AUTHORIZATION TO REPAIR

noted above. I agree that I will assist East Texas Truck Collision in dealing directly with the insurance carrier and will send I, the "customer" hereby authorize East Texas Truck Collision, my chosen repairer, to perform the repair of the vehicleand submit all forms and documents reasonably necessary to facilitate the full payment of the claim. I understand thatCollision has no relationship with the insurance company and is under no financial, legal, moral, or ethical obligation to the repairer may ask for the insurance check up front in order to order parts needed for the vehicle. East Texas Truckinteract with the insurer directly. In that their doing so, is merely as a courtesy to me as their valued customer.

insurance company or third party that may elect to take such action associated with the repair and/or removal of the Furthermore, I agree that I will fully and unconditionally hold harmless, East Texas Truck Collision, it's employees;directors, affiliates, owners, managers, and their heirs from all actions, legal and otherwise, known or unknown, andnoted vehicle. from all expenses, including reasonable attorney fees and costs incurred to defend such actions from any entity,

By my signature, I confirm that I have thoroughly read, understand, and fully agree to above. For consideration ofrepairs to be performed on this vehicle, I hereby authorize, East Texas Truck Collision to sign my name on anyinsurance draft or check resulting from this claim and to take such actions as to negotiate said payments

I further understand as the customer, I am responsible for all costs associated with the repairs of the vehicle and that allbillings are to be paid, in full, prior to the release of the noted vehicle.

I have been advised by this document that all charges must be paid in full before the vehicle can be released. Procuring payment from the insurance company and obtaining lien holder endorsement (if applicable) will be my responsibility;vehicle more than 3 days after notice of repairs being completed may cause additional charges and storage to accrue at however, East Texas Truck Collision will assist whenever possible to expedite the process. Failure to take delivery ofprescribed charges. In the event repairs are halted, terminated prior to completion (considered a total loss) storage charges of $85 per day plus tax, may be owed to East Texas Truck Collision.

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