Liability Form | Newport Mobile Mecha

Towing & Vehicles in Care Liability Waiver

First & Last Name

Vehicle Registration

Today's date

Is the vehicle insured under a comprehensive insurance policy?

No, CTP insurance only

Yes

The vehicle is unregistered and uninsured

Please specify anything we should know about

I declare that the information I have provided is accurate & complete

I aknowledge that if my vehicle is in transit with Newport Mobile Mechanic Pty Ltd & a claimable event occurs, I am liable to pay the excess of $500. I also acknowlege that the maxiumum sum insured for loss or damages whilst in transit is $50,000

I aknowledge that if my vehicle is in the care of Newport Mobile Mechanic Pty Ltd & a claimable event occurs, I am to utilise my own comprehensive insurance policy & am liable for any excess payable. I understand that if I do not hold a comprehensive insurance policy, my vehicle is not insured.

I authorise Newport Mobile Mechanic Pty Ltd to have my vehicle in their possession, for the purpose of replair and/or maintenance.

Signed (Full Name)