Enter your Designated Representative Authorization
I hereby authorize Executive Collision LLC to be my designated representative to reach an agreed price with my insurance company for proper repairs to my vehicle to put it back to pre-loss condition.
Authorization to Dismantle
I authorize Executive Collision LLC and their employees to dismantle my vehicle prior/after insurance company inspection to see any hidden and related damage.
Authorization to Repair
I hereby Authorize Executive Collision to repair above vehicle for agreed price with insured. Executive Collision is not responsible for availability of parts or delays in parts shipments beyond their control, nor for the loss or damage to the vehicle. We are not responsible for articles left in the vehicle in case of fire, theft or anything beyond our control.
Direction of Payment
I authorize my insurance company to pay Executive Collision LLC directly for the repairs to above vehicle. I authorize Executive Collision to endorse all such checks, drafts of exchange for deposit to the aforementioned business account for credit on my account for repairs on my vehicle. I have also received a copy of this form.
