Contact – G&T Autobody

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First Name *

Middle Name

Last Name *

Vehicle Make

Vehicle Registration

Phone Number *

Phone

Email Address *

Service Advisor

Date

Disclaimer

DISCLAIMER

You will be jointly and severally liable for full cost of services if your insurer fails and/or refuses to make payment.
The "MBR" shall exercise their repairer's lien over the vehicle if you and/or your insurer fail to make payment on the due date for services rendered.
The signatory to quote/clearance certificate hereby warrants that he/she is the owner of the vehicle or is duly authorized to accept T&C's on behalf of the owner.
The provisions of this document have been explained to you by the repairer.
You have read and understand the provisions of the document.
The signatory to this document warrants that he/she has read and understands the content, that he/she signs same voluntarily.