed mechanics lien on the vehicle is acknowledged and I further agree to pay reasonable attorney’s fees and court cost in the event that legal action becomes necessary to enforce this contract. Global Auto Hail & Dent Repair doing business as Global PDR.
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