I hereby authorize World Auto Body to complete the necessary repairs to my vehicle. An Estimator will provide me with an oral/written evaluation. I understand that payment in full will be due upon release of the vehicle, including any supplement charges. The final invoice may differ from the insurance estimate due to parts, labor or required procedures. I hereby grant you and/or your employees permission to operate my vehicle on streets, highways, or elsewhere for the purpose of testing, inspecting or sublet repairs, and delivery or pick up. Kaizen will defend you as to any third-party claims made and related to Kaizen’s operation of the vehicle. An Express Mechanic’s Lien is hereby acknowledged on the above vehicle to secure the amount of repairs thereto. I will not hold Kaizen responsible for loss or damage to the vehicle or articles left in vehicle in case of fire, theft, hail, accident or any other cause beyond Kaizen’s control. World Auto Body is not responsible for glass damage resulting from existing chips, cracks, or stress fractures. If glass damage occurs during test drives or vehicle transport, a supplement may be filed with the responsible paying party.

I authorize World Auto Body to disassemble my vehicle for the purpose of diagnosing repairs and preparing a full estimate of the cost of repair. I understand that if I choose not to complete repairs, I may be charged for disassembly, reassembly and/or partially completed work, based on World Auto Body’s normal hourly labor rate.

For insurance claims, I hereby appoint World Auto Body and its authorized employees to be my attorney-in-fact with the limited authority to sign my name on any check or draft covering repairs to my vehicle and to take such action as may be necessary to negotiate any such check or draft.

If an insurance carrier is paying for all or part of my repair order, I authorize payment to World Auto Body Centers, or its affiliated companies. If a deductible is required, I will be responsible for payment. Furthermore, I authorize any and all supplement repair order amounts to be paid to Kaizen Collision.

The length of time to complete your vehicle’s repair may exceed customary time due to (i) parts availability (ii) material shortages and/or (iii) labor shortages. Due to these issues, the length of time to complete the repair may exceed the insurance company approved time for rental charges. World Auto Body is not responsible for rental charges beyond the insurance company approved rental period for issues outside of World Auto Body’s control. World Auto Body is not responsible for these costs and is not responsible if insurance coverage is not sufficient to pay these costs.

I acknowledge that I have removed or will remove all personal and valuable articles from the vehicle. I understand that Kaizen Collision will not be responsible for any belongings left in the vehicle.

Vehicles must be picked up within three days of repair completion or storage fees may apply. After thirty days, the vehicle may be sold or dismantled. Storage fees begin three days after repair completion. It is understood that the storage fee is $150 per day. Vehicles moved or deemed a total loss may incur administrative, cleanup, or estimate fees.

Accepted payments: Credit cards (3% surcharge), debit cards, money orders, cashier’s checks. No cash or personal checks.

I hereby authorize World Auto Body Centers to endorse on my behalf all insurance checks and/or drafts received for payment of repairs completed on my vehicle under this Repair Authorization whereon my signature would be required. I further authorize payor(s) to pay World Auto BOdy Centers directly and understand that any drafts, checks and/or monies received will be applied to the outstanding balance on my account. All insurance checks received for my repair will be deposited and posted to my customer account immediately upon receipt. In the event there are any reimbursements necessary, all monies must be received for the completed repairs and all drafts and/or checks will subject to a TEN-WORKING DAY hold to allow sufficient time for them to process and clear the banking institution. After the 10-Day Hold has expired and all the drafts and/or checks have cleared, a reimbursement check will be requested and issued within72 hours. Only confirmable bank checks, debit cards, credit cards and EFTs are accepted.