INSURANCE REPAIR AUTHORITY 09 Aug, 2022 This Repair Authority is Valid within 30days of Issuance INTECO PAMPANGA ( ISUZU PAMPANGA ) Attantion: Service Manager Unit ISUZU MU-X 1.9 D 4x2 LS RZ4E AT [2021] Plate No. Dtve4o Insured ‘CAROL CANDA MERCADO Third Party (Our Ret. No. v297780 Policy No. DP798149 Gentiemen “This will autnorize you to proceed with the repairs ofthe subject vehicle in accordance with IN HOUSE ESTIMATE for 27,083.22. ‘After the completion of repairs, it becomes your responsibilly to secure the appropriate signature on the attached releaseidesistance forms and collect rom subject owner the participation amounting to 5,850.00 broken down as follows: Deductibie/s ° 5,850.00 Depreciation ° 0.00 » 395000 ‘The net amount due you of 21,233.22 shall be paid by us upon presentation of the repair invoice, together with the duly signed releases, Itis understood that no adstional replacement parts or increase in cost shall be undertaken without our prior written authonty For inquiriesiconcerns, text CLAIM and send to 09178910000 or please call CCharmine Ann Rondero, at phone number 8840-2000 local 59156, Motor Ciaims Department. ‘This Letter of Authoriy is valid only 2 ofthe date ofits tender andi is horaby warranted, declared and agreed that SPIIMS INSURANCE CORPORATION is exempt ftom any pree inereage agjustment on pars &iabor that may ensure from such dat of 'ssue Drought about by non-compliance or delays, intentional or ebwerwise,n bringing tne unit tothe designated shop incicate in the Letter of Authority. Very truly yours, AUTHORIZED sen ConformeNSU RELEASE AND SUBROGATION Claim No. MV297480 IN CONSIDERATION of the sum of Twenty One Thousand Two Hundred And Thirty Three And Twent Two Conts (P21,238.22) Phiioine Currerdy. pad by BPINS NISURANCE CORPORATION fo Tatts CAROL ‘TANDA MERCADO in lll settement and satisfaction of my/our claim under Motor Car Policy No. DP79BTaTin ‘aspect of Myfour ISUZU MU-K 1.9 D 4X2 LS RZAE A/T [2021] with Motor No, RZ4EUY2502 insured under The Gorcsod polo, atsmp roth aceGert iat occured av or dpeut O7/tB2022 ator near We hereby RELEASE AND DISCHARGE now ahd forever, BPYMS INSURANCE ‘CORPORATION ofall claims competent fo melus in respect of any and all loss or damages sustained by melus arising directly from the above mentioned accident We hereby assign and transfer fully tothe Company each and al claim or demand against any or all third persons, fms, corporations responsible or liable to me/us for such loss, damage and expenses, and the Company pursuant tothe provisions ofthe policy, is hereby fully subrogated in persons, firms and or corporations. We hereby agree to execute and deliver all papers required and shall cooperate withthe company in the enforcement of all such claims or demands by suit or otherwise, and the Company may compromise or its ‘solute discretion it may deem convenient provided, however, that should the company obtain any amount of sum ‘of money made by tin respect of the loss, damage repairs and or expenses as above mentioned, the excess shall be turned over to melus after deductions of expenses of collection, judicial cst and attorney’s fees, if any have been incurred. ACKNOWLEDGEMENT REPUBLIC OF THE PHILIPPINES ) MAKATI, METRO MANILA, )ss. At Makati, Metro Manila, this personally came and appeared before me; Residence Certicatels Name Number Date Issued Place Issued known to me and to me know to be the same person/s who executed the foregoing instrument and heishelthey ‘acknowledged to me that the same is her/heritheir voluntary act and deed WITNESS MY HAND AND SEAL on the date at the place first above mentioned NOTARY PUBLIC Boe. No, Page No 00k No. Series No ———