Work Authorization Form

Kens Collision Center, LLC

712 W 10th St
Cassville, MO 65625
(417) 847-1200

WORK AUTHORIZATION

I hereby authorize the repair work herein set forth to be done by Ken’s Collision Center LLC, with the necessary parts and other material for such repair, and agree; that Ken’s Collision Center LLC is not responsible for any delays caused by unavailability or delayed availability of parts or materials for any reason; that you neither assume nor authorize any other person to assume for you any liability in connection with such repair; that Ken’s Collision Center LLC shall not be responsible for loss of or any damage to the above vehicle, or articles left therein, in case of fire, theft or other cause beyond our control. I understand my vehicle was “checked in” and noted for prior un-related damages and that Ken’s Collision Center LLC shall not be responsible for the damages listed in the “Pre-Repair Inspection” Form after the above mentioned vehicle is left in our care and custody for repairs.

I understand that an express mechanic’s lien is hereby acknowledged on the above vehicle to secure the amount of repairs thereto; that your employees may operate the above vehicle on streets, highways or elsewhere for the purpose of testing and/or inspecting such vehicle. I understand that Ken’s Collision Center LLC will NOT be responsible for any rental charges during the repair process.

I do hereby appoint Ken’s Collision Center to accept on my behalf any and all checks, drafts, or bills of exchange, and to endorse all such checks, drafts, or bills or exchange for deposit to the aforementioned business account for credit on my account for repairs on my vehicle which has been released and accepted.

DIRECTION TO PAY

I authorize to pay Ken’s Collision Center LLC direct.

LIMITED POWER OF ATTORNEY

I authorize Ken’s Collision Center LLC to endorse check(s) including any and all Supplemental Payments.

I have read and agree with the above. I hereby authorize Ken’s Collision Center LLC to perform the above detailed repairs to this vehicle.

Signature:

Clear

Print Name:

Disclaimer of warranty

The seller, hereby expressly disclaims all warranties, either expressed or implied, including any implied warranty of merchantability or fitness for a particular purpose, and neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of said products, the seller also does not offer any guarantee on rust or any time depreciation.