Authorization to Repair

First Name Last Name Make of Vehicle Model of Vehicle Telephone Number I authorize Taylor’s Autobody to perform all necessary repairs on my vehicle. A Service Advisor will provide an evaluation in either oral or written form. I acknowledge that full payment is required upon the release of the vehicle, inclusive of any supplementary charges. I grant permission to Taylor’s Autobody and/or its employees to operate my vehicle on public roads, highways, or other locations for the purposes of testing, inspection, sublet repairs, delivery, or pick-up. An Express Mechanic’s Lien is hereby acknowledged on the aforementioned vehicle to secure the cost of repairs. I release Taylor’s Autobody from any liability for loss or damage to the vehicle or any articles left within it due to fire, theft, accident, or any other cause beyond the control of Taylor’s Autobody.

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I authorize Taylor’s Autobody to disassemble my vehicle as necessary to diagnose repairs and prepare a comprehensive repair estimate. I understand that should I elect not to proceed with the repairs, I may be charged for disassembly, reassembly, and/or any partially completed work at Taylor’s standard hourly labor rate.

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For the purpose of processing insurance claims, I appoint Taylor’s Autobody and its authorized employees as my attorney-in-fact, with limited authority to endorse my name on any check or draft issued for repairs to my vehicle and to take necessary actions to negotiate such checks or drafts.

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I acknowledge that modern vehicles contain complex electronic systems that may record data useful for diagnosing repairs and verifying system functionality post-repair. I authorize Taylor’s Autobody to access such data as part of the repair process and to include this data in compilations for the purposes of studying accident causes or improving repair methodologies.

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If an insurance carrier is covering all or part of my repair costs, I authorize payment directly to Taylor’s Autobody. If a deductible is required, I acknowledge my responsibility for its payment. I further authorize payment of any additional repair order amounts directly to Taylor’s Autobody.

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I understand that the time required to complete repairs may exceed customary durations due to factors such as parts availability, material shortages, and/or labor shortages. These factors may result in repair times exceeding the rental period approved by the insurance company. I acknowledge that Taylor’s Autobody is not responsible for rental charges beyond the insurance company’s approved rental period and is not liable for any insufficiency in insurance coverage to cover these costs.

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To maintain Taylor’s Autobody's high standards of repair quality, it may be necessary to transfer vehicles for additional mechanical work if repairs are extensive and require specialized expertise. I authorize Taylor’s Autobody to transport my vehicle and perform all authorized repair work at another facility owned or operated by Taylor’s Autobody or one of its affiliates.

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This Authorization is subject to my consent to electronic transactions and disclosures. I agree that my electronic signature is legally equivalent to my manual signature on this Authorization form. Furthermore, I authorize Taylor’s Autobody to communicate with me regarding my repair via email, SMS, MMS, or other phone-based messaging systems. I understand that message and data rates may apply and that I may opt-out of such communications at any time.

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I have read, understood, and agree to the terms and authorizations contained within these terms and conditions governing Taylor’s Autobody repair services, including the Dispute Settlement & Arbitration provision. I acknowledge that it is advisable to retain a copy for my reference.

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Signature: Date:

항해

TAYLORS AUTO BODY SHOP INC

495 BROOKWAY DR, CHARLOTTESVILLE, VA 22901, United States

+1 434-296-9821

Taylors@taylorsautobody.com

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