PROSTAR
SERVICE · COLLISION REPAIR
LIC #MV – 05050
NAME: | HM: | |
ADDRESS: | WK: | |
CITY: | STATE: | ZIP: |
WORK AUTHORIZATION
I authorize Prostar to perform the repair work described on the repair estimate form, utilizing necessary labor, parts and materials.
I agree that Prostar is not responsible for loss or damage to the vehicle, or articles left in the vehicle, in case of theft, fire, or any other cause beyond our control. I agree that Prostar is not responsible for delays caused by unavailability of parts, or delay in parts shipments by the supplier or transporter. I grant Prostar employees permission to operate my vehicle for the purpose of testing and/or inspection. I understand if any closer analysis finds additional labor, parts or materials are necessary to complete the repair. I will be contacted for authorization, only if the amount of repairs that I will pay will be increased.
PLEASE NOTE: A daily storage charged may be applied of upto $22.00 per day for motor vehicles that have not been picked after 3 working days
from the date of notification that repairs have been completed.
Old parts removed from cars will be junked unless otherwise instructed. ( ) I Do ( ) Do Not want the replaced parts returned.
Owner must pay any core charges before returning.
I acknowledge that this work authorization approved supplemental estimates. I agree that if I should halt repairs for any reason, I will be
responsible for the cost of any and all repairs completed to that point, as well as the cost of the parts which are not returnable, or restocking fees charged to Prostar, if I chose not to purchase said parts outright. I am entitled to retain any parts I pay for that are not returnable to their vendors.
POWER OF ATTORNEY
I appoint Prostar as my attorney in fact, to accept on my behalf and all checks, drafts, or bills of exchange, and to endorse all such checks, drafts, or bills of exchange for deposit to the Prostar account, as credit on my account for repairs of my vehicle.
MECHANICS LIEN
I expressly acknowledge a mechanics lien on my vehicle to secure the amount of the repairs. I agree to pay reasonable attorneys fees
fees and court costs in the event legal action is necessary to enforce this contract.
* Payment Policy *
* We prefer the insurance check for payment *
Other Forms of Payment:
Personal Checks Credit Cards Up to Cashiers Checks
$1,000.00
We do not accept American Express.
Accepted By: ___________________________________________________________________________ Date:______________
PLEASE READ CAREFULLY, CHECK ONE OF THE FOLLOWING STATEMENTS BELOW AND SIGN BELOW:
I UNDERSTAND THAT UNDER STATE LAW, I AM ENTITLED TO A WRITTEN ESTIMATE IF MY FINAL REPAIR
BILL WILL EXCEED $100.00.
_______________ I REQUEST A WRITTEN ESTIMATE.
_______________ I DO NOT REQUEST A WRITTEN ESTIMATE, AS LONG AS THE REPAIR
SHOP COSTS DO NOT EXCEED $_____. THE SHOP MAY NOT EXCEED
THIS AMOUNT WITHOUT MY WRITTEN OR ORAL APPROVAL.
_______________ I DO NOT REQUEST A WRITTEN ESTIMATE.
Accepted By: ___________________________________________________________________________ Date:______________