I HEREBY AUTHORIZE the repair work set forth to be performed by Tristate Collision Center along with necessary parts, labor, diagnostics, materials and sublet, and hereby grant Tristate Collision Center and its employees' permission to operate my vehicle herein described on any highway, street or elsewhere for the sole purpose of sublet, mechanical, testing and/or inspection.

I understand that Tristate Collision Center highly recommends the use of OEM (Original Equipment Manufacturer) parts for my repair. I understand that Tristate Collision Center will request the use of OEM parts with my paying insurer, if any, for the repairs as described within my claim. I understand that my paying insurer, if any, may not cover the cost of OEM parts.

I understand that certain repairs may require the certain use of specific materials to properly repair my damages as outlined within my claim. I understand that Tristate will submit a request to my paying insurance company, if any, for the full reimbursement of all products used. This request will be supported by invoice(s). I understand that my paying insurance company may not pay the value of provided invoice. If not, I understand that I will be responsible for the difference.

I acknowledge and agree to the following:
- TriState is not responsible for rental charges and will not provide a loaner vehicle under any circumstance.
- Tristate is not responsible for delays caused by the unavailability of parts, or delays in shipments by a supplier.
- Tristate is not responsible for any delays caused by an insurance carrier, any third party, or me.
- Tristate is not responsible for any personal items left in my automobile. I acknowledge that I have or will remove all personal items and/or property from my vehicle.
- I will be responsible for any storage charges if I do not pick up my automobile within 2 weeks of any completed work.
- I am responsible for all payments not made by the insurance carrier handling my claim that may be covering the loss. Including but not limited to -the difference in any required material, -deductible, and the difference in any labor rates associated with my repair.
- ALL insurance checks will be signed over to Tristate Collision Center that are meant for the repairs performed within the claim.
- ALL charges are due before the vehicle is released. We will accept an insurance company check, credit card, and cashiers' checks.

REPAIR WARRANTY
-Tristate Collision Center has a Limited Lifetime Warranty on the workmanship outlined within the estimate of repairs completed. Parts and paint are covered by the manufacturer's warranty. All warranty concerns need to be brought back to Tristate Collision Center. Tristate Collison Center will not cover any repairs facilitated by another entity.

DIRECTION OF PAY
- I authorize the responsible insurance company to pay Tristate Collision Center, without my name on the payment, for any balance remaining pertaining to the repair of my vehicle. With this I understand that I am ultimately responsible for the full payment of my repairs to Tristate Collison Center if the DIRECTION OF PAY has not been honored by my paying insurance carrier.
- If additional repairs are needed beyond my original estimate and are required to restore the vehicle. I give permission to Tristate to reach out to the insurance company and negotiate on my behalf. I also authorize this additional work to be performed and payments to be directed to Tristate Collision Center.
- Signing this form gives Tristate authorization to perform and bill the assigned insurance carrier for all work performed and the approval to bill and execute the work for any subsequent supplement.

APPROVAL
By signing this form, I acknowledge that I have read and understood what has been presented to me. I hereby acknowledge and agree to have Tristate Collision Center start the repairs to my/our vehicle.