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Authorization to Pay & Repair

I authorize Capital City Collision to make repairs to my vehicle as specified in my estimate
and/or supplement. I understand that full payment is due upon completion of repairs, including
additional supplemental damage charges. I understand that I will not be allowed access to my
vehicle until the balance is paid in full. I grant Capital City Collision and its employees,
permission to operate my vehicle for the purpose of testing and/or inspection. Capital City
Collision will not be held responsible for loss or damage to my vehicle or articles left inside my
vehicle in case of fire, theft, accident, or any other cause. If the vehicle is not picked up within 72
hours of completed repairs, I will pay a storage charge of up to $28.50 per day.

All parts removed from cars will be junked unless otherwise instructed.

The lifetime warranty only extends to the owner of the vehicle at the time of repair. Damages
acquired from driving conditions, improperly cleaning, and environmental pollution damage are
not covered by Capital City Collision. All rust repairs have no warranty.

I consent to this Authorization to Pay.

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January 15, 2021 11:49 am CDT

Authorization to Pay & Repair Uploaded by Jason Hughes - capitalcitycollisionbr@gmail.com IP 70.172.241.14