Authorization for Repairs

As shown on Repair order #
Vehicle Description
Date Authorization
Amount*

*May not include labor, and/or rate differences, parts price increases, collision repair materials, collision damage or corrections to insurance generated estimates.
Repair Appointment
Do You consent to the installation of:
Rebuilt or recond. parts
Used Parts
Aftermarket Parts
 
Do you want us to save any replaced Parts?


Original Estimated Repair days
Perry & Terry does not guarantee delivery date or repair time and will not cover rental or loss of use costs.

Disassembly of damaged parts will prevent restoration to original condition.

Storage charge of $30.00 per day for any vehicle left 3 days after completion.

I hereby grant you and/or your employee’s permission to operate the above vehicle on streets, highways or elsewhere for the purpose of testing and/or inspection.
I acknowledge receipt of and agree to the terms above.

Customer Signature

Please remember to remove all of your personal belongings including:
  • Tapes and CD's
  • Money Change
  • Lucky Charms
  • Sporting equipment (Bowling balls, Bats)
  • Rental Movies
  • Garage Door Openers
  • Clothing, Blankets
  • Tools, Equipment
  • Boxes – Packages

Your battery will need to be disconnected in the course of these repairs. The owner is responsible for any and all codes needed to reset alarm or sound equipment.

Windshield chips and cracks may spread due to heat changes such as curing the paint. Perry & Terry is not responsible for this type of windshield damage.

Personal checks verified through Secure Payments with Driver’s License present. Master Card & Visa accepted with card present. Insurance drafts properly endorsed, cash & certified funds.

Please inform us of any special instructions for the operation of your alarm system.

I have removed all of my personal belongings and understand the above statements.

"I DO NOT WISH TO RECEIVE ANY ESTIMATE, EITHER WRITTEN OR ORAL,TO WHICH I AM ENTITLED BY LAW, BEFORE REPAIRS ARE AUTHORIZED"

NAME - Customer Signature
DATE
I certify that entering my name in the above form constitutes my legal signature
 
 
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