Procedure :
Step 1
We can process all paperwork once you have made the
initial claim.
Step 2
Report initial claim.
Step 3
Print form and fax to (203) 327 5047.
WAIVER OF ADVANCE
ESTIMATE
I
request that repairs be performed on my vehicle without
an advance estimate of their cost. By signing this form
I authorize the reasonable and necessary costs to remedy
the problems complained of up to a maximum of
$____________________.00 DOLLARS. The repair shop my
not exceed this amount without my written or oral
consent.
Name:___________________________
Date:______________________
Year:_______ Make:_________________
Model:___________________
Signed:________________________________________________
AUTHORIZATION OF
ADDITIONAL REPAIRS
ASSIGNMENT OF PROCEEDS
AND DIRECTION TO PAY
If
additional repairs beyond the waiver estimate are
discovered and related to the problems complained of, I
request Barcello’s Auto Body to negotiate with
_______________________________ insurance company in my
behalf for any additional monies due. I also authorize
and direct the insurance company to pay directly to
Barcello’s Auto Body all payments and supplements due on
the above claim. (PROPERTY DAMAGE ONLY) It is
understood that if these payments are still sent to me I
will forward it to Barcello’s Auto Body as they are
received. I also insist that Barcello’s Auto Body use
only original equipment parts in the repair of my
automobile.
Signed:________________________________
Date:_________________
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