Contract - RSA

Logo invoiceEffective Date:

Service Payment Plans


Customer Name and Address (“Customer”): Repairer Name, Address and Telephone Number (“Repairer”):


In this agreement, you, your, yours, and you means the customer. We, our, us and the Repairer means the Repairer that completes the Repairs (defined below) on your asset and any assignee to this agreement as may be designated by the Repairer. "Asset" means the item listed below:



Year: Make: Model: Odometer: Identification #:

The Repairer agrees to provide a loan to the Customer to finance the tires, accessories, services and/or repairs detailed on the attached invoice (the “Repairs”) in connection with the asset and the Customer agrees to repay the Repairer on an installment payment basis, subject to the terms and conditions of this Agreement.

DISCLOSURE STATEMENT (The following information is effective as of the date of this agreement)


Principal Amount

  • Invoice Amount (total of advance): $ 
  • Service_Fee: $ 
  • Road Side Assistance Fees: $ 
  • Total Principal Amount: $
    All sums of money which are referred to in this Agreement are expressed in lawful money of Canada, unless otherwise specified.

Interest Start Date: Interest will be calculated and charged from this date on

Annual Interest Rate: The applicable Annual Percentage Rate on any outstanding Principal Amount shall be 19.99%, calculated and charged from the , and added to your account on each payment due date. The Annual Percentage Rate increases to 29.99% should you be in default of any payments. The Annual Percentage Rate is calculated by including applicable fees, if any, as part of the cost of borrowing over the term of this agreement. Note: Changes in the rate will result in changes in the cost of borrowing and the amount to be repaid.

Payment Frequency: The payment frequency of your principal is: Monthly

Term: The term of this agreement is months.

Payment and Cost of Borrowing: Your regular monthly payment of $ ("Regular Payment") is due on the of each borrowing month.

Your first regular payment is due on and, your last regular payment is due on (at which time the outstanding balance will be $0 if paid in accordance with this Agreement). The total of all your payments is $

  The total interest included in all your payments is $, and the total cost of borrowing, which is comprised of the total interest payable and the fees (if any) under Line 2 above or under Principal Amount is . Together, the total of all payments under the cost of borrowing shall be called the “Cost of Repair”. The cost of borrowing, as stated here, is the difference between the amount to repaid and the principal amount and is based upon the assumption that the payments required to be made by the borrower are made as they become due.
Terms of Payment: Each payment that you make (other than for a specific fee) is applied first to interest, then to the outstanding principal amount, and then to default charges and other fees. If you do not make your payments as scheduled or if we mutually agree to amend this Agreement, your last Regular Payment due date may differ. All payments under this Agreement shall be made without days of grace, presentment, protest, a notice of dishonor or any other notice whatsoever, all of which are expressively waived by you. Interest will accrue on all outstanding balances, including unpaid charges and overdue interest, at the rate specified herein both before and after default and/or judgment, if any, until payment is made in full. You will make payments by entering into a pre-authorized debit agreement in favor of the Repairer, or by other payment method as mutually agreed to in writing.
Prepayment The Principal Amount hereof, together with any interest accrued and unpaid thereon, may at any time be repaid in part or in full without notice and without prepayment fee or penalty. If you do not prepay the outstanding principal amount in full, you shall continue to pay each Regular Payment when due, if any. If any such full prepayment is made, you may be entitled under applicable law to a refund of a portion of any non-interest finance charges, and such refund, if any, will be calculated in accordance with the applicable Consumer Protection Legislation regulation.
Other Fees Default Charges: If you do not pay any amount when due, you must (i) reimburse us for the full amount of all legal costs and other expenses that we incur to collect the amount that you owe to us, and (ii) pay us $50 for each cheque or pre-authorized debit that is not honored (unless prohibited by law).
  Service Fees: The following additional fees may be payable as described:
  Manual payment processing fee (per item) $5
Pre-Authorized Payment hold; change of payment date or payment $5
Frequency Account Balance or Payment Request $20
Providing a copy of the Agreement, or any other loan documents (plus $25 costs)
Providing a copy of payment history, reference letter, discharge $50
the statement, or loan Amortization (plus costs) $50
Administration of Insurance Claims on behalf of insured $250
Re-Writing of existing Agreement - $125
Demand Letter Documentation and Administration Fee - $250
Recovery Documentation and Administration Fee - $500
Repossession of Vehicle including (may include lien discharge fee of $125) (additional
charges including but not limited to, vehicle storage, vehicle transportation, bailiff retention,
legal fees, etc. may apply)

You hereby acknowledge that, on signing this Agreement, you are indebted to the Repairer the amount set out in the disclosure table above on or before the corresponding due date in accordance with the terms of this Agreement. You further confirm that you authorize the Repairer to complete the Repairs and that you approved the total invoice amount on the attached invoices(s) (“Total Invoice Amount”).

  • You represent and warrant that:
    • you were provided with an estimate for the Repairs, and the Total Invoice Amount does not exceed such estimate by greater than 10% (or such other number as may be required by applicable law) or, if you were not provided with an estimate, the Repairer offered to provide an estimate which you declined, and the Total Invoice Amount does not exceed the total amount you authorized for the Repairs;
    • the Repairs were completed for the purpose of altering, improving or restoring the Asset or maintaining its condition;
    • you have inspected the Asset and the Repairs, and agree and acknowledge that the Repairs have been completed and are satisfactory to you in all respects;
    • you are the legal owner of the Asset, or have the authority of the legal owner of the Asset to approve and authorize the Repairs, to enter into this agreement and to grant to the Repairer the liens set out in Section 2; and
    • you acknowledge that the Repairer is relying upon such representations and warranties in connection with the release of the Asset to you.
  • You hereby grant the Repairer and acknowledge that, immediately upon release of the Asset to you, the Repairer has a valid and enforceable nonpossessory lien against the Asset and repaired components thereof under the Repairs and Storage Liens Act(Ontario) The Repairers Lien Act (British Columbia), the Garage Keepers' Lien Act (Alberta), the Commercial Liens Act (Saskatchewan), The Garage Keepers Act (Manitoba), the Garage Keepers Lien Act (Northwest Territories), the Garage Keepers Lien Act (Nunavut) and/or the Garage Keepers Lien Act (Yukon) and without limitation any legislation for which a lien may be enforced against the Asset for the maximum amount for which a lien may be lawfully registered up to the Cost of Repair. You hereby authorize the Repairer, or its agent or assignee, to register such lien in accordance with the applicable legislation.
  • If the term of this Agreement exceeds three (3) years, you hereby further grant to the Repairer a separate continuing security interest in the Asset throughout the term of this Agreement and until such time as the Cost of Repair has been paid in full. You hereby authorize the Repairer, or its agent or assignee, to register such lien in accordance with the Personal Property Security Act (Ontario), or the analogous legislation in your jurisdiction, and this Agreement shall be deemed to be a security agreement for the purposes of such legislation.
  • You may not assign any of your rights or obligations under this Agreement without the Repairer’s prior written consent. The Repairer may assign its rights and obligations under this Agreement at any time without notice to you. this agreement will bind each party’s heirs, legal representatives, successors, and permitted assigns.
  • You consent to the Repairer's assignment of this Agreement to any third party and any of their assignee or their financiers (the “Assignee”).
  • In connection with the assignment of this Agreement by the Repairer to any assignee, you hereby agree with the Assignee as follows:
    • That all information set forth in this Agreement is accurate and complete, that the materials and services to the Asset have been duly provided and performed, all being found acceptable, and have read and received a duplicate of this Agreement understanding that you are bound by all of the provisions set forth therein;
    • That you have received notice of, and consented to, the absolute assignment of this Agreement to such Assignee, and agree to make all payments due hereunder to the Lender or as it may otherwise direct in writing;
    • To waive any claim for set-off or defense against the Assignee that you may have against the Repairer; and
    • The following documents are attached and form part of this Agreement:
      (i) A copy of a void cheque of the Customer’s bank account, except where an authorization Regarding Pre-Authorized Payments is entered into or banking details are otherwise obtained through electronic banking verification.
      (ii) A copy of the work order(s) or invoice(s) in respect of the Repairs
  • You acknowledge and agree to waive all legal or equitable rights ofset-off against the Repairer, including any rights of counterclaim or defenses which you may have against the repairer.
  • You are responsible for all taxes, including value-added taxes, of whatever nature which are payable on the Cost of Repair or any portion thereof.
  • You covenant and agree as follows:
    • Not to remove the Asset from the Province in which you reside, as set out on the front page of this Agreement, except for temporary trips not exceeding thirty (30) days;
    • Not to cause any further encumbrances to be registered against the Assetwithout our prior consent, including but not limited to creating a possessory or non-possessory lien, or any other purchase-money security interest in the asset.
    • Not to sell, transfer ownership or title or any other interest in the goods to any third party without our prior written consent; and
    • To maintain adequate collision and comprehensive insurance so long as you owe any monies under this Agreement. You may purchase the insurance from any insurer who may lawfully provide this type of insurance, either directly from such insurer or through an agent of your choice. We can disapprove, or reasonable grounds, an insurer selected by you. You shall provide us with a copy of the insurance if so requested and have us named as loss payee. You shall ensure that the policy or an acceptable replacement policy shall remain in full force and effect during the term of this Agreement. If you fail to comply with the foregoing, you shall be conclusively deemed to be in breach of this agreement. In event of an accident involving the Asset, you shall furnish us and the insurer with a report of the details within 24 hours in the acceptable format in connection with any claim or dispute concerning such accident and will comply with any further obligations of the insurance policy required to support a claim with any claim for dispute concerning such accident. If the asset is lost or stolen or so damaged that it cannot be economically repaired, thisAgreement shall terminate immediately, and you shall pay the unpaid balance of the Cost of Repair.
  • This agreement shall be considered in default if;
    • You fail to pay us the Amount set out in the disclosure table above or any part thereof when due.
    • You fail to observe or perform any of the other covenants contained herein;
    • A proceeding bankruptcy, receivership winding up or insolvent is instituted by or against you or the asset;
    • Any execution, attachment or writ is levied upon the asset or the asset is confiscated, or we deem the asset in danger of misuse or confiscation;
    • The asset is lost, secreted, misused or destroyed;
    • Any statement made by you in your application for credit is untrue
    • Our receipt of information that you are unable or unwilling to perform the terms or conditions of this Agreement;
    • You become deceased.
      Upon default, all the Cost of Repair and any amounts owing pursuant to this agreement shall, at Our opinion, immediately become due and payable when we take possession of the Asset (and may for that purpose enter upon the premises where the Asset in located), retain the Asset or sell the Asset at a public auction or private sale after payment out of the net proceeds of such sale of all amounts due to us, we shall pay over any surplus to whomsoever is entitled thereto but if such proceeds are not sufficient to pay all Costs of Repair in full, you shall forthwith pay the deficiency to us.
  • All expenses incurred by us in recovering or enforcing payment of the Cost of repair or any part thereof or realizing upon the Asset, including expenses of taking possession and realizing upon the Asset shall be added to and deemed to be part of the Cost of Repair, shall bear interest at the rate of thirty-six (36%) per annum and be hereby secured.
  • We may if permitted by law, in order to recover any amount owing to us hereunder, pursue either singularly or concurrently the remedy of legal action against you and the remedy of taking possession and selling the Asset and shall not be precluded by the exercise of either remedy from proceeding to exercise the other remedy or any other remedy we may possess.
  • This Agreement shall be interpreted under and governed by the laws of the province in which you reside and the federal laws of Canada applicable therein, asset out on the front page hereof. If any provision hereof or the application of any provision to any person or circumstances is held invalid or unenforceable, the remainder hereof and the application of such provision to other persons or circumstances shall remain valid and enforceable.
  • Notwithstanding any other provisions of this Agreement or any other document entered into in connection with this Agreement, you shall not be obliged to make any payments of interest or any other amount payable to us hereunder or under any other document entered into in connection with this Agreement in excess of an amount or rate which would be prohibited by law or would result in the receipt by is of interest at a criminal rate (as the terms “interest” and “criminal rate” are defined under the Criminal Code (Canada)).
  • You hereby acknowledge receipt of a copy of this Agreement and hereby waive the right to receive a copy of any financial statement, financing change statement or verification statement registered by us or our assigns. You hereby appoint the repairer to act as your attorney to receive the reification statement.
  • You accept as a notice in writing of and consent to Repairer its assignees or transferees, obtaining or exchanging any information about you at any time from any credit bureau, your employer or any others in connection with this Agreement.
  • This Agreement together with the documents attached hereto, incorporated herein by reference or entered into in connection with this Agreement, is the sole and entire agreement between the parties, and supersedes all prior oral or written agreements relating to the subject matter herein.
  • Each party agrees that the electronic signatures, whether digital or encrypted, of the parties included in this Agreement, are intended to authenticate this writing and to have the same force and effect as manual signatures. “Electronic signature” means any electronic sound, symbol, or process attached to or logically associated with a record and executed and adopted by a party with the intent to sign such record, including facsimile or email electronic signatures. Delivery of an executed copy of this Agreement by facsimile or electronic transmission constitutes valid and effective delivery.

IN WITNESS HEREOF, the parties hereto have executed this agreement dated


Add your Initials:



Authorized Signature:  



Capitalized terms not defined herein have the meanings given to them in the Service Payment Plan (the “Agreement”) to which this assignment agreement (the “Assignment”) is affixed.


For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Repairer and the Lender hereby agree as follows:

  • Assignment and Assumption
    • The Repairer hereby assigns all of its rights, title and interest in and to the Agreement, including the non-possessory lien and security interest over the Asset, to the Lender, subject to the terms and conditions of this Assignment set out below The Lender hereby assumes all of the obligations of the Repairer under the Agreement and agrees to pay to the Cost of Repair (as defined in the Agreement) to the Repairer in full on the date of this Assignment in consideration for the Repairer entering into this Assignment.
  • Representation and Warranties

    The Repairer hereby represents and warrants to the Lender that:

    • The Repairs have been completed in accordance with industry standards and were accepted by the Customer;
    • the Customer authorized the Repairer to charge for the Repairs in writing, or if the authorization was not given in writing, the Repairer recorded the name of the person giving the authorization, the time and date of the authorization, and the phone number of the person giving the authorization (if given by phone), or other contact information for the person giving the authorization (if not by phone);
    • all amounts charged for the Repairs were for materials and services properly rendered and the Repairer is not aware of any claim by the Customer that there is any defect in such materials or services;
    • the Repairer applied labour, skills and/or material to the Asset for the purpose of altering, improving and/or restoring it or maintaining its condition;
    • the Repairs were made to the Asset while in the Repairer’s possession;
    • prior to commencing the Repair, the Repairer either (i) provided the Customer with a written estimate of the cost for the Repairs in compliance with all applicable laws, rules and regulations, such estimate by greater than 10% (or such other number as may be required by applicable law) without charging for the estimate, or (ii) offered the Customer a written estimate, which the Customer declined, and the Customer authorized a maximum amount that he or she would pay for the Repairs, and the Cost of Repair does not exceed such amount;
    • the Repairs are compliant with all applicable laws, rules, and regulations, and prescribed requirements thereunder, and create an enforceable non-possessory lien against the Asset in accordance with applicable legislation;
    • possession of the Asset was delivered to and accepted by the Customer on the date of this Assignment;
    • this Assignment is a legal, valid, and binding obligation of the Repairer, enforceable against it in accordance with its terms; and
    • all other facts and signatures set forth in this Agreement are true and correct.
  • Indemnification
    • If any of the foregoing representations and warranties of the Repairer prove to be untrue in any material respect then (in addition to any other right or remedy available to the Lender), the Repairer agrees, upon demand by the Lender, to repay the outstanding Principal Amount under the Agreement plus all accrued and unpaid interest at the Annual Percentage Rate following default and before and after judgment and all other costs, fees, and charges incurred by the Lender related thereto, and the Repairer further agrees to indemnify and hold harmless the Lender for any other loss or damage suffered by the Lender as a result of the breach of any such representations and warranties.
  • Further Assignment
    • This Assignment may be assigned by the Lender to any other party without notice or approval of the Repairer.
  • Interpretation, Choice of Law and Venue
    • This Assignment shall be interpreted under and governed by the laws of the Province of Ontario and the federal laws of Canada applicable therein. Headings are for convenience only and shall not be referred to in the interpretation of this Assignment. Any action or proceeding arising out of or based upon this Assignment may be instituted in the courts of the Province of Ontario in the City of Toronto, and each party irrevocably submits to the exclusive jurisdiction of such courts in any such action or proceeding.
  • Electronic Signatures and Electronic Delivery
    • Each party agrees that the electronic signatures, whether digital or encrypted, of the parties included in this Assignment are intended to authenticate this writing and to have the same force and effect as manual signatures. “Electronic signature” means any electronic sound, symbol, or process attached to or logically associated with a record and executed and adopted by a party with the intent to sign such record, including facsimile or email electronic signatures. Delivery of an executed copy of this Assignment by facsimile or electronic transmission constitutes valid and effective delivery.

IN WITNESS HEREOF, the parties hereto have executed this Assignment dated as of the first date written above.



I have the authority to bind the company
Repairer: .

Authorized Signature:



You hereby agree and consent as follows:

  • To the terms of autologiQ's Privacy policy which are incorporated herein by reference and can be found at
  • To receive information about new products and services from autologiQ via e-mail, telephone, or similar electronic account. You can withdraw your consent to receive these messages at any time by contacting autologiQ as noted above; however, autologiQ may continue to communicate with you electronically in relation to the provisions of this agreement.
  • You agree to make all payments due hereunder to autologiQ or as they may otherwise direct in writing and by signing below you hereby acknowledge that you have notice of assignment to autologiQ.



Add your Initials

Authorization regarding Pre-Authorized Payments (to be completed for each
separate pre-authorized account, if more than one account to be debited)

Type of service (Check one):


You (which in this section only of this agreement also includes any person who has signed below as holder of a PAD account (defined below)) authorize us to debit your account indicated below or such other replacement account as indicated on a new void specimen cheque provided by you (each, a “PAD Account”), with the amount of each Regular Payment on the due date thereof (indicated on page 1).
Plus all other amounts that you may owe to us under this agreement on the due date of any scheduled regular payment. In each case, if the date that such debit is to be made is not a business day, then the debit will be made on the next business day. The foregoing payment amounts and the due dates thereof may change, but by signing this pad authorization you waive any requirement that we provide you with pre-notification of any such change(s). You also authorize us from time to time to debit the PAD Account for prepayments and other amounts, which authorization will require a password, secret code or another equivalent of your signature which will constitute valid authorization for the Processing Institution (defined below) to debit the PAD Account for such amounts. We may re-debit to your PAD Account any payment that is rejected by your Processing institution for any reason, including insufficient funds. You acknowledge that this authorization is for the purposes of persona pre-authorized debits.

Attach VOID cheque or bank form when returning this agreement to us

Account Number_________________________________________________________

Transit Number_________________________________________________________

Branch _________________________________________________________

Branch Address_________________________________________________________

You acknowledge that this authorization is being provided for our benefit and the benefit of the financial institution where the PAD Account is held (the “Processing Institution”) and is being provided in consideration of such Processing Institution agreeing to process pre-authorized debit requests (each, a “PAD”) against the PAD Account in accordance with the rules of the Canadian Payments Association.

You may cancel this authorization at any time by giving 30 days prior notice to autologiQ or its assignee. Such notice may be in writing or maybe given orally (if we are able to verify your identity). If you cancel this authorization and do not provide us with alternative pre-authorized debit instructions acceptable to us at least two weeks before the next date that the debt is to be made, you must still arrange for payments to be made in accordance with the terms of this agreement. This authorization only applies to the method of payment under this agreement and neither this authorization nor cancellation thereof affects your obligations under this agreement. To obtain a sample cancellation form, or for more information on your right to cancel a PAD agreement, you may contact your financial institution or visit

You acknowledge: (i) that this authorization to us also constitutes delivery thereof by you to the processing institution, and (ii) that the processing institution is not required to verify that each PAD submitted by us has been issued in accordance with this authorization (including the amount) or that the purpose of the payment for which a PAD was made has been fulfilled as a condition of honoring a PAD.

You may dispute a PAD if (i) it was not drawn in accordance with this authorization or (ii) you have canceled this authorization. In order to be reimbursed for a disputed PAD, you must deliver a written declaration that either (i) or (ii) above took place, to the processing institution within 90 days after the date that the disputed PAD was posted to the PAD account, and if you don't, the disputed PAD must be resolved between yourself and us. You have certain recourse rights if any debit does not comply with this PAD agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD agreement. To obtain more information on your recourse rights, you may contact your financial institution or visit

You warrant to us on a continuing basis that all persons whose signatures are required to deal with the PAD account have signed this authorization or have provided a separate authorization, and you agree to provide us with updated information in writing concerning any change to the PAD account. A processing fee of $5 per item may be applied to your account for each payment that us not received by PAD or other electronic means.

We may assign this authorization at any time, directly or indirectly, by operation of law, change of control, or otherwise. In such event, we will notify you in writing of the assignment and the identity and contact information of the assignee.

You may contact AutologiQ

By mail at: PO Box 60085 OAKVILLE RPO GLEN ABBEY, ON, L6M 3H2

1X9 By e-mail at:

By telephone at: 1 (888) 929-6476



Required Documents

Payment Information


Drivers License

Other Documents

Signature of PAD Account Holder

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Signature Certificate
Document name: Contract - RSA
lock iconUnique Document ID: dcda7d11cf47d71f5e9117090556475a6392c982
Timestamp Audit
July 18, 2022 5:35 am ESTContract - RSA Uploaded by John Brereton Brereton - IP
August 4, 2022 8:17 am ESTautologiQ EMP - added by John Brereton Brereton - as a CC'd Recipient Ip:
August 4, 2022 10:20 am ESTautologiQ EMP - added by John Brereton Brereton - as a CC'd Recipient Ip:
February 11, 2023 7:53 am ESTautologiQ EMP - added by John Brereton Brereton - as a CC'd Recipient Ip:
November 7, 2023 5:59 am ESTautologiQ EMP - added by John Brereton Brereton - as a CC'd Recipient Ip: