Joshawa Auto Repairs

Customer Name

First NameLast Name

Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

I agree to receiving calls, texts, and emails in regards to my vehicle service request, repairs, billing and other service related matters.

Type YES if you agree

Email Address

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Vehicle Information

YearMakeModel

Vehicle Identification Number (VIN)

License Number

Vehicle Tag Number

Vehicle Color

Current Mileage

Service Request Date

Date

Do you have insurance?

Will you be filing the repairs on your insurance?

Direction to Pay (to receive insurance payments)

Service Requested

Drivability

Other concerns or needs

VEHICLE REPAIR AUTHORIZATION

WARRANTY DISCLAIMER:

ALL PARTS AND ACCESSORIES ARE SOLD AND ALL REPAIRS ARE PROVIDED BY JOSHAWA’S AUTO REPAIRS AS-IS. THE DEALERSHIP HEREBY DISCLAIMS ALL WARRANTIES, EXPRESS AND IMPLIED, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, AND NEITHER ASSUMES NOR AUTHORIZES ANY OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH THE SALE OF ANY PARTS OR ACCESSORIES OR ANY REPAIRS PERFORMED TO THE VEHICLE. THE ONLY WARRANTIES ON PARTS AND ACCESSORIES OR REPAIRS ARE THOSE WHICH MAY BE OFFERED BY THE MANUFACTURER OR ORIGINAL PARTS DISTRIBUTOR AND ONLY SUCH MANUFACTURER OR DISTRIBUTOR SHALL BE LIABLE FOR PERFORMANCE UNDER SUCH WARRANTIES.

CUSTOMER SHALL NOT BE ENTITLED TO RECOVER FROM JOSHAWA’S AUTO REPAIRS ANY CONSEQUENTIAL DAMAGES, DAMAGES TO PROPERTY, DAMAGES FOR LOSS OF USE, LOSS OF TIME, LOSS OF PROFIT OR INCOME, OR ANY OTHER INCIDENTAL DAMAGES.

PAYMENT TERMS:

I agree to pay for the inspection and repairs I authorize, along with the necessary materials, in Cash or approved credit card upon completion of the Repairs unless JOSHAWA’S AUTO REPAIRS agrees to other payment arrangements in advance. If I authorize commencement of repairs or disassembly of the vehicle or a vehicle component for diagnostic purposes and do not authorize completion of a repair or service, I understand that a charge will be imposed for disassembly, reassembly or partially completed work and I agree to pay the same. Such charges will be directly related to the actual amount of labor and parts involved in the inspection, repair or service. An express mechanics lien is hereby acknowledged on the vehicle to secure the cost of labor, materials, and other authorized changes.

I understand that JOSHAWA’S AUTO REPAIRS is not responsible for any delays caused by unavailability of parts or shipping by the parts manufacturer or distributor or the transporter, nor is it responsible for loss or damage to the vehicle or articles left in the vehicle in case of fire, theft, hail, wind, or any other cause beyond its control.

I hereby grant JOSHAWA’S AUTO REPAIRS permission to operate the vehicle on streets, highways or public roadways for the purpose of testing and/or inspecting the vehicle. I authorize the retrieval of on-board data as needed to facilitate vehicle repair, as well as sharing that data with the vehicle manufacturer for diagnostic research purposes.

Agree to terms

DISCLAIMERS

Joshawa Auto Repairs is not responsiblefor loss or damage to vehicle or articles left in vehicle in case of fire, theft or any other cause beyond shops control. I hereby grant you and/or your employees permission to operate the vehicle herein described on streets, highways or elsewhere for the purpose of testing and/or Inspection. An express Garage keeper's lien is hereby acknowledged on vehicle to secure the amount or repairs thereto.

1 Month or 1,000 miles Warranty on Repairs.

*** ALL REPAIRS ARE EXPECTED TO BE PICKED UP & PAID IN FULL WITHIN 72 HOURS OF COMPLETED REPAIR, INCLUDING ANY STORAGE FEES IF APPLICABLE

*** ALL VEHICLES LEFT MORE THAN 72 HOURS AFTER REPAIRS ARE COMPLETED WILL INCUR A $25 PER DAY STORAGE FEE UNTIL THE VEHICLE IS PICKED UP (STORAGE FESS ARE APPLIED FOR THE WEEKENDS AS WELL) AND PAID IN FULL

*** AT THE DISCRETION OF JOSHAWA’S AUTO REPAIRS A "MECHANICS LIEN" could BE PLACED ON ALL VEHICLES LEFT MORE THAN 7 CONSECUTIVE DAYS AFTER REPAIR IS COMPLETE

*** VEHICLES LEFT IN THE POSSESSION OF JOSHAWA’S AUTO REPAIRS MORE THAN 30 CONSECUTIVE DAYS, WILL BE CONSIDERED ABANDONED & IS AT THE DISCRETION OF JOSHAWA’S AUTO REPAIRS TO FILE FOR AN "ABANDONED TITTLE"

JOSHAWA’S AUTO REPAIRS RESERVES THE RIGHT TO REFUSE SERVICE TO ANYONE

Agree to terms

Repair Authorization Agreement

I have been informed and acknowledge that the repairs and date of completion may be affected by the following factors: A) Discovery of additional damage upon disassembly of damaged area B) Parts availability C) Inspection and Authorization delays from responsible parties (i.e. insurance companies) D) Some electrical or telematic systems cannot be checked/diagnosed until other systems/parts are repaired E) Payment of repairs (Insurance company and/or deductibles).

Electronic Data Agreement

Authorized Representative Agreement

Date

Hour MinutesAM/PM Option

Customer Name

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Digital Customer Signature

By signing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.