ACEVEDOS COLLISION BODY & PAINT

366 W. LAFAYETTE STREET STOCKTON, CA. 95203

(209) 670-9430 acbp209@gmail.com

PLEASE READ!

Customer :_________________________________________________________________________________

Vehicle:___________________________________________________Plate:___________________________

Insurance:_________________________________________________________________________________

Acevedo Collision Body & Paint cannot start on repairs or order supplement parts until the supplement amount
is agreed upon and Acevedo Collision Body & Paint gets an OK from the owner on proceeding with the repairs
on the original estimate, supplement, and, if any, denied items. Please pay customer/owner of vehicle direct on
supplement. Acevedo Collision body & Paint will collect total due from the owner at time of delivery.
For Acevedo Collision body & Paint to start any repairs, we will need the adjuster’s estimate to show the agreed
amount or a signed agreement on the supplement amount from Acevedo Collision body & Paint to let the owner
know the amount they will be receiving from the insurance co. and go over the denied items, (out of pocket
expenses) if any. The customer/owner of vehicle will be responsible for any denied items (out of pocket
expenses). Thank you for your cooperation and understanding in this matter....

I authorize Acevedo Collision body & Paint to prepare an estimate of repair costs and if necessary dismantle
parts of my vehicle to do so. I understand that this is not an authorization to repair damages for myself or the
insurance company covering the cost of repair.

Owner/Representatives Signature:____________________________________