VICE Authorization Form (Estimate & Dismantling)

Authorization For Estimate & Dismantling
I authorize Valley Insurance Collision Experts (VICE) to handle all property damage concerns for any Insurance Company and/or attorney’s needs. We will prepare an estimate of repair costs and if necessary, dismantle parts of my vehicle to do so. I understand that this is not an authorization to repair and is only for evaluating damages for myself or the insurance company covering the cost of repair. VICE will not be held responsible for items left in any vehicle either towed or driven in for estimating or repairing. Any labor involved in dismantling, estimating, or towing must be paid before the vehicle is moved from VICE premises. Vehicles towed or driven in, then deemed a total loss, or moved to another location for any reason by customer or Insurance Company may be subject to admin, storage, or estimate fees. In the event there is no first or third party insurance coverages customer would be responsible for any cost associated with any originating fees VICE paid to acquire vehicle to the shop.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Year
Make / Model
Insurance Company
Claim Number
Signature

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Todays Date

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Date
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Authorization For Estimate & Dismantling