609 Amistad
Laredo, TX 78041
Ph) 956-728-8221

Vehicle Repair Authorization

We’ve made it simple to authorize repairs to your vehicle online.
Complete the required information below, click the boxes to agree to the statements and sign with your finger or mouse before submitting.

Customer Information
Vehicle & Insurance Information
Number of people in vehicle at the time of accident?
Additional Service Request
Oil Change Alignment State Inspection
Do you have wheel locks or a storage compartment key?
Does insurance check need lienholder endorsement?
Did you receive a first check from the insurance company?
Are there any warning lights on your dash?
Do you feel your vehicle has been driving differently since accident?
Clicking the boxes indicates you have read and agree to the following statement(s):

A-1 Collision Super Center - Amistad is not responsible for loss or damage to vehicles, articles, or personal property left in vehicles, in case of fire, theft, natural disasters, or any other caused beyond our control. Please remove all personal belongings from your vehicle.

No car will be released until full payment is made. Deductible and insurance check or proof of loss must be received before vehicle is released. Be certain all payee's (including lien holders) have endorsed the insurance check prior to completion of repairs.

The maximum payment using a credit or debit card shall not exceed $3,000.00.
Vehicles that have sustained extensive damage could require more time to repair and exceed tour rental coverage. A-1 Collision Super Center - Amistad will not be responsible for any rental expense in the event this occurs.
NOTICE PURSUANT TO SECTION 70.001, TEXAS PROPERTY CODE Customer understands that this vehicle is subject to repossession in accordance with Section 9.609, Texas Business & Commerce Code, if written order of payment for repairs of the vehicle is stopped, or dishonored because of insufficient funds, no funds, or because the drawer or marker of the order has no account or the amount on which it is drawn has been closed. I have read and agreed to the Terms & Conditions.

Known all men by these presents; that I (or we) the undersigned, do hereby and constitute and appoint A-1 Collision Super Center - Amistad as my (or our) true and lawful agent and attorney-in-fact to endorse in name, place and stead of the undersigned and check or draft issued by the above insurance company to cover all or part of repairs to my (or our) vehicle which are authorized by me (or us) in whatever manner is necessary to negotiate such check or draft for the purpose of paying for the such repairs. I (or we) hereby ratify and confirm whatever action said agent and attorney in fact my take in such regard by virtue hereof.
I authorize A-1 Collision Super Center - Amistad to complete estimated repair work to be done along with the necessary materials. And hereby grant you, and /or your employees’ permission to operate the vehicle herein described on streets, highways or elsewhere for the purpose of completing repairs, testing and/or inspection. An express mechanic's lien is hereby acknowledged on above vehicle to secure the amount of repairs there to.
Authorization to Access Vehicle Data: I understand that modern vehicles are complex, and that electronic date recorded in vehicle systems may help to diagnose necessary repairs and to confirm that applicable systems are functional after repairs are performed. I authorize A-1 Collision Super Center - Amistad to access this data as part of the diagnostic and repair process.

In the event of the insurance company processing repairs reject payment for repair scans and necessary calibrations to your vehicle as per manufacturer guidelines, these repair scans and calibrations are required and will be paid by the vehicle owner.
I understand storage charges of $65 per day are applied after 72 hours of repair completion, or if the vehicle is not repaired at A-1 Collision Super Center, or if the vehicle is deemed a total loss.
I understand that I am solely responsible for such charges if the insurance company is unwilling to pay for said charges.
By using this service, you agree that A-1 Collision Super Center - Amistad may text you at the number provided. Message and data rates may apply.
By drawing your signature in the space provided above, and clicking the "complete authorization" button, you are consenting to use electronic records and signatures in connection with this transaction, confirming your name displayed above is correct and you understand and agree to the statements above as well as our Terms and Conditions for Use in Document Executions. Your electronic signature will be just as enforceable as signing the same document using a handwritten signature.
Digital Signature: 3137322e37312e3232322e323235
IP Address: User Agent: CCBot/2.0 (https://commoncrawl.org/faq/)
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