Repair Authorization

Courtesy Collision Center
1233 E. Camelback Rd.
Phoenix, AZ, 85014
(602) 604-3080
    * I agree to receive text messages from Courtesy Chevrolet Collision Center and I understand that message and data rates may apply.
    Customer authorizes the repair work to be performed along with the necessary materials and agrees that Courtesy Chevrolet is 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. 

    Customer grants Courtesy Chevrolet and/or it's employees’ permission to operate the vehicle herein described on streets or highways for inspection. A expressed mechanic’s lien is hereby acknowledged on the 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 Courtesy Chevrolet.  

    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. 

    Customer agrees 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.
    Check authorization box above and type your name in box below for your digital signature.
    I do hereby appoint Courtesy Chevrolet and its representatives as my attorney, in fact to accept on my behalf all checks and drafts for deposit to the aforementioned business account for credit to my account for the repairs on the above said vehicle. Accepted and Authorized for Repairs.  
    Check box above and type your name in box below for your digital signature.
    I have removed all personal items from my vehicle, plus all un-mounted equipment.