AUTHORIZATION TO REPAIR

The undersigned authorizes KAUAI FOREIGN CARS to repair my vehicle, order parts and materials. If I cancel the repair, I will pay all costs, parts, materials and labor, including storage fees. I grant permission to operate my vehicle on the street or highways for the purpose of testing or inspection.

I will pay the full amount of repairs when I take my vehicle. I agree to pay $20.00 per day storage fee, if I do not take my vehicle within 5 days. An expressed mechanic's lien is acknowledged on my vehicle to secure the amount of repairs and other costs if any.

Further, I will not hold KAUAI FOREIGN CARS responsible for loss or damage to my vehicle by WEATHER, FIRE, THEFT, VANDALISM, ACCIDENT or COLLISION during the repair or storage, caused beyond control.

*PLEASE PRINT A COPY FOR YOUR RECORDS AS WELL AS PROVIDE A COPY FOR US. ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________________

___________________________________________________________________________________________

____________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Powered byFormsiteReport abuse