Job Summary Vehicle Details

VAT Reg No. GB 239 7992 01 VR N

Technician D ate & Time GX07LPA
Job N umber:
000001019645475 1005121 01/08/19 09:44 Make & Model
AUDI A6

Location Information Billing Details

Location C orporate N ame
CE SLOUGH SWIFTCOVER INSURANCE SERVICES LTD
Service Type Fitting Location Policy Holder N ame
SUPPLY & FIT BRANCH MR AVNI FAZLIU
Policy N umber
Customer Details 302149902
C ustomer N ame Policy Expiry D ate
MR. AVNI FAZLIU 04/03/2020
Owner Address Fitting Address VAT Status G lass Limit
FLAT 3 KWIK FIT PLUS N/A £9999
DEWHURST COURT 1 BATH ROAD
INVERNESS ROAD SLOUGH G lass Excess Minimum: R epair Excess Minimum:
HOUNSLOW UNITED KINGDOM £75 £15
UNITED KINGDOM SL1 3UA Outstanding Excess: Outstanding Amount:
TW3 3LJ £ £0.0
Online Payment
ON-LINE VISA £75.0

C ontact
Primary: 07832373333 Work:
Home: Mobile: 07832373333

Job Products
Stock C ode D escription Quantity
PSER00400B ENVIRONMENTAL LEVY CHARGE REAR SCREEN 1.0
PSER01227A IN BRANCH DISCOUNT 1.0
PSERUK00033A CLAIMS HANDLING 1.0
8582BGSSABGJPZ BACKLIGHT 1.0

Job Collects
What was the cause of your glass damage?
ACCIDENT-NO PERSON INVOLVED
What is the incident date?
31/07/2019
What is the Policy number?
302149902

Job Inspections
The following items were checked on the vehicle prior to, and after completion of work by our technician
New replacement glass/products*
Vehicle exterior
Vehicle interior
Window mechanism*
Wiper operation*
Seat belt operation*
Door locks*
Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.
Wiper blade condition
Wiper replacement required
Bonnet close
Air bag warning light/sensors
* if applicable

Aperture C ondition
Rusty
Damaged
OK

Job Inspection - Damage

No damage found

Damage found (as indicated below)

The diagram( s) indicate damage identified during vehicle inspection prior to any work

Mileage: 164758
Adhesive B atch N umber : f113j43024
C omments:

Glass Repairs

No damage found
Damage found (as indicated below)
N umber of repairs: 0

Signature Before Work

C ustomer signature before provision of the service
C ustomer Print N ame B efore Job: avin fazliu

C ustomer N ame : MR. AVNI FAZLIU

Customer Available

Job Billing
C orporate N ame C orporate Type N et Amount VAT Amount Total Amount
GENERIC MOTORIST GENERIC MOTORIST £75.0 £0.0 £75.0

Job Payments
No job payments

Wiper Sales
No wiper sales

Signature After Work

I have inspected the vehicle upon completion of work and confirm work has been carried out to my satisfaction. I agree that [ 0 ]
glass repair( s) indicated on the vehicle inspection diagram have been carried out.
C ustomer Print N ame After Job: avni fazliu

Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.
D rive away time: 10:13

Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.
 Terms and Conditions
Terms of Business

Terms of Business for vehicle glass repair and replacement services - our contract with you

1. You are dealing with Belron UK Limited, trading as Autoglass®. In these terms of business, references to “we” or “Autoglass®” or “our”
means Belron UK Limited. By asking Autoglass® to carry out vehicle glass repair and replacement work on your vehicle you agree that our
work shall be governed by the following terms. Our contract with you is formed at the time of you making your appointment with us. Most but
not all of the terms set out below are reproduced on the sales document that you (or your representative) will be asked to sign when we attend
your vehicle. If our work is the subject of a claim on an insurance policy and you (the person making the booking with us) are not the
policyholder for the vehicle that is the subject of the claim, you promise that your dealings with us are made with the authority of the
policyholder. If we have not been appointed as agent of the insurer to handle a claim under a policy issued by that insurer and our work
includes assisting you in a making a claim under a policy issued by that insurer, you appoint us as your agent to assist in the administration
and performance of your insurance policy. The signature (made by you or your representative) that we receive at the time of the appointment
confirms our appointment as agent of the policyholder on that basis.

2. Where relevant and available to us, we check the latest information submitted to us by insurers to confirm that our work may be paid for
under your insurance policy. Where practicable, Autoglass® will contact your insurer directly to verify the nature and scope of your insurance
cover. You acknowledge that Autoglass® is not responsible for the extent of your policy cover or its conditions (such as excess payable).

3. In the course of repair, glass may crack beyond repair through no fault of our technician. You acknowledge that risk. If that happens, we
will ask if you would like us to replace the glass. If you wish to proceed with replacement, you agree that paragraph 4 below shall apply to that
service. We will take into account any excess you may have already paid to us.

4. Payments up front and in part. You agree to be responsible for the full cost of our glass repair and replacement work on your vehicle. In
making arrangements to deliver our service to you, we incur business costs. You agree that we can immediately charge (i) for or in respect of
these arrangements or costs and/or (ii) an up front part payment in respect of our glass service.

If you are making an insurance claim in respect of our service, we are entitled, immediately upon any cost or charge as aforesaid being
incurred or made, (i) to obtain any excess, or other portion of the insurance claim which your insurance policy obliges you to pay or fund for or
from your own account, from you and (ii) to apply such excess or portion against any such cost or charge.

Assignment: If you are making an insurance claim in respect of our service, you agree that, with immediate effect from the time we begin
work on your vehicle, (i) you have assigned to us your right to collect the claim proceeds, and (ii) you shall take any steps necessary or
reasonably beneficial, including signing any further document, to prove or otherwise give all practical or legal effect to such assignment.

5. If the policyholder is registered for VAT, the policyholder agrees to pay VAT on our service. When you booked your appointment, you may
have paid VAT calculated on the cost of the materials we usually use for a vehicle like yours. If our work on your vehicle requires us to use
materials (such as a trim or clip) that we did not expect to use for the job, the price we charge and the VAT due from you may change. In that
case, you agree to pay all additional costs and VAT due to us and we agree to refund our costs and VAT to the extent the amount you should
have paid reduces.

6. The visibility of a repair to glass depends on the nature of the damage at the time of repair. If you are not happy with the look of our repair,
we can replace your windscreen if you pay the required amount.

7. A diagrammatic record of visible damage existing on your vehicle will be made by our technician before starting work on your vehicle. We
exclude all liability for repair of damage, whether visible or not, existing before we began to work on your vehicle.

8. We will perform our service to the best of our ability at a time and location to be agreed between us. We reserve the right to change our
appointment time with you for any reason. We will notify you in advance of any change to the agreed appointment time. If you have a
complaint about our service, please call 0800 011 3896 or write to Customer Services c/o Autoglass® at the address shown at the bottom of this
page or email us using the following link customer.services@autoglass.co.uk. If we damage your vehicle, we can arrange its repair at no cost
to you. If without our prior written approval to proceed with any repair, you organise a repair yourself, we do not guarantee to pay the costs you
incur. Our approval for you to organise a repair of your vehicle at our expense will be conditional upon you sending us a minimum of two
written estimates prepared by independent repairers in advance of commencement of the work. We reserve our right to require additional
estimates where for any reason we believe the estimated costs are not reasonable.

9. Key limitations to our work: (1) We are unable to install a replacement windscreen on corroded metal. If we find your vehicle to be corroded,
Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.
we will stop work and explain your options; and (2) Certain vehicles now have Advanced Driver Assistance Systems (ADAS) cameras mounted
on their windscreen. Vehicle manufacturers specify that certain of those ADAS cameras require recalibration following replacement of the
vehicle’s windscreen. Autoglass® is not able to provide that service for some vehicle types. Where we are not able to effect calibration following
completion of a windscreen replacement, you may arrange for your vehicle’s camera to be recalibrated at your own cost by an alternative
supplier, which may include the vehicle’s dealership network. Where recalibration is recommended for your vehicle’s ADAS camera, before
making your booking with us, we will advise you of that fact and ask whether you would like us to calibrate your ADAS camera. Where we do
not offer calibration for your vehicle’s ADAS camera, we will check that you wish us to proceed with replacement of your vehicle’s windscreen.

10. Our liability to you: we intend that our liability to you should be limited to putting you in the position you would have been in had we not
damaged your vehicle, after taking account of your legal duty to minimise the loss. You acknowledge that the cost to us of repairing your
vehicle in the event that we damage it is likely to exceed the amount we are paid for our service and may exceed the market value of your
vehicle as at the time you presented it to us for repair. Accordingly, you agree that our total liability to you in aggregate both for any service
failure or vehicle damage is limited to: (A) the lesser of (i) and (ii), as set out below: (i) the total estimated or actual cost (as the case may be) of
repairing any damage we have caused to your vehicle; and (ii) as at the time the vehicle was presented to us for repair, its standard market
price (where "market price" means such value as shall be determined by Autoglass®, acting reasonably, with reference to Glass's Guide or
any comparable guide and/or the opinion of an independent vehicle damage assessor); plus (B) for any period where your own car will be
unavailable to you, at our choice (acting reasonably), the cost we incur to provide you with alternative means of transport or a replacement
vehicle of our choice (acting reasonably); plus (C) such amount as may be adjudicated as pertaining to unique and/or exceptional
circumstances. Except as stated above, you agree that, unless you brought your circumstances to our attention in advance and we wrote to
you to confirm otherwise before we began our work, you and Autoglass® do not intend that Autoglass® reimburse or compensate you for: your
time; any loss of income; any loss of use of your vehicle; any costs or expenses incurred from loss of use of your vehicle; any loss of business
or profits; any pure economic loss; any indirect or consequential loss suffered by you as a result of our work; any other loss not contemplated
within sub-paragraphs (A), (B) and/or (C) of this paragraph 10.

11. Dealerships & accident management companies: If you allow a dealership or an accident management company to manage the repair
process in relation to your vehicle, you are likely to incur costs in excess of those we would incur if you allow us to manage the repair on your
behalf. A dealership or accident management company is likely to offer to provide you with a replacement vehicle. The costs of that vehicle is
likely to be very high (thousands of pounds) – much higher than the cost to us of organising a rental on your behalf. We will not pay for the
costs of any vehicle supplied to you unless we have arranged the rental directly on your behalf. Please be aware the costs to the dealership
and accident management company will be your personal liability and you may be at significant financial risk if you choose to use their
services.

12. Nothing shall limit our liability for fraud or death or personal injury caused by our negligence. Your statutory rights are not affected.

13. Where payment for our work on your vehicle will be made using a trade or company account, our trade/company terms will apply to our
work in priority to the terms written above.

14. You authorise us to remove your damaged vehicle glass as waste (European Waste Catalogue 16-01-20) to an authorised site for
appropriate treatment (recycling).

15. Autoglass® is authorised and regulated by the Financial Conduct Authority in respect of insurance mediation services only. Our
authorisation number is 314575.

16. You agree that our privacy policy and policy on cookies as it or they appear from time to time on our website shall govern the handling of
your personal information that we receive from you, your insurer or other third party (such as a broker). If you wish to limit our right to use
your personal information, please write to Data Protection c/o Autoglass® at the address shown below.

17. At Autoglass®, we are committed to reducing fraud made using credit cards. We reserve our right not to accept payment from you by debit
or credit card where we suspect that by doing so a fraud may be perpetrated against us or the registered card holder.

18. Our terms of business and any dispute or claim arising out of or in connection with them or their subject matter (including non-
contractual disputes or claims of any kind arising directly or indirectly) shall be governed by and construed in accordance with the laws of
England and Wales.

19. The courts of England will have exclusive jurisdiction over any claim arising from, or related to, our goods and services although we retain
the right to bring proceedings against you for breach of these conditions in your country of residence or any other relevant country.

Consumer rights information

Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.
20. Any booking that you make with us by phone or online will be subject to The Consumer Contracts (Information, Cancellation and
Additional Charges) Regulations 2013 (SI 2013/3134) (as amended from time-to-time). We are pleased to provide you with the following
information in accordance with those regulations:

a. Autoglass® is the trading name of Belron UK Limited, company number 494648 whose registered office and head office location is at 1 Priory
Business Park, Cardington, Bedford, Bedfordshire MK44 3US. Telephone number 0800 011 3896. Fax number: 01234 831 100. You can
contact us using the following link: customer.services@Autoglass.co.uk

b. Autoglass® supplies vehicle glass repair and replacement services and products.

c. If you are insured, normally you only need to pay us an excess, if applicable. If you wish to pay in full for our work yourself, we will provide
you with a quote for our work including VAT. If you intend that your insurer pay us the balance above the excess for our work and you are VAT
registered, we are instructed by your insurer to ask you to pay the applicable VAT on our charges. When we accept your booking and, where
required, quote the price of our service, we make assumptions as to what parts your vehicle will require. If those assumptions prove to be
incorrect, our costs of service and therefore our price will change to take account of the parts we require for our work. For example, we may
have to replace a vehicle glass trim that usually we do not have to replace for a vehicle like yours. We reserve our right to adjust our price
and, where applicable, the amount of VAT we charge you according to the goods we supply to you in the course of providing our service to you.

d. Where you make a claim under your insurance and we have received the relevant information from your insurer, we will advise you of the
excess we believe you are required to pay and will claim the balance of our fee from your insurer.

e. Where we have been unable to validate your policy details in advance of providing our services to you, we shall rely on the information that
you provided to us. We reserve all our rights to recover payment for our services in all circumstances including without limitation where
information you have provided to us was incorrect regardless of whether you are at fault.

f. We make no additional charge for delivery of the products that we will use in the course of providing our service. We accept payment using
Visa, MasterCard, Visa Electron or Maestro. We do not accept cash, American Express, Diners Club, PayPal or personal cheques. Payment
by business/company cheque is available for trade account holders only.

g. We will provide our service to you by appointment at a location agreed between us.

h. Our contract with you is for the supply of vehicle glass repair and replacement services. Normally, under the Regulations, if you are a
consumer, you will have a right to cancel our contract for 14 working days counting from the day after our contract with you was formed. When
we are given the keys to your vehicle, we shall understand that to be your express consent to begin our work on your vehicle. Usually, that
means we will have begun our work before the end of the usual cancellation period. Your cancellation rights under the Regulations will end
when that work starts. You may cancel your appointment and receive a full refund of any monies that you have paid to us at any time before
we commence repair or replacement work on your vehicle. To cancel our service, please call us, contact us via our website or tell our
technician before he starts work on your vehicle. We do not require you to complete any special form to cancel your appointment. We
recommend that the easiest way to cancel your appointment is to call us on 0800 36 36 36 which is free from a landline. You may prefer to
print off this page and complete the following details and post the section below to us if that is easier for you:

To: Autoglass® (Belron UK Limited), 1 Priory Business Park

Cardington, Bedford, Bedfordshire MK44 3US

I:_____________________________________________________________

give notice that I request to cancel my order for the following service:

____________________________________________________________

Vehicle registration number: _______________________

Appointment date:__________________________________________

Your address:_______________________________________________________

Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.
Your telephone number (in case we need to call you): _________________________

Your signature:

Date:

Please note that you may not cancel your appointment after we have commenced our work on your vehicle and we reserve all rights to
recover payment for our service in circumstances where you attempt to cancel your appointment or require us to cease work on your vehicle
after our work has commenced.

i. The validity of any price we offer you for our services is limited to the duration of the call during which the offer was made. Accordingly, we
may refuse to honour a price offered to you where you do not agree to purchase the relevant service during the continuation of the call in
which the offer was first communicated to you.

j. Where we have taken any payment from you in the course of you making an appointment with us, we shall hold that payment to your order
until the moment we begin our work on your vehicle. With effect from commencement of our work on your vehicle, we reserve our right to
retain for our account any payment you have made to us.

k. The only language offered by us for any contract is English.

Date of issue: 01/12/2017 Version 2

Belron UK Limited t/a Autoglass®, 1 Priory Business Park, Cardington, Bedford MK44 3US. T: 01234 273 636 F: 01234 831 100 www.autoglass.co.uk
Part of Belron® Group. R egistered in England N umber 494648. R egistered office: 1 Priory Business Park, Cardington, Bedford M K 44 3U S. Autoglass® and the device are registered trademarks of Belron S. A. and its affiliated companies.
Authorised and regulated by the F inancial Conduct Authority in respect of insurance mediation services only.