After hours drop off information - Print this page, fill out information and put
inside envelope. Orange drop off box
located between shop doors #2 and #3 for your keys and this form. Thank you for your business.
Roosevelt Laramie Service Center
708-652-6555
| Name: |
Address: |
| City: |
Zip: |
| Home Ph: |
Work Ph: |
Cell: |
| Year: |
Make: |
Model: |
| Color: |
License: |
Mileage: |
| |
Lube Oil and filter |
|
Transmission service |
| |
Cabin Filter |
|
Air filter |
| |
Tune Up |
|
Brakes |
| |
Fuel Filter |
|
Emission Diagnosis |
| |
Exhaust/Muffler |
|
Steering |
| |
Suspension/Shocks |
|
Tires |
| |
Air conditioning |
|
Cooling system |
| |
Radiator Flush |
|
Wheel Alignment |
| |
Rotate tires |
|
Differential service |
Do you want the old
parts??
Yes No
Comments:__________________________________________________________
____________________________________________________________________
____________________________________________________________________ |
Not responsible for any personal items left in vehicle. I
hereby authorize the
above work to be done along with the necessary materials. You and your
employees may operate the above vehicle for purposes of testing,
inspection, diagnosis or delivery at my risk. An express mechanic's lien
is acknowledged on the above vehicle to secure the amount of repairs
thereto.
You will not be held responsible for loss or damage to vehicle or
articles left in vehicle in case of fire, theft, accident or any other
caused beyond your control. |
| Signed
X:
Date: |
|
Payment terms: Cash, Visa, MasterCard, Discover, American
Express
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