AUTHORIZE TO REPAIR form



I authorize DJ ROGERS COLLISION & SERVICE CENTER to complete the repairs. I understand the payment in full will be due upon release of the vehicle, including any supplement charges and/or deductible. I grant you and/or your employees permission operate my vehicle on streets, highways or elsewhere for the purpose of testing, inspecting or sublet repairs. I will not hold DJ ROGERS COLLISION & SERVICE CENTER responsible for loss or damage to vehicle or articles left in vehicle due fire, theft, accident, or any other cause beyond their control. I have REMOVED ALL UNATTACHED PERSONAL AND VALUABLE ARTICLES from said vehicle. I acknowledge that DJ ROGERS COLLISION & SERVICE CENTER is not responsible for for the availability of parts, delays in shipment of parts or damaged or wrong parts delivered to them.


BY SIGNING THIS FORM, I AGREE THAT MY ELECTRONIC SIGNATURE IS THE LEGALLY BINDING EQUIVALENT TO MY HANDWRITTEN SIGNATURE. WHENEVER I EXECUTE AN ELECTRONIC SIGNATURE, IT HAS THE SAME VALIDITY AND MEANING AS MY HANDWRITTEN SIGNATURE. I UNDERSTAND THAT MY ELECTRONIC SIGNATURE IS LEGALLY BINDING.


BY SIGNING BELOW, I ACCEPT THE CONDITIONS OF THIS AGREEMENT.