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You may also be responsible for your deductible and any betterment taken on claim at time of delivery. COACH AND CARRIAGE AUTO BODY 66 School St Watertown MA 02472 Phone 617 924 4845 Fax 617 923 8020 RS 4624 Exp May 31 2018 Tax 042475187 coachandcarriageautobody gmail.com Repair Authorization and Direction to Pay Form NAME DATE ADDRESSTOWNSTATEZIP YEARMAKEMODEL PHONE NUMBER CELL PHONE EMAIL CLAIM INSURANCE COMPANY STATEMENT OF REPAIR According to the provision of the Direct Payment Plan...

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