Liability Waiver For Continued Used Of A Defective Lithium-Ion Battery, Form - OF47.70-P-3000-02A
Model 447 with Engine 780.701/702
Model 451.390/391/490/491, 453.091/391/491
Model 910 with Engine 780.703
Model all (CAR)
with code ME01 (Electric motor)
Model all (CAR)
with code ME02 (Fuel cell)
Model all (CAR)
with code ME04 (Mild hybrid drive)
Model all (CAR)
with code ME05 (Hybrid drive 85 kW-94 kW variant (incl. plug-in))
Model all (CAR)
with code ME06 (Hybrid drive 60 kW variant (incl. plugin))
Model all (CAR)
with code ME08 (Hybrid drive 75-84 kW VARIANT (INCLUDING PLUGIN))
Model all (CAR)
with code ME10 (Hybrid vehicle (plug-in, PHEV))
| Company-owned sales and service outlet/Agency - Dealer no. | Customer | |||
| Vehicle identification number | Repair order no. | |||
| Serial number of lithium-ion battery | ||||
| Tester: Name | Date | |||
| License plate number | Initial registration | Model | Engine no. | Odometer reading: km/miles |
At the express request of the customer*
Your vehicle has been determined to have damage that requires the high-voltage battery to be replaced and professionally safeguarded according to the manufacturer's specifications.
High-voltage batteries, as installed in your vehicle, may exhibit damage that is not visible. This can lead to a safety risk and, therefore, to damage to persons or property. If you continue to use the vehicle without replacing the high-voltage battery* or if the high-voltage battery is not professionally safeguarded, then the workshop and Mercedes-Benz AG accept no liability for such damage.
On the basis of the determined damage, I hereby declare and confirm:
- that I have been informed by the workshop representative that the high-voltage battery must be replaced due to the extent of the above-mentioned damage, and that the high-voltage battery must be professionally safeguarded. Otherwise, there is a danger to the safety of the vehicle that can also result in potential damage to persons and property, including for third parties.
- that I do not permit the workshop to replace the above-mentioned high-voltage battery.
- that I exempt the workshop from any liability and claims in relation to any negative consequences that may arise in connection with the use* of the vehicle without replacing the high-voltage battery, without prejudice to the workshop.
- that I completely waive indemnity due to damage and additional costs resulting from the use* of the vehicle without replacing the high-voltage battery, and also completely waive legal action on any legal grounds, including in relation to authorities intended to enforce such provisions.
- that I shall make any potential future buyer or user of the vehicle aware of the content of this declaration and the possible risks involve (in connection with the use* of this vehicle.
The exclusion of liability also refers to the respective national organization and the manufacturer Mercedes-Benz AG.
*"Use of the vehicle" also refers to leaving the vehicle purely switched off.
| Ms./Mr. is in agreement with this procedure. He/she indicates that he/she will not assert further claims and that he/she will be liable for any consequential damage. | |
| Date: | Signature of customer*: |
| Date: | Signature of workshop representative: |