<h4>B&E Collision - Customer Authorization Form</h4>

• If your claim is being handled electronically by one of our direct repair programs, all payments owed by the insurance company should be made directly to us. You will need to sign a power of attorney and any other necessary forms to insure we are able to collect payment from the insurance company.
• If your repairs are covered by any other insurance company, we must have a copy of that insurance company's estimate. This is so we can begin repairs on your vehicle. In the event that you do not provide us with a copy of the insurance company's estimate, we have no way to communicate with the adjuster; therefore any additional expense that is incurred will be your responsibility.
• If you have rental car coverage, you may be limited to the number of days or have a specific dollar amount that you can not exceed with the rental car. You should verify this in advance with the insurance company responsible for payment.
• This vehicle is being repaired for you as the owner, You are responsible for payment for repairs. If you do not intend to pay the bill with an acceptable form of payment, please make certain you have insurance company releases signed and returned to the proper insurance company so they can deliver their check to you in time to get your vehicle.
• If a lien holder is named as a payee on the insurance check, you must make arrangements to secure the lien holder's endorsement.
• In the event your insurance company makes a supplemental allowance for items not included in their initial settlement check, you will be expected to supply payment for the additional amount and obtain reimbursement from the paying insurance company or we retain the right to hold your vehicle until the insurance company sends us payment.
• In addition to the amount of damage paid for by the insurance company, you are responsible for payment of the deducible in the amount dictated by your insurance policy.
• Before we can release your vehicle to you all repair bills must be paid in full by an acceptable form of payment. We accept Visa, MasterCard, and Discover, personal and business checks (TN and VA only-up to $500.00), cashier's checks and cash.
• Storage will be charged at the rate of $30.00 per day on vehicles not repaired by our facility beginning the day after the estimate is completed and for vehicles repaired but not picked up within seven (7) days of completed repairs.
• The repairs to your vehicle has be ESTIMATED and is subject to final invoices from our vendors. • An estimate is a rough, preliminary calculation of the approximate amount or extent of visible damage during the initial estimate procedure.
• If you leave personal items in your vehicle while being repaired you understand that B&E Collision Inc. is not responsible for lost, missing or damaged items.
• B&E Collision is not responsible for lot damage, overspray or cleanliness of your vehicle if it is not picked up within seventy two (72) hours of completed repairs.
THANK YOU FOR YOUR BUSINESS!

BY CHECKING THE BOX BELOW, I HAVE READ AND AGREE TO THE ABOVE TERMS AND AUTHORIZE B&E COLLISION TO REPAIR, TEST DRIVE, AND THOROUGHLY INSPECT MY VEHICLE.
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