Orlando Body Repair Authorization Form
In accordance with the attached repair estimate, I hereby authorize repair work to be done on the above vehicle using
whatever materials Orlando Auto Body, Inc. deems necessary. I acknowledge that the estimate is based upon a
surface inspection and does not cover any additional parts or labor that may be discovered to be necessary after the
job as begun. Therefore I understand that the estimate price may be subject to supplementation. Additionally, I hereby
grant Orlando Auto Body, Inc. and its employees permission to operate the vehicle on streets and elsewhere for the
purpose of testing and/or inspection, including offsite storage in a lot or building not located on the premises my vehicle
was originally delivered. I will not hold Orlando Auto Body, Inc. responsible for loss or damage to articles left in my
vehicle in case of fire, theft, or any other causes beyond their control.
Orlando Auto Body, Inc. shall have the right to have the work performed at any of its locations or the locations of
any of its affiliates, at its sole discretion (“Load Level”). Load Leveling shall not result in additional cost to me,
and once repairs are completed and paid in full I may pick up my vehicle at the original drop off location, unless I
agree to pick it up at a subsidiary’s or affiliate’s shop.
I hereby designate Orlando Auto Body, Inc. as my sole authorized representative for the settlement of any insurance
claims regarding the repair of this vehicle and authorize this representative to negotiate with the insurance adjuster
assigned to this claim for the safe restoration of my vehicle. I authorize and grant to Orlando Auto Body, Inc. and its
management a power of attorney (POA) to sign any insurance draft and any other instruments used for the
payment of repair for this vehicle.
I acknowledge that Orlando Auto Body, Inc. has an express mechanics lien on the vehicle to secure payment of the
amount of repairs thereto, for storage fees, and for related costs and fees as more fully set forth below. I authorize
Orlando Auto Body, Inc. to retain possession of the vehicle until such time as all indebtedness is paid or otherwise
While Orlando Auto Body, Inc. shall endeavor to seek payment for the work from insurance, whether my own or that
of a responsible third party, I acknowledge that I assume full responsibility for all work performed. I acknowledge that
Orlando Auto Body, Inc.’s efforts to obtain compensation from insurance is done as a benefit to me and that it is under
no obligation to do so. If Orlando Auto Body, Inc. cannot obtain full and complete payment from insurance, I will remain
responsible to Orlando Auto Body, Inc. for any unpaid sums. If I and/or the applicable insurance company(ies) decide
not to pursue repair, or if there is any delay in approval by insurance, I will be responsible to pay storage fees at the
daily rate set forth on the repair estimate(s) and supplement(s). Additionally, I shall remain responsible for any fees
and costs incurred by Orlando Auto Body, Inc. to obtain full payment for all services rendered, parts provided, storage
fees, title and auction fees and costs related to lien enforcement, and to any and all attorney, collection, and other legal
fees or costs incurred in obtaining payment for the work performed, whether or not a lawsuit is filed. Should Orlando
Auto Body, Inc. exercise its lien rights, the proceeds from the sale of my vehicle will be applied to offset the total
balance owed. Any excess proceeds will be paid first to any other lienholder and then any remaining balance to me. If
the sales proceeds are insufficient to pay the full balance owed, I understand that Orlando Auto Body, Inc. shall have
the right to seek payment from me of the remaining balance due. Orlando Auto Body, Inc. shall be entitled to interest
on any unpaid balance due at the rate of 18% per annum beginning 30 days after the due date.
Copyright 2023, Orlando Auto Body, Inc. All rights reserved.
BY SIGNING THIS DOCUMENT I GIVE AUTHORZATION AND POWER OF ATTORNEY TO ORLANDO AUTO BODY AS STATED FORTH IN THIS DOCUMENT.