Work Authorization Form

I, ______________________________, hereby authorize the repair work described in the estimate, including the purchase and installation of all materials listed therein.

I understand and agree that Heritage Collision is not responsible for loss of or damage to the vehicle or any personal articles left inside the vehicle due to fire, theft, weather, or any other cause beyond Heritage Collision’s control. Heritage Collision is also not responsible for delays caused by parts suppliers, shipping carriers, or other third parties.

I grant permission to Heritage Collision and its employees or agents to operate the vehicle as reasonably necessary for testing, inspection, or quality control purposes.

I acknowledge and grant an express Mechanic’s Lien on the described vehicle to secure payment for all repairs, materials, storage charges, and/or improvements performed by Heritage Collision.

I understand that I am personally responsible for full payment of all repairs, materials, storage charges, and/or improvements if the above-named insurance company fails to pay Heritage Collision in full. Failure to make prompt payment may delay release of the vehicle and may result in collection efforts and/or legal action.

I agree to pay a storage fee of $55.00 per day beginning on the fourth (4th) calendar day after notification that the vehicle is ready for pickup. I further agree to pay all reasonable attorney’s fees, court costs, and collection expenses incurred by Heritage Collision in the enforcement of this agreement.

Power of Attorney

I hereby appoint Heritage Collision as my Attorney-in-Fact for the limited purpose of accepting, endorsing, and depositing insurance checks, drafts, or bills of exchange related to payment for repairs, materials, and improvements made to the vehicle identified above.

Direction to Pay

I authorize ______________________________ to pay Heritage Collision directly for Claim #____________________ in the initial amount of $____________________, together with any supplemental amounts authorized by the insurance company and/or approved by the customer.

If any insurance settlement or supplemental payment is mailed directly to me, I agree to notify Heritage Collision immediately and deliver such payment to Heritage Collision within twenty-four (24) hours of receipt.

I further agree to pay my insurance deductible in full, along with any insurance pre-payment amounts issued directly to me, at the time the vehicle is delivered.

Accepted Payment Methods: Credit Card, Debit Card, Cash, Insurance Issued Two Party Checks

A 3% processing fee will be added to all credit card transactions.

Deductible Amount: $____________________

Customer Authorization

Tesla Parts Disclaimer

Thank you for choosing Heritage Collision Center for your vehicle repairs. As a certified repair facility for Tesla, Inc. and Rivian Automotive, Inc., we are committed to maintaining the highest standards set by these manufacturers.

To retain our certifications, we are required by both Tesla and Rivian to use Original Equipment Manufacturer (OEM) parts only in all repairs. These guidelines are strictly enforced and are essential to ensure the safety, performance, and integrity of your vehicle.

In some cases, your insurance policy may specify or encourage the use of aftermarket or recycled (LKQ) parts as part of the repair process. These requirements are determined by your individual insurance coverage and are not controlled by Heritage Collision Center.

If your insurance company approves payment for an aftermarket or LKQ part instead of the required OEM part, you will be responsible for the difference in cost between; The OEM part (as required by the manufacturer), and the amount paid by your insurance provider for the alternative part

Heritage Collision Center has made significant investments in specialized equipment, advanced training, and certified technicians to meet Tesla and Rivian repair standards. Any deviation from the OEM-only requirements would put our certifications at risk, potentially preventing us from continuing repairs on your vehicle and compromising the level of service we are able to provide.

If there is a price difference between what your insurance company covers and the required OEM parts, your Collision Estimator will review this with you in detail. This amount will be due in addition to any applicable deductibles or co-pays outlined in your policy.

We appreciate your understanding and cooperation as we work to ensure your vehicle is repaired safely and according to manufacturer’s standards.

If you have any questions, please do not hesitate to contact us.

______________________________

Sincerely,

Heritage Collision Center