When an estimate is required to be presented to a consumer, a collision repair facility shall disclose to the prospective consumer an estimated price quotation with the following statement included or attached with the consumer’s signature:
     “You are entitled to a price estimate for the repairs you have authorized. The repair price may be less than the estimate but shall not exceed: (1) any price limited estimate; or (2) any parts or labor estimate by more than 10%. Additional repairs may not be performed without your consent.
     You may waive your right to notification, which gives the collision repair facility the right to set the price without your permission. Your signature will indicate your selection.
     (a) I request an estimate in writing before you begin repairs.
     Signature …………………..
     (b) Please proceed with repairs but call me for approval before continuing if the price exceeds $…………..
     Signature ………………….
     (c) I do not want an estimate and you may set the price of repairs.
     Signature ………………..
     Date…………..    Time…………………
     This estimated price for authorized repairs will be honored if the motor vehicle is delivered to the facility within the time period agreed to by the consumer and the collision repair facility.”