• Auto Bionix Intake Form

    11450 FM 1960 RD W #204, Houston, TX 77065 | autobionix@gmail.com
  • Format: (000) 000-0000.
  • Text Message Permisssion
  • Insurance Claim*
  • Format: (000) 000-0000.
  • Work authorization
    I hereby authorize Auto Bionix to repair of the above vehicle. I agree that Auto Bionix is not responsible for the loss of items left in the vehicle, or vehicle damage caused by fire, theft, or any other cause beyond our control. I understand that there may be delays due to product unavailability and or shipping delays. I grant permission of auto bionix employees and contractors to operate the above vehicle for the purposes of testing, inspection, and delivery.

  • Payment authorization
    I hereby authorize any and all insurance supplements and payments to be made directly to Auto Bionix. I understand that I am responsible for the payment for any deductible, adjustment and/or betterment amounts or failure of my insurance company to pay other labor, part or material costs necessary to restore my vehicle to its pre-accident condition as required by state law. Unless other arrangements are made, half total deposit is made upon drop off, and remainder is due in full before the vehicle will be released. Any quote provided is good for 30 days, quotes are subject to change based on cost of materials, parts and labor.

    To secure payment in the amount of repairs hereto, an express mechanic’s lien is acknowledged, and further agree to pay reasonable attorney’s fees and court costs in the event that legal action becomes necessary to enforce this contract.

  • Warranty
    Auto Bionix provides a limited lifetime warranty on paint-related priming and painting work against solvent blistering, peeling, hazing and excessive loss of pigmentation for as long as you own the vehicle. Paint Warranty is valid only when the paint is applied over original factory finishes that are free of defect.

  • Date*
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  • Should be Empty: