Authorization

VEHICLE REPAIR AUTHORIZATION AND CUSTOMER AGREEMENT

Customer Authorization and Agreement
I, the undersigned, authorize the repair work on my vehicle, as specified, to be performed by Turner Body Shop & Towing Inc. ("the Repair Shop"). I understand and accept the following terms and conditions regarding the repair and payment of my vehicle.

Care, Custody, and Protection (CCP) Fee

A Care, Custody, and Protection (CCP) Fee will be charged as follows:

• $150 per day for vehicles stored inside
• $125 per day for vehicles stored outside

These charges begin on the day the vehicle is dropped off at the Repair Shop. In the event that the vehicle is deemed a total loss, this CCP fee will apply from the date of drop-off until the date of removal by the customer or their insurance provider.

Authorization for Parts and Cancellation Terms

I authorize the Repair Shop to order necessary parts for repairs. Should I cancel the repairs after parts have been ordered, I agree to the following:

• Restocking Fee: A 30% restocking fee will apply to all parts ordered.
• Non-Returnable Parts: If any part ordered is non-returnable due to its status as an electronic or special order, I agree to pay for the part in full, and that part will be provided to me.

Repair Agreement

• The Repair Shop is not responsible for loss or damage to my vehicle, or any articles left in the vehicle, due to fire, theft, or any cause beyond its control. The Repair Shop is also not responsible for delays caused by unavailability of parts or other delays beyond its control.
• I grant permission to the Repair Shop and its employees to operate my vehicle on streets, highways, or elsewhere as necessary for testing and/or inspection.
• An express mechanic's lien is hereby acknowledged on the above-described vehicle to secure payment for all repair work done, pursuant to Nebraska Revised Statutes Section 52-201 (Artisan's Lien).
• Old Parts: Old parts removed and replaced will be discarded unless otherwise specified by me before repairs begin.

Payment and Insurance Responsibilities

All repair costs, including deductibles and any customer-paid expenses, must be settled in full before the vehicle is released. If my insurance issues a direct payment to me instead of the Repair Shop, I acknowledge that I am solely responsible for paying any outstanding balance.

If repairs are canceled or partially completed, the Repair Shop may charge for teardown costs, parts ordered, and any labor required to reassemble the vehicle.

Estimate Time and Rental Policy: The Repair Shop makes no guarantee regarding repair completion times due to possible delays from insurance approvals, parts availability, or other factors beyond our control. Rental or alternative transportation coverage, if required, is my responsibility and may not be reimbursed by the Repair Shop.

DIRECTION TO PAY

Assignment of Benefits, Authorization to Settle Claim, and Direction to Pay Provider Directly

(Separate Signature Required)

By my signature below, for good and valuable consideration (including but not limited to the extension of credit to me), I hereby assign, transfer, and convey to Turner Body Shop & Towing Inc. ("the Provider") all of my rights, title, and interest in and to auto repair reimbursement in any form, including but not limited to insurance coverage under property damage, comprehensive, collision, windshield, and/or any coverage otherwise payable to me through auto insurance.

• Payment Obligation: This payment shall not exceed my indebtedness to the Provider, and I acknowledge that I will timely pay any remaining balance owed by me to the Provider that is not otherwise satisfied by the assigned proceeds. I further acknowledge that any expenses not covered under my insurance policy will be my responsibility.
• Authorization to Act on My Behalf: I further authorize the Provider to negotiate, collect, and settle any claim with any insurance carrier or third-party payor regarding these services. This authorization includes, but is not limited to:
  1. Requesting and receiving from any insurer or third party any and all documentation and records I am empowered to request regarding this claim, including, without limitation, a statement of coverage, policy declarations page, and insurance policy. The Provider may also request and receive any documents that have been provided to me.
  2. Endorsing in my name any check issued for payment where benefits were assigned.
• Protest of Partial Payments: The Provider hereby objects to any reductions or partial payments. Any partial or reduced payment, regardless of the accompanying language, issued by the insurer and deposited by the Provider shall be done so under protest, at the risk of the insurer, and shall not be deemed a waiver, accord, satisfaction, discharge, settlement, or agreement by the Provider to accept a reduced amount as payment in full.

I further direct my insurer to direct all payments for services rendered by the Provider directly to the Provider at the billing address contained on Provider's repair bills.

THIS IS A DIRECT AND IRREVOCABLE ASSIGNMENT OF MY RIGHTS AND BENEFITS UNDER MY POLICY OF INSURANCE. A photocopy or digital version of this form shall be considered as effective and valid as the original.

CONSENT TO ELECTRONIC COMMUNICATIONS & ELECTRONIC SIGNATURES

I authorize Turner Body Shop & Towing Inc. to contact me about my repair via phone, email, or text message and agree to any data rates that may apply. You may opt-out of communications at any time.

The customer and Turner Body Shop & Towing Inc. agree that this Authorization Form may be executed and delivered by electronic signatures, in accordance with the Electronic Signatures in Global and National Commerce Act (ESIGN Act) and the Uniform Electronic Transactions Act (UETA). Both parties acknowledge that the signature appearing on this Authorization Form, whether electronic or manual, has the same force and effect and is the legal equivalent of your manual signature, as provided by the ESIGN Act and UETA.