• MYERSCollision Center

  • Image field 2
  • Format: (000) 000-0000.
  • WORK AUTHORIZATION

  • I authorize this repair shop to perform repairs as outlined in its estimate or that of the responsible insurance company, including parts, labor, and diagnosis. Parts prices may change per manufacturer notice. I permit employees to operate my vehicle for testing, inspection, or delivery. I am responsible for removing personal belongings before repairs and will not hold the shop liable for loss or damage to my vehicle or items left in it due to fire, theft, accident, or any other cause.
  • PAYMENT AUTHORIZATION

  • I authorize insurance payments for my vehicle repairs to be paid directly to the repair shop. The repair shop is appointed to accept such payments on my behalf. I acknowledge that I am responsible for any deductible, depreciation, or other costs not covered by my insurance policy. Payment in full is required prior to the release of my vehicle. An express mechanic's lien is recognized, and I agree to cover any legal fees incurred if enforcement of this contract becomes necessary. I further acknowledge that any payments issued to me by the insurance company in connection with this claim will be remitted to the body shop. If payment is made via credit card, a 3% fee will be assessed.
  • CONTACT AUTHORIZATION

  • I hereby agree to participate in Myers Collision's text messaging service for the purpose of receiving updates and information regarding my repair.
  • DATE
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  • Should be Empty: