I authorize the stated insurance company above, to pay INS United Auto Body, Inc. In the event the insurance, or the adjustment company inadvertently mails the settlement/ supplement check to me in error, I hereby agree to notify the said shop immediately, and I agree to deliver such check to the repair facility within 24 hours of my receipt of such check.

In the event that the car is completed and we have not received the complete amount of the repairs, we will give you a five days' notice to return the entire sum. We cannot release the vehicle if we do not have possession of the sum by then; therefore, we have the right to set a lien.

I hereby authorize the repair work to be done along with the necessary material and hereby grant tear down upon drop off, and you/your employees permission to operate the vehicle herein described on streets, highways, or elsewhere for the purpose of testing/inspecting. An express mechanics lien is hereby acknowledged on the above vehicle to secure the amount of repairs thereto. INS United Auto Body, Inc. is not responsible for the availability of parts, or delays in part shipments beyond their control, nor for the loss, or damage to the vehicle, or articles left in the vehicle in case of fire, theft, or any cause beyond our control.

I do hereby appoint the aforementioned business to accept on my behalf any, and all checks, drafts, or bills of exchange, and endorse all such checks drafts, or bills of exchange for deposit to the aforementioned business account.

As long as you have your vehicle, we offer warranty on our completed repairs based on the estimate written and approved by the insurance company. I acknowledge that the shop orders and installs parts by any given vendors the insurance company has provided.

If you should decide to pull your car out of the shop, you are responsible for any charges. The following charges listed are including but not limited to: daily storage $150, admin fee $250, tow bill TBD, tear down $65 hourly, dolly fee $150, and hazmat fee $150.