K&M Collision provides the full range of collision repair services.
K&M Collision is a certified collision center for many of the world’s top vehicle manufacturers, and we repair all makes and models.
K&M COLLISION WORK AUTHORIZATION FORM
Name*
Home Phone:
Cell Phone:
Address:
Email*
City
State:
Zipcode:
Vehicle Year:*
Make:*
Model*:
Vehicle Vin:
Insurance Company*:
Claim #*:
How Can We Contact You?
By Text? YesNo
By Email? YesNo
Work Authorization
I hereby authorize the repair work that has been explained to me to be done along with the necessary materials. I agree that K&M Collision is not responsible for loss or damage to my vehicle or articles left in case of fire, theft, or any other cause beyond K&M Collision's control; or for any delays caused by unavailability of parts or delay in parts shipments by the supplier or transporter. I hereby grant you and/or your employees' permission to operate the vehicle herein described on street, highway, or elsewhere for the purpose of testing and/or inspection. An express mechanic's lien is hereby acknowledged on the vehicle to secure the amount of repairs thereto.
Direction of Pay
I authorize the insurance company listed above to pay K&M Collision directly for repairs to my vehicle and grant K&M Collision power of attorney to receive and deposit any payments related to this claim.
Accepted By:*
Date:*
BY CLICKING SUBMIT I AM DIGITALLY SIGNING THIS FORM AND GIVING AUTHORIZATION AND POWER OF ATTORNEY TO K&M COLLISION AS STATED FORTH IN THIS DOCUMENT.
