Work Authorization Form
Inspection & Damage Report Authorization:
I authorize disassembly, inspection, test drive and diagnosis for the purpose of providing an estimate of repair costs for this vehicle. If I elect not to have the work done after the estimate of repairs costs is disclosed, I understand that I will incur charges for above services, to include but not limited to:, Disassembly/ Inspection & Damage Report fee of 10 labor hours, storage fees of $85 per day, weatherproofing & diagnostic scan fee as needed. No reassembly will be performed due to the nature of damages. These charges are included in the estimated cost of repairs if you elect to have work performed. This “Inspection Authorization” does not constitute authorization of repairs; the commencement of repairs must be authorized by a separate signature below.
I warrant and represent that I am the owner of the vehicle or an authorized agent of the owner and that Bates Collision Center ("BCC") is authorized to repair the vehicle and provide the necessary services, parts, and materials needed for the repair. I further authorize BCC's employees to operate the vehicle on streets and elsewhere for the purpose of sublet repairs, testing and/or inspection and delivery or pick-up. An express mechanics lien is hereby acknowledged on said vehicle to secure the amount of repairs thereto. I authorize BCC to be my representative to negotiate with any insurance company/representative regarding the repair of the vehicle. I further authorize any and all payment for repairs to be paid directly to BCC. Some estimates may include the use of aftermarket, reconditioned or used parts. By signing this form, I authorize use of these parts if indicated on the estimate. By signing this form, I am giving consent to receive text messages on behalf of BCC that you may opt out of at any time. I acknowledge that all vehicles left more than three (3) days after completion of repairs will incur an $85.00 per day storage fee.
In the process of performing a diagnostic scan, BCC will collect important historical vehicle data, including in some cases, the date, time and mileage of when a Diagnostic Trouble Code was created. This information is helpful in understanding if a problem is accident related or pre-existing. It is possible this information will be shared with your insurance company. Your acceptance of this procedure grants BCC permission to share this information with others, including your insurance company. No personally identifiable information is collected during the pre or post-repair scan.
Notice Pursuant to Sec. 70.001, Texas Property Code:
I am the person or agent acting on the behalf of the person, who is obligated to pay for the repairs of the motor vehicle herein described. I understand that this vehicle is subject to repossession in accordance with Sec. 9.609, Texas Business and Commerce Code, if a check, money order or credit card transaction for repair on the vehicle is stopped, dishonored because of insufficient or no funds, or because the drawer or maker has no account, or account on which it is drawn has closed.
Power of Attorney:
For consideration of repairs made to this vehicle I hereby grant my Power of Attorney to Bates Collision Centers to endorse any insurance checks/drafts issued by the insurance company covering said repairs to my automobile authorized by myself in whatever manner is necessary to place checks or drafts, for this repair only, into a cashable position.
Direction to Pay
I authorize the insurance company to pay Bates Collision Center on my behalf.
BY CLICKING SUBMIT I AM DIGITALLY SIGNING THIS FORM AND GIVING AUTHORIZATION AND POWER OF ATTORNEY TO BATES COLLISION CENTER AS STATED FORTH IN THIS DOCUMENT.