I warrant and represent that I am the owner of the vehicle or an authorized agent of the owner and that Metropolitan Collision Service (MCS) is authorized to disassemble and inspect this vehicle for the purpose of providing an estimate for myself and/or the insurance company. Once discussed and verbally approved by myself and/or the insurance company, repairs will commence. I further authorize MCS’s employees to operate the vehicle on streets and elsewhere for the purpose of sublet repairs and test driving.

Some insurance estimates may include the use of aftermarket, reconditioned, or used parts. By signing this form, I authorize the use of these parts if indicated on the estimate. If I wish to use OEM parts, I agree to pay the difference at the time of completion.

PAYMENT—I AGREE TO PAY MCS UPON COMPLETION OF REPAIRS FOR ANY AND ALL MONIES PAID

by insurance to me (us) by ENDORSING OVER any and all insurance checks to MCS. Credit cards, personal checks, and cash are only accepted for amounts not paid by insurance (i.e. deductibles and/or additional repairs requested by you).

In the event that I receive the insurance check that is co-payable to my lienholder, I am aware it is my responsibility to get it properly endorsed by the lienholder prior to picking up my vehicle.

AN EXPRESS MECHANICS LIEN is hereby acknowledged on the said vehicle to secure the amount of repairs thereto. Notice Pursuant to Sec. 70.001, Texas property code: I am the person who is obligated to pay for the repairs of the motor vehicle herein described. I understand that this vehicle is subject to repossession in accordance with Sec. 9.609 Texas Business and Commerce Code if a check, money order, or credit card transaction for repair on the vehicle is stopped, dishonored because of insufficient or no funds, or because the drawer or maker has no account, or an account on which it is drawn has closed.

CANCELED REPAIRS—If for any reason, I or my insurance company chooses not to repair the vehicle, I understand I will incur additional costs, to include but not limited to: Disassembly/Inspection and Damage Report fee of 10 labor hours, towing, a storage fee of $50 per day, weatherproofing as needed, the full price of any non-returnable parts, a restocking fee of 25% for refundable parts and other fees reasonably incurred by MCS.

POSSESSIONS LEFT IN CAR---I HAVE REMOVED ALL UNATTACHED AND VALUABLE ARTICLES from my vehicle. MCS is not responsible for possessions left in my car.

ACTS OF GOD—in the case of damage caused by wind, hail, flooding, or other “Acts of God”, I agree to file with my own insurance company. I understand MCS is unable to keep all vehicles under cover or otherwise protect from these exposures and is not responsible for these types of losses.
I authorize Metropolitan Collison to act as POWER OF ATTORNEY to sign insurance checks on my behalf.
I have read, acknowledge, and agree to all terms and conditions above and I hereby give Metropolitan Collision Service authorization to repair my vehicle.