Legally Binding Repair Authorization and Consent

This document serves as a formal and legally binding agreement between Champions Collision 1, Inc. and the undersigned customer. By affixing your digital signature, you acknowledge your consent to the outlined repair services, terms, and conditions, and agree to comply with all relevant legal requirements. Please read carefully before proceeding.

Your Details:

Vehicle Details:

Insurance Information: (Required if using Insurance)

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 DO NOT REQUEST A WRITTEN ESTIMATE AS LONG AS THE REPAIR COSTS DO NOT EXCEED $
THE SHOP MAY NOT EXCEED THIS AMOUNT WITHOUT MY WRITTEN OR ORAL APPROVAL.

COMPANY INVOICE

MV: 111636

MVR: 092912

Address: 2550 Ali Baba Ave, Opa-locka, FL 33054

Phone Number: (786) 508-1300

  • *U/Used
  • R/Repaired
  • A/Aftermarket
  • S/Straightened
  • M/Manufactured Part

LABOR HOURS

  • QTY
  • *
  • Part No.
  • Description
    CUSTOMER COMPLAINT/PROBLEM CLAIM #
  • Body
  • Paint
  • Frame
  • Mech

All parts and labor are warrantied for months/ miles unless otherwise stated.

Vehicle Information

  • Save Parts:

    No
  • Core may apply:

    Yes

Charges based on:

  • Hourly Rate
  • Flat Rate
  • Both Apply

Estimate Diagnosis:

  • Fee: $ or
  • Hourly at $ /hr.

Payment Method:

  • Cash
  • Check
  • Visa
  • MC
  • Amex

Estimated Cost: $

**This charge represents costs and profits to the motor vehicle repair facility for miscellaneous shop supplies or waste disposal.

***s. 403.718, F.S. mandates a $1.50 fee for each new or manufactured battery sold in the State of Florida.

Estimate good for 30 days. The facility is not responsible for damage caused by theft, fire, or acts of nature. I authorize the above repairs to my vehicle including the necessary materials and sublet work. You and your employees may operate my vehicle for the purpose of testing, inspection, and delivery at my risk. If I cancel repairs to my vehicle for any reason, I understand that a tear-down and reassemble fees of $ 800 will apply. I understand that a charge of $ 200/20per day will be charged if I fail to pick up my vehicle within (3) working days of notification of completion.

  • Body Hours/@ Paint Hours/@ Mech Hours/@ Paint Supplies Body Supplies Tow Storage: Epa/Waste Miscellaneous
  • $60 $60 $210 $40 $40 $200/300 $55 $
  • Parts: Labor: **Shop Sup: Sublet: ***Fees: Subtotal: Tax: Total:
  • $ $ $ $ $ $ $ $

Repair Agreement

Authorization for Repairs and Vehicle Operation:I hereby authorize the required repair work to be completed on my vehicle, including the necessary materials. I grant Champions Collision 1, Inc. and its employees permission to operate the vehicle described herein on streets, highways, or elsewhere for the purpose of testing and inspection. An express mechanic's lien is hereby acknowledged on the above vehicle to secure the amount of the remaining balance due, should the need arise.

Payment and Release of Vehicle:

No vehicle will be released until payment is made in full. Please ensure that all payees, including lienholders, have endorsed the insurance check prior to the completion of repairs.

Estimate and Invoice Discrepancies:

I understand that the final invoice from Champions Collision 1, Inc. for the repairs on my vehicle may not match the insurance company’s estimate regarding parts, labor, or procedures used. Parts prices are based on recent Estimating Software; however, prices may vary due to currency fluctuations or varying supplier costs. I acknowledge that repair techniques are employed based on Champions Collision 1, Inc.’s judgment to ensure a high-quality repair. Labor charges are based on hourly time allowances as provided in the collision repair industry estimating software and the experience of the technicians. These charges may be more or less than the actual time spent on repairs.

Flat Rate Hour Understanding:

I understand that all estimates and final invoices from Champions Collision 1, Inc. are based on flat rate hours, as is customary in the collision repair industry, and not on the actual time spent on the repair. A flat rate hour is a unit of time assigned to a certain repair operation. Actual time spent on a repair operation may vary depending on technician experience, equipment provided, and training.

Liability and Personal Property:

Champions Collision 1, Inc. is not responsible for loss or damage to vehicles and/or articles left in vehicles due to fire, theft, or any cause beyond our control. Please remove any personal articles from your vehicle, as it may be necessary for outside companies to perform sublet work on your vehicle. Care, Custody, and Protection Fees will accrue three days after notification of the completion of repairs. Failure to make payment within 20 days of notification will result in the commencement of the auction process to satisfy the mechanic’s lien.

Insurance and Care, Custody, and Protection Fees:

In the event that an insurance company fails to provide an estimate, or if there is an inability to agree on a price for either the initial estimate or a supplement, an inside Care, Custody, and Protection Fee of $300 per day and an outside Care, Custody, and Protection Fee of $200 per day will apply, beginning on the day the vehicle arrived.

Additional Fees and Part Restocking:

Vehicles towed or driven in, then deemed a total loss, or moved to another facility by the customer or Insurance Company may be subject to administrative, loss, debris cleanup charges, or estimate fees. Any labor, towing, or lift inspection fees must be paid before the vehicle leaves Champions Collision 1, Inc. Prior written notice must be given if the customer desires the return of used or damaged parts. If parts have been ordered for the repair and the Customer cancels the repair, a 30% restocking fee will apply to all parts purchased. If any part is non-returnable, the Customer will be responsible for paying the full cost of that part.

Champions Collision 1, Inc. is not responsible for loss or damage to vehicles and/or articles left in vehicles in case of fire, theft, or any cause beyond our control. Please remove any personal articles from your vehicle as it may be necessary to have outside companies do sublet work on your vehicle. Storage charges will accrue 3 days after notification of the completion of repairs. Failure to make a payment within 20 days of notification of the completion of repair will result in the commencement of the auction process to satisfy the implied mechanic’s lien.

In the event that an insurance company fails to provide an estimate or there is an inability to come to an agreed price for the cost of either the initial estimate or supplement, an inside storage charge of $300 per day and an outside storage charge of $200 per day will apply, beginning on the day of drop-off.

Vehicles towed or driven in, then deemed a total loss, or moved to another facility for any reason by the customer or Insurance Company may be subject to administrative, lost, debris cleanup charges or estimate fees. Any labor, towing, or lift inspection fees must be paid before the vehicle leaves Champions Collision 1, Inc. Prior written notice must be given if the return of used or damaged parts is desired by the customer. In the event that parts have been ordered for the repair and the Customer cancels the repair, a 30% restocking fee will apply to all parts purchased. If any part is non-returnable, the Customer will be responsible for paying the full cost of that part.

Direction to pay

In the event that an insurance carrier is paying for all or part of my repair costs, I hereby authorize payment to be made directly to Champions Collision 1, Inc. and its affiliated companies. I understand that I am responsible for paying any deductible associated with my claim. I also authorize the payment of any and all supplemental repair order amounts to Champions Collision 1, Inc.

Consent to Electronic Communications & Electronic Signatures

I authorize Champions Collision 1, Inc. to contact me about my repair via phone, email, or text message and agree to any data rates that may apply. You may opt-out of communications at any time.

The customer and Champions Collision 1, Inc. agree that this Authorization Form may be executed and delivered by electronic signatures, in accordance with the Electronic Signatures in Global and National Commerce Act (ESIGN Act) and the Uniform Electronic Transactions Act (UETA). Both parties acknowledge that the signature appearing on this Authorization Form, whether electronic or manual, has the same force and effect and is the legal equivalent of your manual signature, as provided by the ESIGN Act and UETA.

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