I have read the estimate of damages or have discussed the repairs necessary with a representative of Xtreme
Auto Group LLC (XA) and authorize the repair of the vehicle noted.
I understand that this estimate is preliminary and additional repairs may be necessary to return the vehicle
noted to pre-accident condition per oem guidelines. I authorize XA to repair any additional hidden damage XA
may find during the repair process of the vehicle.
I authorize employees of XA to operate my vehicle for the purpose of testing, inspection, or delivery.
I understand that it is my responsibility to remove personal belongings from my vehicle prior to repairs, and I
will not hold XA or its employees responsible for loss or damage to the vehicle or articles of personal property
left in vehicle, regardless of value, in case of fire, theft, accident or any other cause.
I authorize any and all insurance payments and supplements for repairs made to my vehicle to be paid directly
to XA. I do hereby appoint XA 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 for deposit as a credit on my account for repairs on my
I understand that I am responsible for any deductible, adjustment or depreciation and/or betterment amounts
or failure of my insurance company to pay other labor, part, or material costs necessary to restore my vehicle to
its pre-accident condition as required by state law.
Unless other arrangments are made, the total amount of the repair charges and any additional
supplemental charges must be paid in full before the vehicle will be released for delivery.
To secure payment in the amount of repairs hereto, an express mechanic's lien is acknowledged, and I further
agree to pay reasonable attorney's fees and court costs in the event legal action is necessary to enforce this