TERMS & Conditions: -

Southwest Towing & Recovery
Southwest Roadside Assistance
Southwest Towing & Roadside Assistance

Revision: #128a Date: 1/1/23

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– Authorization Form to Service Vehicle –

LEGAL NOTICE: This is a legal agreement/contract/document/instrument and shall outline the below TERMS, including any other additional TERMS as specified via visiting: Terms-SWTRA.OhioTowGroup.com; Be it hereby known that the undersigned, herein after referred to as “I/me/my/myself” , does affirm and agree that “I” have requested: Southwest Towing & Recovery, Southwest Roadside Assistance, Southwest Towing & Roadside Assistance, Southwest Winching & Recovery, Southwest Off-Road Recovery, Southwest Storage, Southwest Storage Facility, Southwest Vehicle Storage Facility and/or any other subsidiaries and/or DBA’s operated by the parent company, Southwest Companies LLC, hereafter referred to as “Southwest”, to assist “me” with the stated: vehicle, trailer, boat, machinery, equipment, cargo, or any other, herein after collectively referred to as “vehicle” and as described below. “I” affirm that “I” am the legal owner of the “vehicle” stated below, or “I” am authorized by the legal owner to possess, operate and maintain the “vehicle” stated below and that “I” can read/write and understand the English language as this document is written, “I” am not under the influence of and/or impairment of any drug/substance that would limit “my” ability to understand this document and enter into this agreement. “I” understand that damage to the “vehicle” may occur, whether direct or indirect, as a result of the efforts of “Southwest” during any assistance they provide to “me” with said “vehicle”. “I” am aware that “I” may seek assistance from other local services, at “my” own expense if “Southwest” is unable and/or refuses to assist “me” with the requested services and/or if damage is received in the process of such services. This request is made knowingly and freely with the understanding that damage, either direct or indirect, may occur as a result of service(s) and “my” signature herein shall signify “my” Informed Consent that damage may occur, as notated on the reverse of this form. Be it further, that any resulting damages will be the sole responsibility and at the sole cost of “myself”, as listed herein below, if said damages are not due to the negligence of “Southwest”. Additionally, “I” agree and accept that “Southwest” shall not be held liable for damages, either direct or indirect, that occur after the vehicle has been released back to “my” care/custody & control. “I” agree to release, indemnify and hold harmless, “Southwest”, the parent company of “Southwest”, the technician/operator named herein below, and any/all representatives, agents, officers, owners, employees and heirs of “Southwest”, from any and all liability/damages resulting directly/indirectly from the service(s) provided, including such damages resulting from services as stated under the Informed Consent portion of this form, on the reverse. “I” have read and understand the TERMS of this document. Additionally, “I” accept that “I” shall be fully and personally financially responsible for payment of any/all monies due for service call fees, billable mileage and any other related fees for services rendered or attempted to be rendered in accordance with this assistance, even if “Southwest” is unable to assist, is unsuccessful in assisting, if “I” request “Southwest” to discontinue any service(s) and/or if “my” insurance/motor club fails to make payment on “my” behalf, for service(s) rendered or that were attempted or if such service(s) will exceed “my” policy coverage limit. “I” agree, accept and authorize “Southwest” to cause to be filed, any such invoice/request for payment under my insurance/motor club policy coverage and such payments for services shall be paid to “Southwest” for which they are entitled. Additionally, “I” hereby assign and signify assignment of claim to “Southwest” for certain rights, monies, interest and remedies from any insurance and/or motor club from which the undersigned expects to receive certain monies from payments and/or reimbursement for any such said services which have been provided and/or attempted to be provided and cause such assignment of claim to be paid in full amount of coverage and/or indebtedness directly to “Southwest” and in event such is not paid in full, “Southwest” may proceed to recover and collect monies on “my” behalf that are owed to “Southwest”. Notice to Customer: Payment is due at the time service(s) are rendered! • Furthermore, if payment is not made, in-full, for outstanding balances due at time of service, “I”, the herein below signed, do hereby authorize the “vehicle” to be held by “Southwest” and furthermore “I” agree and enter into a STORAGE AGREEMENT which shall authorize the “vehicle” to be towed [by “Southwest”] and then held and stored, by Southwest Storage, acting as “Southwest”, until payment for all services, including the tow(s) and storage fees [billed on a per calendar day basis], can be made in full, otherwise loss of title/ownership to said “vehicle” may result thru forfeiture. Additionally, “Southwest” may pursue “Lien Rights” against said “vehicle”, in instances where betterment has occurred to said “vehicle”, as a result of any service(s) provided by “Southwest”, inclusive of “Southwest” filing/causing to be filed for Mechanics and/or Repair Lien Rights for any charges due to betterment of said “vehicle” and until all monies due to “Southwest” have been paid. Furthermore, be it understood that should a “vehicle” be towed, held and stored by “Southwest” this shall constitute a STORAGE AGREEMENT AND STORAGE CONTRACT, entered into between “Southwest” (including Southwest Storage, (acting as a place of storage) and the herein signed, which shall also serve to meet the requirements of ORC 4505.101 (A) (as applicable), and shall be a contract to store and hold the vehicle, as set forth: for a period of fifteen (15) days from the original service date as indicated herein, then if not paid within that period, shall enter into a fifteen (15) day unclaimed period. If payment for all services is not received by the end of this second period, thus being a total of thirty (30) days after the original date of service, then the “vehicle” operator/owner shall be aware that forfeiture of the “vehicle”, including any/all contents, due to unclaimed/non-payment, may result, as per the Storage Agreement & Contract. Storage will not exceed a maximum period of thirty (30) calendar days, unless otherwise noted, in writing, and at the sole discretion of “Southwest”. As per sections: ORC 4505.101 and/or ORC 4505.10 through affidavit and/or court order legal process, a “vehicle” may undergo forfeiture if left unclaimed and/or for non-payment of balances due for services rendered. Any “vehicle” held in storage of “Southwest”, shall only be released, after payment, in full via CASH only method of payment, of all monies due for services rendered, and will only be released to the registered/titled owner, the original operator at the time services were rendered, to a valid lien holder or other prescribed agent by direction of law, upon presentation of proper and valid documents of proof of ownership to herein stated “vehicle”. Personal property, not including “vehicle” parts attached to the “vehicle”, may be recovered and removed from a “vehicle” in storage of this facility, during normal business hours, after payment of a Gate Fee, if applicable. Anti-Dumping Notice: ORC 4513.64 and ORC 4513.65 prohibit the abandoning of vehicles. Theft of Services Notice: per ORC 2913.02, theft of services is a criminal offence. Pickup of a “vehicle” being held in storage of our facility will require a minimum of a TWO (2) hour advance notice, via telephone call to our facility, of intent to pickup/release, so that “Southwest” can arrange for someone to be available for the release/pickup. “I” understand that “Southwest” may pursue all collections actions and/or any/all legal remedies to recover any outstanding balance owed to “Southwest”, including collections/court fees, this shall also be true if “my” insurance/motor club fails to remit payment on “my” behalf in full for all services rendered with herein stated “vehicle” and that “my” signature herein shall signify that I accept full responsibility to make payment, in full, to “Southwest” for all services rendered. “My” signature as indicated below hereby shall authorize “Southwest” to assist “me” and signify that “I” accept these TERMS and that “I” have been provided a written and/or verbal estimate for services prior, if requested, and that “I” accept & authorize service(s) to be preformed. Any claim of damages made by the herein named “vehicle” operator and/or registered “vehicle” owner, when such “claimed” damages are found to be fraudulent reported/claimed and/or not caused by “Southwest” and/or listed under the Informed Consent portion on the reverse, to include, but not limited, to any attempt to receive compensation and/or services, shall be considered fraud/extortion and held punishable under applicable Ohio law. Any falsification of any information contained herein and/or breach (including breach of contract) will be held punishable under applicable sections of Ohio Revised Code as governed by Ohio Law; this document, inclusive of the reverse side, shall serve as a legally binding agreement/contract/document/instrument and governed by the laws of the State of Ohio and enforceable by any court of competent jurisdiction of venue. No legal right(s) of “Southwest” shall be limited by this instrument in regards to the enforcement of this legal document.

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Payment Terms: The signature herein above signifies that I am an authorized holder/bearer/signer of such check and/or credit card as presented to the merchant listed herein. I hereby agree that payment in full for the amount indicated herein on this statement shall be due upon receipt of this statement or within fourteen (14) days from invoice date, if invoiced. My signature herein above shall also constitute authorization to charge the credit card specified herein above any charges incurred as listed above, that I am satisfied with any/all services received. Furthermore, if a check or credit card charge is returned for any reason, there will be a service fee of $35, in addition to any charges listed herein, for each attempt to collect funds, plus any charges incurred by any attempt to collect by use of a credit collection agency and/or legal fees incurred shall be paid by/at customers expense. Additionally, there may be an Administrative fee/Shop Fees charged in addition to amounts due for services and I am hereby made aware of such and my signature shall signify that I accept such terms. Furthermore, if herein said customer fails to provide payment in full for services rendered in accordance with the payment terms (payment due at time of service if not invoiced at SWT&R discretion), the herein stated vehicle may be impounded for storage & held until payment for services can be made in full, via CASH only, and/or a lien may be placed against herein stated vehicle and/or forfeited and customer is hereby notified and their signature shall signify acceptance of these terms regarding payment/impoundment for non-payment at time of service. My signature (as the customer/responsible party) as signed herein above shall indicate that I agree to these terms, have read this notice and have given consent for all services and charges as indicated herein above. Payment terms are governed by applicable laws of the State of Ohio.

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– RELEASE OF LIABILITY & WAIVER FOR SERVICE –

Be it known that “I”, the undersigned, have requested and do hereby authorize Southwest Towing & Recovery and/or Southwest Roadside Assistance, and/or any other -dba- (Doing Business As) name(s) of the parent company, hereafter referred to as “Southwest”, to assist “me” and provide service(s) for the stated “vehicle” as described herein. “I” affirm that “I” am the legal owner of the “vehicle” stated below, or “I” am authorized by the legal owner to possess and maintain the “vehicle” stated below. “I” understand that damage to the “vehicle” or other persons/property may occur, whether direct or indirect, as a result of the efforts of “Southwest” during any assistance they provide. “I” am aware that “I” may seek assistance from other local services such as locksmiths, service stations, or tow companies, at “my” own expense, if “Southwest” is unable to assist “me” with the requested services and/or if damage is received in the process of such services. “I” understand that “I” shall still be responsible for payment of any/all monies due to “Southwest” for any service(s) attempted/rendered, including, but not limited to, any service call fee(s), special equipment and/or mileage fees, even if damage(s) occur to the herein stated “vehicle” and/or any other person(s) or property. This request is made freely with the understanding that damage may occur as a result of the procedure and “my” signature herein shall signify “my” Informed Consent that “I” have been made aware that damage(s) may occur and such damage(s) is/are herein listed below under the Informed Consent section of this form. Be it further, that any resulting damages or claims of damages to said “vehicle”, persons or property, including any real property (land) where the “vehicle” may be located and/or accessed from, will be the sole responsibility and at the sole cost of the “myself”, as listed herein below. “Southwest” shall not be held liable for damages, or claims for damages, either direct or indirect, that occur after the “vehicle” has been released back to “my” care/custody & control. “I” agree to release, defend, indemnify and hold harmless, “Southwest”, the parent company of “Southwest”, the technician named herein below, and any/all representatives, agents, officers, owners, employees and heirs of “Southwest”, from any and all claims of damage and/or liability resulting, either directly or indirectly, from the service(s) given in accordance with my Informed Consent. Be it further that any such damage(s) herein listed under the Previous Damages section of this form, shall not be held liable to “Southwest”, as such damage(s) is pre-existing and prior to any service(s) attempted and/or rendered by “Southwest”, therefore “Southwest” shall be hereon and forever released from any and all claims of liability for such pre-existing damage(s). “My” signature herein below shall signify that “I” have read and understand the TERMS of this document and the authorization to service, release of liability and waiver sections of this form, which shall constitute and be held as a legal document/agreement/contract/instrument that is enforceable within this State of Ohio. “My” signature as indicated herein shall hereby authorize “Southwest” to assist and signify that “I” accept these TERMS any others which may be viewed via Terms-SWTRA.OhioTowGroup.com, including such Release of Liability & Waiver for Service. Any claim of damages made by the herein named “vehicle” operator and/or registered “vehicle” owner, when such “claimed” damages are found to be fraudulent reported/claimed and/or not caused by “Southwest” and/or listed under the Informed Consent portion on this document, to include, but not limited, to any attempt to receive compensation and/or services, shall be considered fraud/extortion and held punishable under applicable Ohio law. Any falsification of any information contained herein and/or breach will be held punishable under applicable sections of Ohio Revised Code and governed by Ohio Law according to a court of competent jurisdiction. “Southwest” shall assert an automatic right to inspect and such claim of damage and shall be fully entitled to the insurance company/coverage of “Southwest” to investigate any such claim and make a determination on any such claim. No legal rights of “Southwest” shall hereby be limited by this instrument or any defect of such instrument.

***Any alleged “damage(s) that a “vehicle” owner/operator/lien holder may claim to be the responsibility of “Southwest” shall require WRITTEN NOTIFICATION to “Southwest” within THIRTY (30) days after the date of service and shall be via WRITTEN NOTIFICATION in the form of a letter/statement/claim, along with supporting color photographs depicting alleged damages, and shall be sent via US Mail to our corporate address:->

Southwest, ATTN: Damage Claims Dept, PO Box 1101, Lancaster, Ohio 43130

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Informed Consent: The following will serve as an informed consent for services to be rendered. This will serve as a full release of liability, as stated and detailed herein above of this form, for the services, which the customer has requested to be preformed, which may and/or will result in the below stated damages to said vehicle. This release will be according to the TERMS & conditions stated herein. Customer fully accepts responsibility for any/all damages that occur, directly or indirectly as a result of their request for service. Furthermore, I shall hereby fully release liability after the herein stated vehicle has been released back to my (the herein named owner/operator) care/custody/control.