Nu Auto Group
1100 Summit Ave. Suite 105
PIano, TX 75074
972-514-5277
Impact Chip Repair Work Authorization & Consent
I hereby authorize and assign Nu Auto Group the right to perform a chip repair on my vehicle. I further
understand and accept to all risks of repairing a chip on my windshield including but not limited to the
expansion of the cracks beyond its pre-repair condition and that Nu Auto Group is not responsible for
such incidents. I understand that Nu Auto Group is only performing the repair services to the best of
their ability with no guaranty of the repair’s outcome.
I understand within next 30 days from the date of this repair service, if there are apparent changes in
the condition of this repair, I could use my chip repair Fee’s as a credit toward a windshield replacement
cost performed by Nu Auto Group.
Name:______________________________
Sign:______________________________
Date:______________________________