Mitchell Collision Repair Authorization Mitchell Collision Repair Authorization Please enable JavaScript in your browser to complete this form.Name *Phone *Email *Year, Make, Model: *Insurance Company: *Location *Location:Belleview LocationLand O' Lakes LocationPreferred Contact MethodTextCallEmailAUTHORIZED: *I HEREBY AUTHORIZE MITCHELL COLLISION REPAIR TO PERFORM REPAIRS ON THE ABOVE REFERENCED VEHICLE. You and your employees may operate the vehicle for purposes of testing, inspection, sublet repairs, and delivery. Mitchell Collision Repair will not be held responsible for loss or damage to the vehicle or articles left inside in the case of fire, theft, accident, or other causes beyond our control. I understand Mitchell Collision Repair may access vehicle data from vehicle control unit for repairs and reprogramming.AUTHORIZED: * I AUTHORIZE THE INSURANCE COMPANY TO MAKE DIRECT PAYMENT TO MITCHELL COLLISION REPAIR. PAYMENT IS EXPECTED UPON DELIVERY OF VEHICLE, UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE IN ADVANCE.I HAVE READ AND UNDERSTAND THE ABOVE TERMS *PLEASE READ CAREFULLY, CHECK ONE OF THE STATEMENTS BELOW, AND SIGN. I UNDERSTAND THAT UNDER STATE LAW I AM ENTITLED TO A WRITTEN ESTIMATE IF MY FINAL BILL WILL EXCEED $100. *I REQUEST A WRITTEN ESTIMATE.I DO NOT REQUEST A WRITTEN ESTIMATE AS LONG AS THE AMOUNT DOES NOT EXCEED THE AMOUNT I SPECIFY.I DO NOT REQUEST A WRITTEN ESTIMATE.The shop may not exceed the following amount by more than 10% without written or oral approval: *The shop may not exceed the following amount by more than 10% without written or oral approval:Signature *Clear Signature(Signature)Date *LIMITED POWER OF ATTORNEY For consideration of repairs made to this vehicle, I hereby grant my power of attorney to sign and endorse any checks and/or drafts payable to me as settlement for my claims for repairs to the above listed vehicle.Clear Signature(Signature)Date *Submit
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