WORK AUTHORIZATION FORM

K&M COLLISION WORK AUTHORIZATION FORM

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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.

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.