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I hereby authorize the repair work to be performed along with the necessary material and agree that you are not responsible for loss or damage to the vehicle, articles in the vehicle, fire, theft, or any other cause that is not a direct result of your gross negligence or for delays caused by unavailable parts or delays in parts shipped by the supplier or transporter. I hereby grant you and/or your employees? permission to operate the vehicle herein described on streets or highways for inspection. An expressed mechanic?s lien is hereby acknowledged on above vehicle to secure the amount of repairs thereto. Customer is aware of damage noted on diagram, and agrees that it occurred prior to acceptance by this Collision Center. Customer agrees that he/she will be jointly and severally responsible and liable for payment of all charges for labor, parts, material and accessories, sublet repairs to the vehicle, and any other charges incurred under this Agreement, and payment in full shall be made prior to the release of the vehicle. If the vehicle is not picked up within ten (10) days after the dealership has notified the Customer that the repairs are completed, the dealership may charge daily storage fees at rates that are ordinary and customary for the area, but not to exceed $50.00 per day.

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Collision Center of Peoria

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