Preferred Location:
    BaytownNorth Channel

    I authorize Progressive Casualty Insurance Company and any affiliated insurance company (collectively "Progressive") to designate a qualified repair facility to complete repairs to my damaged vehicle (the "Repair Facility").

    I authorize my vehicle to be driven by Progressive and the designated Repair Facility for the purpose of pick-up, repairing, inspecting, testing and/or delivery. If my vehicle is determined to be a total loss and I do not want to retain the vehicle, I authorize Progressive to move the vehicle to a salvage facility consistent with the salvage and titling laws of this state.

    I authorize Progressive, on my behalf, to (1) order the Repair Facility to commence and complete the repair work, and (2) coordinate and approve the repair work and any supplements necessary to return my vehicle to its pre-accident condition. I acknowledge and agree that such action by Progressive does not constitute an admission of liability on the part of Progressive or an acknowledgement that the repairs are covered by any policy of automobile insurance issued by Progressive.

    I authorize the Repair Facility to order parts and perform the repair, service and other necessary activities that will restore my vehicle to its pre-accident condition.

    For Progressive policyholders only: Subject to any rights that I may have agains any other party involved in the accident, I acknowledge that I will be responsible for any repair charges that are not covered by my insurance policy ("Uncovered Charges") and, if my policy does cover the repairs, any deductible amount thereunder. I agree to pay to Progressive my deductible amount and any Uncovered Charges upon completion of repairs.

    I hereby release Progressive and the Repair Facility from liability for any personal property that I left in my vehicle.

    I agree to pick up my vehicle within twenty-four(24) hours after Progressive has notified me that the repairs are complete or after my vehicle has been determined to be a total loss and I want to retain the vehicle. If I fail to so comply, I will be responsible for any additional rental and/or storage charged generated by my delay. If I fail to pick up my vehicle within eleven (11) business days after Progressive first notifies me that the repairs are complete, Progressive may have the local authorities impound my vehicle at my expense.

    I hereby authorize and direct Progressive to pay the Repair Facility on my behalf.