About Chesapeake Collision | Maryland's Collision Repair Shop

Repair Authorization and Direction to Pay

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Note: If you elect to receive text message or email updates you will also receive system-generated updates to the estimated completion date of your vehicle.

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AUTHORIZED AND ACCEPTED: I certify that I am the vehicle owner and hereby authorize Chesapeake Collision to incur costs and make repairs as specified in the original estimate as well as any supplemental estimate(s) necessary to completely repair the vehicle described above.

I understand that payment is due in full prior to release of the vehicle, including any and all additional supplemental charges, and I acknowledge the existence of an express mechanic’s lien on the vehicle until Chesapeake Collision has been paid in full for the total repair cost.

NO CASH, PERSONAL CHECKS OR AMERICAN EXPRESS WILL BE ACCEPTED.

I grant permission to Chesapeake Collision and its employees and agents to operate my vehicle as advisable for the repair, testing, transportation, and/or inspection. I agree that Chesapeake Collision shall not be responsible for any damage or loss to the vehicle, or any contents left therein, including but not limited to loss by fire, theft, accident, or any other cause. Further, I agree that Chesapeake Collision is not responsible for the replacement of vehicle parts/ components that fail during the course of the repair and that are unrelated to the repairs being performed (e.g., dead battery, seat or window motors, or other components that are subject to wear and tear). I acknowledge and agree that Chesapeake Collision may choose to use upgraded parts from those written in the repair estimate in its sole discretion and at its own cost to expedite the repair process. I understand that any old and/or replaced parts removed from the vehicle will be disposed of by Chesapeake Collision, unless otherwise indicated below.

I understand that Chesapeake Collision has multiple locations and occasionally transfers vehicles to another of its locations for repair when authorized to do so by the vehicle’s owner. All relocation of vehicles between Chesapeake Collision’s shop locations is performed at Chesapeake Collision’s sole expense and may result in a shorter repair time.

All vehicles will be returned to the original shop location when ready for pick up. I authorize Chesapeake Collision to transport my vehicle to another of its locations, if needed.

DIRECTION TO PAY:I authorize the insurance company indicated below to make payment to Chesapeake Collision directly on my behalf. I further authorize Chesapeake Collision to act as Power of Attorney to sign on my behalf any insurance checks issued to pay for the repair of the vehicle identified above.

I confirm that I have not received any payment from the insurance company except as listed below and agree to remit promptly all insurance payments I receive to Chesapeake Collision. NOTE: Insurance checks cashed and later paid by credit card will incur a 3% convenience fee.

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Phone

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Repair Authorization and Direction to Pay

Glen Burnie

Huntingtown

Randallstown