Vehicle Maintenance Oil Change Form

VEHICLE MAINTENANCE OIL CHANGE AUTHORIZATION AND SERVICE AGREEMENT

Parties and Recitals

This Vehicle Maintenance Oil Change Authorization and Service Agreement (the Agreement) is entered into by and between:

Customer Name:   Phone:

Service Provider:   Shop Phone:

WHEREAS, Customer desires that Service Provider perform an oil change and related maintenance services on the vehicle described below; and

WHEREAS, Service Provider is duly qualified, licensed, and equipped to perform such services and agrees to perform them in accordance with the terms and conditions set forth in this Agreement; and

WHEREAS, the parties wish to set forth their mutual rights and obligations with respect to the oil change and related services.

Vehicle Information

Scope of Work

The Service Provider shall perform the services described below. Customer authorizes the Service Provider to perform the work as specified and to use parts and materials necessary to complete the work in a professional manner.

Service Date:   Technician Assigned:

Standard Oil Change Options

Oil Type: Conventional Synthetic High-Mileage Diesel

Additional Services: Replace oil filter Check fluids Tire pressure check Inspect belts & hoses

Itemized Parts & Labor

Labor (hours & rate):

Parts / Oil (description):

Payment Terms

Payment Method(s) Accepted: Cash Card Check

Balance Due On Completion:   Balance Due Date:

Late Fee:

Term and Termination

Agreement Start Date:   Estimated Completion Date:

Either party may terminate this Agreement for material breach by the other party upon written notice and a cure period of days. Termination does not relieve Customer of payment for completed work or parts ordered prior to termination.

Authorization, Warranties & Liability

Customer authorizes Service Provider to perform the work described above and to operate the vehicle for testing and inspection as reasonably necessary. Customer further authorizes Service Provider to order replacement parts and perform agreed additional repairs up to $ without prior approval. Any amount exceeding this will require Customer authorization.

Service Provider warrants labor performed for a period of days and warrants parts as provided by manufacturers. Except as expressly set forth herein, Service Provider disclaims all other warranties, express or implied, including merchantability and fitness for a particular purpose.

Liability of Service Provider for claims arising out of this Agreement shall be limited to direct damages not to exceed the total amount paid by Customer for the specific service giving rise to the claim. Service Provider shall not be liable for incidental, consequential, or special damages.

Confidentiality

Each party agrees to keep confidential all non-public information disclosed by the other party in connection with the services under this Agreement. Confidential information does not include information that is or becomes publicly available through no fault of the receiving party or information required to be disclosed by law.

Governing Law; Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to its conflicts of law principles.

This Agreement, including any written estimates or work orders incorporated herein, constitutes the entire agreement between the parties with respect to the subject matter and supersedes all prior and contemporaneous agreements, proposals and communications, whether written or oral.

Customer Acknowledgment and Notices

Customer acknowledges that Customer has reviewed and understands this Agreement and the scope of work. Customer represents that Customer is the owner or authorized agent of the owner of the vehicle and has authority to authorize the work.

Used oil and parts will be handled and disposed of by the Service Provider in accordance with applicable law. Customer shall remove all personal property from the vehicle prior to leaving it with Service Provider. Service Provider is not responsible for loss of personal items left in the vehicle.

Acknowledgements

By signing below, Customer authorizes the Service Provider to perform the described services and agrees to pay for parts and labor as set forth in this Agreement. Customer acknowledges receipt of any written estimate and understands that actual charges may vary if additional repairs are required.

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