PDR LCLN Laundry Work Authorization

PAUL DAVIS RESTORATION & REMODELING
3641 S.6th Street
Lincoln NE 68502
(402) 474-1414 - Fax: (402) 474-1467

LAUNDRY Work Authorization & Information Questionnaire

We authorize RDF Inc. d/b/a Paul Davis Restoration of Lincoln, herein-after referred to as Contractor, to perform services related to our soft textiles as they see fit with consideration to the information provided below:

Customer Information (Name, Address, Phone Number)

I AUTHORIZE Paul Davis Restoration to perform their recommended procedures of removing, securing and processing all of the garments and soft textiles, based on their discretion, from the loss site. I agree and understand that Paul Davis Restoration is not liable for any pre-existing conditions, staining, or other “non-desired” effects to the item after cleaning and the restoration process has been performed, due to said “pre-existing” conditions.

I understand Paul Davis Restoration is liable for the limited amount of items removed from the loss site and services authorized within this contract. Paul Davis Restoration will provide me as the property owner and the insurance carrier or contract, holder a general inventory of items in their possession. I understand Paul Davis Restoration is not responsible for damage caused to any item during, or there after the event of the loss occurrence. Furthermore, I understand Paul Davis Restoration is not responsible for customer’s allergic reactions, that may or may not occur to contents restored in normal laundry or dry cleaning processing.

I understand that I am fully responsible for payment of charges to Paul Davis Restoration, and agreed upon with my insurance carrier if applicable, as well as authorizing and directing my insurance carrier to issue payment to Paul Davis Restoration directly for the full amount of the charges for their services. If I should for some reason receive payment directly from my insurance carrier, I understand it to be my responsibility to make payment in full, based upon the charges submitted to the insurance company, when applicable, to Paul Davis Restoration.

Customer/Property Owner

Paul Davis Restoration Representative