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NATIONAL VEHICLE SERVICE CONTRACT <br />APPLICATION, TERMS & CONDITIONS <br />(All vehicles up to and including Transit and F-550) <br />RFGISTRATInN INFnRMATInN <br />RECEIVED <br />r ` 1 <br />KITTITAS COUNTY SHERIFF <br />ACCOUNTING <br />1A F T <br />(JIM 00 LI NCCLN <br />PROTECT <br />Vehicle Identification Number <br />Signature Date <br />07/20/2017 <br />Warranty Start Date <br />05/11/2017 <br />❑CPO <br />1 1 F <br />I T <br />F <br />W <br />1 1 <br />E J F <br />5 <br />1 H <br />K <br />I D <br />1 2 <br />0 <br />7 <br />3 1 4 <br />Internet Sale <br />Yes XL] N, <br />Current Mileage <br />Current Hours* <br />IPP Term <br />f <br />Incomplete <br />Q(Cab/Chassis) <br />$ 292,74 <br />218 <br />Options FX First Day Rental Delete ❑ Enhanced Rental [:] Key Services Delete (New Plans only) ❑ Interior/Exterior Lighting Delete (New Plans only) <br />1 <br />Plan Name B <br />Surcharges : <br />F112 Months/12,000 Miles n36 months/36,000 miles (Ford and Competitive Make or 48 months/50,000 miles (Lincoln vehicles) <br />Limo/Livery Wrap <br />Turbocharger/Supercharger [:] Snowplow X Commercial Use 0 Specialty - Emergency (Fire, Ambulance) <br />E]Component Wrap <br />Specialty - Emergency (Fire, Ambulance, Police pursuit units - except Ford Police Interceptor), Limo, Livery, Shuttle, Tow Truck) <br />(Non -CPO) <br />••"•• •^•• _"•"•"5" `�•`• � •�-, •+u .-, y., �-, 1 Il ulnvnnG kV IallUalU you Ui'UUIC 13 y IVV) <br />LeaseCARE •New PremiumCARE with Wear Items - (Standard Deductible is $0) <br />Rental Care - (RentaICARE- Standard Deductible is $0) <br />Super Duty Coverages - (Diesel EngineCARE, Diesel EngineCARE Plus - Standard Deductible Is $100) <br />Used Plan Coverage: Core (PowertrainCARE, BaseCARE, ExtraCARE, PremiumCARE - Standard Deductible is $100) <br />PLAN rnVFRAC.F n New Plan n uRPd Plan <br />Plan Name A <br />Deductible <br />Plan Term TT <br />Plan Expiration - (Earliest of all 3) <br />Purchase <br />Sales Tax <br />Total Purchase Price <br />307 W UMPTANUM RD <br />_ <br />Months Mileage Hours* <br />Date Mileage Hours* <br />Price <br />Service Contract Lienholder Name <br />with Sales Tax <br />PremiumCARE <br />$100 <br />60 <br />125000 <br />Telephone No <br />052022 <br />125000 <br />$ 3485,00 <br />$ 292,74 <br />$ 3777,74 <br />Options FX First Day Rental Delete ❑ Enhanced Rental [:] Key Services Delete (New Plans only) ❑ Interior/Exterior Lighting Delete (New Plans only) <br />Key Services Opt -In (Used Plans only) [:] Interior/Exterior Lighting Opt -In (Used Plans only) F-] PDL (Lincoln Only) <br />Plan Name B <br />Deductible <br />Plan Term <br />Plan Expiration • (Earliest of all 3) <br />Purchase <br />Sales Tax <br />Total Purchase Price <br />Months Mileage Hours* <br />Date Mileage Hours* <br />Price <br />with Sales Tax <br />$ <br />$ <br />$ <br />Options First Day Rental Delete n Enhanced Rental Key Services Delete (New Plans only) [] Interior/Exterior Lighting Delete (New Plans only) <br />Key Services Opt -in (Used Plans only) Interior/Exterior Lighting Opt -In (Used Plans only) n PDL (Lincoln Only) <br />*Super Duty and Incomplete Vehicle Plan Coverages require current hours and expiration <br />hours for all vehicles with an hour meter, <br />Total <br />$3485.00 <br />$292,74 <br />$ 3777.74 <br />L OLPLUJUKC IIVI-VKIVIHI IUIV: <br />THE PURCHASE OF THIS AGREEMENT IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN FINANCING FOR A MOTOR VEHICLE. YOU MAY <br />PURCHASE THE SERVICE CONTRACT BY CASH OR UNSECURED CREDIT CARD. IF YOU ELECT TO PURCHASE THIS AGREEMENT, IT GIVES YOU <br />SPECIFIC LEGAL RIGHTS, WHICH MAY VARY FROM STATE TO STATE. I acknowledge receipt of a complete copy of this Application and Terms and <br />Conditions (the "Agreement") at signing and agree to all the terms and conditions. I agree to maintain the covered vehicle In accordance with the manufacturer's <br />stated periodic maintenance recommendations as a condition of receiving coverage under this Agreement, except as otherwise provided by law. <br />Mississippi Residents Only: By signing below, I agree to the Washington Residents Only: By initlaling this box, I acknowledge I have reviewed <br />binding arbitration language in the Mississippi Section. with Dealer the section of this Service Contract titled, What This Agreement Covers <br />and What is Not Covered, Your Responsibilities for Care of the Vehicle, Implied <br />Signature (not valid without Signature) Warranty of Merchantitibility and Your and Our Rights to Cancel Agreement. <br />;FRVICF rOKITRArT I-Inl nFR / PIIRruACPR <br />Signature (Not Valid without Signature) <br />Signature Date <br />CIAi.�' 11 fir <br />—07/2tf/20T7— <br />Name <br />Address <br />KITTITAS COUNTY <br />307 W UMPTANUM RD <br />City <br />State <br />Zip Code <br />E-mail Address <br />Service Contract Lienholder Name <br />ELLENSBURG <br />WA <br />98926 <br />NONE <br />I■1 .lw aIJI\1 I.d INA aill I-11■,NI J11 <br />Dealership Signature <br />BETH SHEETS <br />Dealer Name <br />Columbia Ford, Inc. <br />Address 1 <br />Address 2 <br />700 -7th Avenue <br />City <br />State <br />Longview <br />WA <br />Zip Code <br />Telephone No <br />98632 <br />Employee Stars Id <br />P&A Code <br />0 8 6 0� <br />0 <br />0 <br />2 <br />1 4 <br />1 7 <br />7 <br />1 6:= <br />ESP 8240 -Nat App/Provs W/Key(July 17) (Previous Editions May Not Be Used) <br />