Ramp Agent Auto Body
Resume:
U-***
AUTO BODY REPAIR CONSUMER BILL OF RIGHTS
A CONSUMER IS ENTITLED TO:
1. SELECT THE AUTO BODY REPAIR SHOP TO REPAIR AUTO BODY DAMAGE COVERED BY THE INSURANCE COMPANY. AN INSURANCE COMPANY SHALL NOT REQUIRE THE REPAIRS TO BE DONE AT A SPECIFIC AUTO BODY REPAIR SHOP. 2. AN ITEMIZED WRITTEN ESTIMATE FOR AUTO BODY REPAIRS AND, UPON COMPLETION OF REPAIRS, A DETAILED INVOICE. THE ESTIMATE AND THE INVOICE MUST INCLUDE AN ITEMIZED LIST OF PARTS AND LABOR ALONG WITH THE TOTAL PRICE FOR THE WORK PERFORMED. THE ESTIMATE AND INVOICE MUST ALSO IDENTIFY ALL PARTS AS NEW, USED, AFTERMARKET, RECONDITIONED, OR REBUILT. 3. BE INFORMED ABOUT COVERAGE FOR TOWING AND STORAGE SERVICES. 4. BE INFORMED ABOUT THE EXTENT OF COVERAGE, IF ANY, FOR A REPLACEMENT RENTAL VEHICLE WHILE A DAMAGED VEHICLE IS BEING REPAIRED. 5. BE INFORMED OF WHERE TO REPORT SUSPECTED FRAUD OR OTHER COMPLAINTS AND CONCERNS ABOUT AUTO BODY REPAIRS.
6. [effective January 1, 2010, pursuant to AB 1179 (Jones, Chapter 141, 2009)] SEEK AND OBTAIN AN INDEPENDENT REPAIR ESTIMATE DIRECTLY FROM A REGISTERED AUTO BODY REPAIR SHOP FOR REPAIR OF A DAMAGED VEHICLE, EVEN WHEN PURSUING AN INSURANCE CLAIM FOR REPAIR OF THE VEHICLE.
COMPLAINTS WITHIN THE JURISDICTION OF THE BUREAU OF AUTOMOTIVE REPAIR Complaints concerning the repair of a vehicle by an auto body repair shop should be directed to: Toll Free 866-***-****
California Department of Consumer Affairs
Bureau of Automotive Repair
10240 Systems Parkway
Sacramento, CA 95827
The Bureau of Automotive Repair can also accept complaints over its Web site at: www.autorepair.ca.gov COMPLAINTS WITHIN THE JURISDICTION OF THE CALIFORNIA INSURANCE COMMISSIONER Any concerns regarding how an insurance claim is being handled should be submitted to the California Department of Insurance at:
(800) 927-HELP or 213-***-****
California Department of Insurance
Consumer Services Division
300 South Spring Street
Los Angeles, CA 90013
The California Department of Insurance can also accept complaints over its Web site at: www.insurance.ca.gov
(Rev 04/2010)
AUTHORIZATION FORM
Insured Name
Daytime Phone Number
Checking Savings
Bank Routing Number
Account Number
Financial Institution
Insured's Signature: Date
Account Type
U-240 (REV 05/2020)
{Docusign Name:sign."CustomerSignature"here,InputType:"Signatory",FieldType:"Typed Automatic Payment- Checking/Savings
(To use a debit card, sign up online at mercuryinsurance.com/account) Visa MasterCard
Card Expiration Date (mm/yyyy)
Card Number
Card Type
Automatic Payment- Credit Card
Discover American Express
Sign up today for Mercury's Automatic Payment program and your installment payments will be automatically withdrawn from your bank account or charged to your credit card. Simply complete the form below. Payments will be made depending on the payment plan and form of payment selected, and the account information provided.
Under certain conditions you may receive bills for payments that cannot be automatically withdrawn or charged. Authorization For Automatic Payments
Please complete all information requested, and return with your initial payment. I authorize Mercury Insurance Services, LLC. to initiate automatic periodic payments from my bank account or credit card on the day each installment is due, or the following business day. I understand that Mercury will notify me if the amount to be paid changes by more than $1.00. I may terminate this agreement at any time by notifying Mercury in writing at least three business days prior to the next scheduled payment. I understand that scheduled payments may still occur if termination notification is not received within this time. For credit cards, I also understand and agree that Mercury may update the card number and expiration date, as needed, without further authorization from me.
I understand that a $2.00 service fee per payment applies for checking/savings, and a $6.00 service fee per payment applies for credit cards.
Policy Number
By signing below I certify that I am the holder of the bank account or credit card account shown above, or an authorized user and the spouse of the holder.
BRIAN RENNICK
X
322283220
7123
UNIVERSAL CITY STUDIOS CU
COMMUNITY SERVICE STATEMENT
Policy Type
# Policyholder Number (for New Business Only)
This information is requested by the State of California in order to monitor the insurer's compliance with the law. All new policyholders are requested to voluntarily provide the following information. No such information shall be used for purposes of underwriting or rating any policyholder. Policyholder's Name and Address (to be provided in order to refer back to the policy) Note: use additional forms if needed.
Fire Personal Fire Commercial
Homeowners Commercial Multi-Peril
Private Passenger Auto-Liability
* If policyholder does not wish to provide the Department of Insurance with this information, please check here.
Check the Race or National Origin as it applies to the policyholder(s). For the purpose of completing this form, the policyholder is defined as: an individual, spouse, domestic partner, or business partner(s) named on the policy. POLICYHOLDER CO-POLICYHOLDER
Male Female Nonbinary Business Male Female Nonbinary Business African-American
American Indian or Alaskan Native
Asian/Pacific Islander
Latino
White
Other
Edition: 2018
BRIAN RENNICK
289 Maywind Lane
Simi Valley, CA 93065
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