Please enable JavaScript in your browser to complete this form.Aiken Collision, Inc. 727 Richland Avenue East, Aiken, SC 29801 PH: 803-226-0270 | Email: info@aikencollision.com AUTHORIZATION TO REPAIR & TEARDOWN Name *FirstLastDate *Phone *Email *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeYear *Make *Model *Insurance Co *Claim # *I hereby authorize Aiken Collision, Inc and its employees to drive my vehicle for testing and/or inspection. I understand that it is my responsibility to remove personal belongings from my vehicle prior to repairs, I will not hold Aiken Collision, Inc or its employees responsible for loss or damage to the vehicle or articles of personal property left in the vehicle, regardless of value, in case of fire, theft, accident or any other cause. I understand that part prices are quoted current, but are subject to change upon further notice by manufacture pricing. I understand that upon completion of disassembly and I decide not to proceed with repairs of my vehicle that some and/or all damaged parts may not be able to be re-installed on my vehicle. I understand that Aiken Collision, Inc charges $65 per hour for paint labor, $65 per hour for body labor, $45 per hour for paint supplies, $10 per hour for body supplies, $125 per hour for mechanical labor, and $85 per hour for frame labor. The rates listed above are for light duty passenger vehicles only, rates are subject to change for larger vehicles on a case-by-case basis. I understand that Aiken Collision, Inc is unable to release any vehicle without full payment. I agree to pay Aiken Collision, Inc in full for the repairs of my vehicle, either before or after completion of work. I understand that as of the owner of the vehicle, I am responsible for all charges incurred for the repair. I authorize the insurance company to pay Aiken Collision, Inc. I understand that I am responsible for any difference/overages not covered by insurance payment. I, the undersigned, hereby authorize Aiken Collision, Inc to perform a complete disassembly of the damaged components so that an estimate may be written for the repair of my vehicle. I understand that Aiken Collision, Inc charges a fee for the tear down, administrative fees, and $65 per day storage fee from the date of drop off until pick up (including weekends and holidays) if my vehicle is not repaired by Aiken Collision, Inc or in the event your vehicle is declared a total loss by an insurance company. A 5% convenience fee will be added to all credit/debit card transactions. Aiken Collision, Inc does not accept personal checks. I have read and agree to the above Vehicle Owner or Insured Signature * Clear Signature Date *Submit33898