Repair Authorization Form Logo
  • SMITTY'S MAINTENANCE REPAIR & COLLISION, INC.

    3301 FREEMANSBURG AVENUE EASTON, PA 18045 * 610-258-5297
  • TAX ID 23-2915063

  • Repair Authorization Form

  • Estimates performed prior to disassembly of vehicle are not accurate due to the probability of hidden damage. Therefore, it is our practice that accurate estimates of the cost to repair and the expected time to complete repairs, are not made until we have disassembled the area of damage to your vehicle. Note: After disassembly additional repair and parts will cause delays.

    Before dropping off your vehicle, please ensure it is washed and that all personal belongings are removed. If Smitty’s Maintenance Repair & Collision needs to remove and store any items left inside the vehicle, a fee may be charged. Smitty’s Maintenance Repair & Collision is not responsible for any missing belongings left in the vehicle during the repair process.

    Additionally, Smitty’s Maintenance Repair & Collision is not liable for any damage caused by fire, theft, vandalism, or other incidents, whether occurring inside or outside the vehicle.

    Be aware, Smitty’s Maintenance Repair & Collision, Inc. labor rates are posted in the collision office. Smitty’s will review all insurance estimates for an acceptable labor rate and parts replacement. If we do not accept the insurance estimate, you may or we may contact the insurance company to discuss the labor rate and parts replacement. If in a rare situation, Smitty’s and the insurance company cannot agree on an accepted labor rate, the customer will be responsible for any difference. There may be instances when the insurance company expects Smitty’s to purchase parts outside of our normal vendor accounts. We will make the effort to make the purchases requested by your insurance company however some parts may no longer be available or they may be inferior parts below our standard of quality. Smitty’s will do everything within our limits to work with your insurance company however it is our warranty for the work performed “NOT THE INSURANCE COMPANIES.” We take pride in the quality, service, and safety that we provide to you as our customer. 

    Employees of Smitty's and its sublet vendors may occasionally operate your vehicle for testing, moving, or pickup/delivery purposes. During the process of repair, it is normal for the battery to be disconnected which may result in memory presets.

  • CANCELLATION FEES: Once the repair authorization is signed by customer, parts will be ordered per the estimate. If Smitty's does not repair your vehicle, there will be an estimate fee, fee for administrative time to process vehicle prior to repair, any labor performed in regards to disassembling and estimating the damage, parts, restocking fees for parts and materials, storage for the time the vehicle was in our possession, and any other fees reasonably incurred by Smitty's related to your vehicle.

  • SUPPLEMENTAL/ADDITIONAL DAMAGES: During the teardown process of repairing said vehicle additional damage may be found.  Smitty’s Maintenance Repair & Collision, Inc. will complete a supplement damage analysis.

    Insurance Claim: Smitty’s Maintenance Repair & Collision, Inc. will submit the additional damage estimate to insurance for approval. Repairs will be on hold until approval is received from the insurance company. The vehicle owner will be notified of the additional damage for approval. 

    Supplement Payments from Insurance: I agree to allow my insurance company handling the claim to issue supplement payments directly to Smitty's Maintenance Repair & Collision, Inc. once a supplement has been approved. I understand that any payment not received by the time the vehicle repair is complete may delay the delivery of the vehicle. If payment has not been received, proof of payment from the insurance company will be required to release the vehicle.

    Customer Pay and Third Party Pay: The vehicle owner will be notified of the additional repairs for approval. The vehicle owner will be financially responsible for the additional cost.  Refer to our Payment Policy for financial responsibility and payment methods.

     

  • PAYMENT POLICY - Vehicle owner accepts the financial responsibility for repairs to said vehicle. 

    Card Processing Convenience Fee:  A 2% convenience fee will be applied to all collision repair payments made using credit, debit, or check cards. We also accept Insurance checks, Cashier's checks, Money orders, and Cash with no additional fees.    

    Personal and Business Check Payments: accepted only if received 14 days prior to repair scheduled start date.

    Returned Check Fee: If a check payment is returned unpaid for any reason, the customer agrees to pay the full amount of the check plus a $30 returned check fee within 24 hours of notification. Payment must be made by cash only.

    Customer Pay: A 50% deposit of the Estimate of Record is required no later than two weeks prior to the vehicle’s scheduled repair date.

    Third Party Pay: 100% of the Estimate of Record is due no later than two (2) weeks prior to the vehicle’s scheduled repair date. Please note that our agreement is exclusively with you, the vehicle owner, and not with any third-party payer. Smitty’s does not offer third-party billing. As the vehicle owner, it is your sole responsibility to obtain payment or reimbursement from your insurance company or any other third party. Smitty’s assumes no responsibility for any delays, denials, or nonpayment by third parties. All repair costs remain the full responsibility of the vehicle owner until payment has been received, verified, and cleared by Smitty’s. Any remaining balance must be paid in full at the time of vehicle delivery. It is solely the customer’s responsibility to pursue and secure reimbursement from any third-party payer.

    Change from Customer/Third Party Pay to Insurance Claim: If the vehicle owner or third-party payer elects to switch to insurance coverage after repairs have commenced, the customer may be responsible for additional charges, including an administrative fee of up to $250 and any portion of the repair costs not covered by the insurance provider.

    Vehicle Completion: Vehicles are expected to be picked up within 24 hours of notification of completion unless other arrangements are made. If a vehicle is not picked up within three (3) days of notification, Smitty's reserves the right to assess storage fees at our posted daily rate.

    Final Bill: All customer-responsible repair costs must be paid in full before the vehicle will be released. 

    Insurance Payment/Financial Responsibility/Verification: I acknowledge and agree that if I receive payment from an insurance company for the purpose of covering repair costs, I am required to promptly remit the insurance check to Smitty’s or provide an alternative form of payment acceptable under the terms of the repair agreement. I acknowledge payments from insurance must be verified, if a payment cannot be verified by proof of payment or other acceptable documentation, I understand and agree that it is my responsibility, as the vehicle owner, to pay for all repair costs in full at the time of vehicle delivery. I further acknowledge that Smitty’s reserves the right to withhold release of the repaired vehicle until such payment has been received, verified, and cleared in full. I further acknowledge I will be reimbursed once the insurance payment is received by the Smitty's.

    Customer Financial Responsibilities:  I also acknowledge that I am responsible for any of the following but not limited to: Deductible amounts, Adjustments for depreciation and/or betterment, and Any portions of labor, parts, or materials not covered by my insurance, as required by state law to restore my vehicle to its pre-accident condition. If Smitty’s is not a direct repair facility for my insurance company, I acknowledge and accept responsibility for any labor rate differences or additional costs not covered by insurance.

    Insurance Follow-Up and Payment Authorization:  In certain cases, your assistance may be required to follow up with the insurance company to ensure the timely progression of the repair process, receipt of necessary documentation, and issuance of payments. If the insurance company does not respond to Smitty’s submission for supplements and/or payments, it will be the customer’s responsibility to contact and follow up with the insurer directly. This may include, but is not limited to, matters such as supplement damages identified during the repair process, final supplement adjustments, or insurance payments.

     

  • Rental Acknowledgement: If the vehicle owner chooses to use a rental vehicle—whether paid by themselves, their insurance provider, or a third party—Smitty’s is not responsible for any rental fees or associated charges.

  • Texting Consent:  Smitty's Maintenance Repair & Collision, Inc. would like to send text (SMS) messages to the mobile number you have provided in our records. By signing this form, you are agreeing to receive text (SMS) messages from Smitty's Maintenance Repair & Collision, Inc. relating to my vehicle repairs. Message frequency varies. Message & data rates may apply. Reply STOP to opt-out at any time. 

  • Photo/Video Disclosure: Please be aware, Smitty's Maintenance Repair & Collision, Inc. may take photos/videos of said vehicle during the repair process and may use the photographs/videos in publications or other media material produced by Smitty's including but not limited to: brochures, website, advertising, social media, etc. I agree the photos/videos will become the property of Smitty’s Maintenance Repair & Collision, Inc. I will receive no financial compensation for the photos/videos. I hereby release any and all claims against any person or organization utilizing the material for the purposes listed but not limited to those listed.

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    Authorization
    By signing below, you authorize Smitty’s Maintenance Repair & Collision, Inc. as your Power of Attorney to communicate with the insurance company and endorse your name on any insurance check issued for the purpose of paying for repairs to your vehicle.

  • I have read the above paragraphs and I hereby authorize the repair to the above referenced vehicle as described in the estimate and acknowledge that I understand all the above.  Smitty's is not responsible for the security or condition of any personal property left in the vehicle. An express mechanics lien is hereby acknowledged on this vehicle to secure the amount of repair thereto.

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