If you would like Liberty Mutual to issue payment to the repair shop you have selected directly, please sign and date this authorization below. I authorize Liberty Mutual Insurance Company to make payment, on my behalf, directly to:

Repairer Name: Badell’s Collision
Repairer Address: 143 Conchester Highway
City, State, Zip: Aston, PA 19014
Federal Tax I.D.: 74-307-7404
State Tax I.D.: 82559797

For any approved covered damage and for which I am entitled to be compensated, resulting from the above captioned claim. Repair shops are required to contact Liberty Mutual prior to performing additional repairs. Supplemental charges submitted without prior authorization from Liberty Mutual will be denied.

Liberty Mutual

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