Name* First Last Select Your Location*SelectUnion CitySouth PlainfieldPrincetonFreeholdBrunswickBranning Collision Centers is authorized to perform the above listed and attached RO# repairs and any SUPPLEMENTAL repairs necessary to return my vehicle to PRE-COLLISION condition. I understand that Branning Collision Centers will notify ME and any INSURANCE CARRIER involved of the cost and need for any supplemental repairs prior to performing the same. BRANNING COLLISION CENTERS having notified all parties as to the need for these repairs, will consider authorization in force unless specifically instructed not to proceed with our sole concern being the timely completion of repairs. I hereby grant to you and/or your employees, permission to operate the car, truck or vehicle herein described on streets, highways or elsewhere for the purpose of testing and/or inspection, transporting to and from your sublet vendors and to test drive or delivery. Branning Collision Centers will use its choice of professional and qualified suppliers and vendors when sublet repairs are required and cannot be performed by our company due to the nature of collision repairs.Notice of Right to Inspect Repairs Before Making Payment: Customers of this shop or his/her insurance company have the right to inspect the repaired vehicle before paying for the repairs.Warranty Terms & Limits: These repairs are covered by a limited warranty. Labor for a period of lifetime. Parts and materials subject to the terms as extended by each manufacturer or vendor. Warranty repairs to be performed at seller’s place of business. Seller hereby limits implied warranty to the period stated.Storage Notice: Customers of this facility are hereby notified that we charge storage at the rate of up to $150.00 per day outside and $200.00 per day inside on vehicles left at our facility that we do not repair and on vehicles left at our facility for more than three days after being notified the vehicle is ready to be picked up.Estimated Date of Delivery Notice: Estimated date of delivery may change due to parts delay or backordered parts, weather conditions, insurance related delays or unforeseen and uncontrollable factors.Payment: I understand the sole responsibility for payment is mine and that all charges are due upon delivery. I further understand and agree that if the INSURANCE CARRIER is billed and fails to pay for the agreed repairs, I will pay all outstanding sums immediately. ACCEPTABLE PAYMENTS: INSURANCE COMPANY CHECK, CASH, CASHIERS CHECK, or MONEY ORDER. We DO NOT Accept personal checks. Any Credit Card Payment over $1000 will be charged a 3% processing fee. It is understood that an express garage keeper’s lien exists against the vehicle herein described and its contents. I further understand and agree that all charges for labor, parts, storage and towing must be paid prior to the release of my vehicle. Execution of such lien shall in no way waive our rights to a civil cause of action and shall include reasonable attorney’s fees which may be necessarily incurred. If there is a legal owner of your vehicle i.e.: BANK or FINANCE COMPANY we may require additional information from you. By placing my signature below, I hereby acknowledge and agree to the terms and conditions of this authorization.ANY CHECKS RECEIVED BY INSURED/CLAIMANT MUST BE TURNED OVER TO THE AUTOBODY SHOP IMMEDIATELY. ANY ATTEMPT TO WITHHOLD PAYMENT AFTER SIGNING THIS DOCUMENT COULD RESULT IN THE INSURED/CLAIMANT BEING CHARGED WITH INSURANCE FRAUD AND FINED UP TO $5,000.00.Right to Receive Replaced Parts Notice/Waiver*A customer of this shop has the right to receive the replaced parts from vehicle. Customer is hereby notified that there will be a $50.00 fee per day for storing the replaced parts commencing on the date the vehicle is delivered or the date the repairs are paid for, whichever comes first if the parts are not picked up by customer at that time. I DO NOT want my replaced damaged parts. I DO want my replaced damaged parts. Power of Attorney – Branning Collision CentersI do hereby appoint the aforementioned business as my attorney in fact to accept on my behalf any and all checks, drafts, or bills of exchange and to endorse all such checks, drafts or bills of exchange for deposit to the aforementioned business’ account for credit on my account for repairs on my vehicle which has been released and accepted.Signature:*Date:* MM slash DD slash YYYY By attaching this document to the estimate, it shall be considered a part of the Estimate/Repair order. **Signing this document is confirming that I am the owner of the vehicle. If I am not the owner a verbal authorization is still required by the owner** REMINDERS: Sometimes our customers forget to remove, or leave personal or necessary items in the vehicle. WE ARE NOT RESPONSIBLE FOR PERSONAL ITEMS LEFT IN THE VEHICLE. INITIALS*YOU WILL BE PROVIDED WITH WEEKLY UPDATES ON REPAIR STATUS UNLESS OTHERWISE REQUESTED. UPDATES WILL PRIMARILY BE DONE USING EMAIL. With what method(s) would you prefer to be contacted: PLEASE PROVIDE GOOD CONTACT NUMBERS (PRINT CLEARLY) Cell PhoneE-mail RENTAL ADVISORY: Once repairs are completed, you are given a 24-HOUR grace period to pick up your vehicle. You may incur rental charges if you do not return your rental vehicle within this time frame.INITIALS*TRANSFERS: I hereby grant Branning Collision Centers permission, in the case of a work flow balance, to transfer my vehicle to any of our 7 locations to expedite my collision repairs. I will pick up the vehicle from the location that it was dropped INITIALS*PARTS PRE-ORDERS: Many parts suppliers DO NOT accept return of parts. If suppliers DO accept returns, there is a restocking fee. Should you cancel your scheduled repair appointment or are a NO-SHOW for your scheduled appointment, these restocking fees and/or Administration fees or parts costs will be billed to you and/or your insurance company. You will be responsible for any attorney fees and court costs related to collections of payments for these parts. WE DO NOT DO REFUNDS FOR CANCELLED REPAIRS INITIALS*NOTE: WE MAY NEED TO DISCONNECT YOUR BATTERY DURING THE REPAIRS SO YOU MAY NEED TO REPROGRAM YOUR RADIO STATIONS. PAYMENT POLICY Upon completion of the vehicle, any deductible, betterment, or customer pay items must be paid for in full by cash, certified check, Visa, MasterCard or Amex. We DO NOT accept DISCOVER or PERSONAL CHECKS. If I receive payment from an insurance company Branning will only accept cash or certified check for those funds. If I choose to use a credit card to pay the insurance pay portion of my bill I will be charged 3% processing fee. I understand the vehicle will not be released to me until payment is received or arrangements have been made for payment with the primary payee. It is the customer’s responsibility to secure third party endorsements. Insurance checks can simply be endorsed by all parties directly to the repair center. Vehicle owner will be responsible for any attorney fees and court costs related to collections of payments. Any Credit Card Payment over $1000 will be charged a 3% processing fee INITIALS*Privacy Policy: Your information will not be sold to any party outside of our direct control. Any personally identifiable information (PII) and all information regarding you and/or repairs is strictly confidential. BRANNING COLLISION CENTERS AT FREEHOLD 98 CROW HILL ROAD FREEHOLD, NJ 07728 732.462.2909 STATE LICENSE#02228A TAX ID#22-3811821 BRANNING COLLISION CENTERS AT BRUNSWICK 1120 ROUTE 18 NORTH E.BRUNSWICK, NJ 08816 732.964.1400 STATE LICENSE#02052A TAX ID#22-3270809 BRANNING COLLISION CENTERS AT PRINCETON 875 STATE RD., ROUTE 206 PRINCETON, NJ 08540 609.921.8585 STATE LICENSE#01644A TAX ID#22-3425534 BRANNING COLLISION CENTERS AT SOUTH PLAINFIELD 4307 NEW BRUNSWICK AVENUE S.PLAINFIELD, NJ 07080 732.752.3900 STATE LICENSE#01914A TAX ID#45-5459716 BRANNING COLLISION CENTERS AT UNION CITY 2818 KENNEDY BOULEVARD UNION CITY, NJ 07087 201.758.7700 STATE LICENSE#02776A TAX ID#46-1469496