1. owner information

2. Vehicle information

3. claims

The following questions are being asked with the intention of making sure the repair process and delivery of the completed vehicle go as smoothly as possible.

If yes, please note we will not be able to finalize the date to begin repairs or order parts without first receiving a copy of their estimate.

Estimates of repairs include all known parts, labor handling and diagnosis; on closer analysis additional repairs may be necessary. If applicable, I authorize Red River Collision Center to act as my agent in negotiating the final cost of repairs with my insurance company. I hereby authorize the repair work described herein to be performed, including sublet work, and grant you or your employees permission to operate the vehicle on streets or highways for the purpose of repairing or testing, and acknowledge receipt of this estimate. Red River Collision Center shall not be liable for any items left in vehicle. This includes but is not limited to, any aftermarket audio equipment. I understand that I am responsible for payment of the cost of the said repairs and agree that in the event legal action is required I will also pay such additional amount as the court may fix as attorney fees. If an insurance claim, the undersigned does hereby constitute and appoint Red River Collision Center my true and lawful attorney to sign my name on any insurance drafts covering any authorized repairs to my automobile and to take such action as may be necessary to negotiate said drafts.

4. Vehicle release

I hereby authorize Red River Collision Center to make specified repairs. I understand that full payment will be due upon release of the vehicle, including additional supplemental damage charges. I hereby grant Red River Collision Center employees permission to operate the vehicle on streets, highways or elsewhere for the purposes of testing and/or inspection. An express mechanics lien is hereby acknowledged on the vehicle to secure the number of repairs thereto. Red River Collision Center will dispose of old parts removed from the vehicle unless otherwise instructed. Red River Collision Center will not be held liable for loss or damage to vehicle or articles left in the vehicle in the case of fire, theft, accident, or any other cause not due to the negligence of Red River Collision Center or its employees.

I do herby appoint Red River Collision Center to act as power of attorney in fact to accept on my behalf all checks, drafts, or bills of exchange, and to endorse all such checks, drafts, bills of exchange for deposit to Red River Collision Center account for credit on my account for repairs to my vehicle. I authorize any and all supplemental charges to be made payable to Red River Collision Center.

  • All repairs must be paid in full prior to vehicle release (Unless prior arrangements have been made)
  • We do not accept personal checks over $500.00 and all checks are subject to a funds availability check before acceptance.
  • We accept: Cash, All Major Credit Cards Except American Express, Debit Card, Money Orders, Cashier's Checks.
  • All Deductibles are payable to Red River Collision Center.
  • Multiple party checks MUST be endorsed by all parties.

5. safety inspection

In order to verify the vehicle is safe and continues to perform the same in subsequent accidents, please provide the information below.

6. final authorization

This information will be used to verify and authorize work to begin on the specified vehicle. Incorrect information or an unauthorized person submitting this form may result in delay and further communication from Red River Collision Center to the vehicle owner/authorized person(s).
This information will be used to verify and authorize work to begin on the specified vehicle. Incorrect information or an unauthorized person submitting this form may result in delay and further communication from Red River Collision Center to the vehicle owner/authorized person(s).
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Red River Collision Center

location icon

500 Barksdale Boulevard #100, Bossier City, LA 71111

calendar icon

Mon - Fri: 8:00 am - 5:00 pm | Sat - Sun: Closed

Find us on map

Red River Collision Center
at Moffitt Automotive

location icon

1960 Old Minden Road, Bossier City, LA 71111

calendar icon

Mon - Fri: 8:00 am - 5:00 pm | Sat - Sun: Closed

Find us on map