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MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />Vehicle Identification Number (nVINn) (17 Digits) <br />I 1 I F I M I 5 I K I 8 I A I R I 2 I FIG I C I 1 I 6 I 7 I 2 I 9 I <br />Internet Sale <br />D Yes [8J No <br />Surcharges D 12 Month/12,000 Miles (PMP Only -Not applicable for CPO) <br />Signature Date <br />12/28/2015 <br />Current Mileage <br />3124 <br />D Snow Plow (PMP Only -Not applicable for PMP E, PMP L, PMP BL or CPO) <br />[8J Special%,-Emergency (fire, ambulance, all police). limo, livery, shuttle, tow trucks - <br />(Gas/Hy rid, Diesel and Lincoln Premium Maintenance Plans Only) <br />~ I ffi LINCOLN <br />PROTECT <br />I Warranty Start Date [8J Gas/Hybrid <br />03/25/2015 <br />D Diesel <br />D Electric <br />DCPO <br />D Incomplete <br />D Medium Duty <br />PREMIUM MAINTENANCE PLANS: Gas/Hybrid, Electric, Diesel, Lincoln, Black Label, Incomplete (Cab/ChasSIS), Medium Duty, CPO - <br />(Standard $0 Deductible) <br />LIMITED, BASIC AND ENGINE MAINTENANCE PLANS: Gas/Hybrid and Diesel-(Standard $0 Deductible) <br />For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warranty Start Date and Zero Miles. Coverage <br />ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of the Maximum Number <br />of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles. <br />For LIMITED, BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage. Coverage ENDS at <br />THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of the Maximum Number of Service <br />Intervals Purchased from the Signature Date or Current Mileage. <br />PLAN COVERAGE <br />Plan Name Plan Term Plan Expiration (Earlier of) Purchase Price Sales Tax Total Purchase <br />Months Mileage Date Mileage Price with Sales Tax <br />Premium Maintenance 72 1100000 03/2512021 1100000 $ 2,480.00 $ 198.40 $ 2,678.40 <br />Premium Mai~tenance I D First Day Rental (Not available on Incomplete or <br />Plan Options Medium Duty Plans) <br />Mainten~nce I D Full Synthetic Oil (Not available on Lincoln, Black Label, Electric, <br />Plan Options CP Incomplete Plans and Medium Duty) <br />Service Intervals Service visits <br />D 3,000* [8J 5,000 D 7,500 D 10,000+ 20 <br />*Not available on PMP Plans. + only service interval available for PMP Electric <br />DISCLOSURE INFORMATION <br />NOTE: THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN FINANCING FOR A <br />'MOTOR VEHICLE. <br />I acknowledge receipt of a complete copy of this Maintenance Plan (the Application, Terms and Conditions constitute the "Entire Maintenance <br />Plan") at the time of signing and agree to all the terms and conditions. I agree to maintain the covered vehicle in accordance with the <br />manufacturer's stated periodic maintenance recommendations as a condition of receiving coverage under this Maintenance Plan except as <br />otherwise provided by law. <br />MAINTENANCE PLAN/PURCHASER <br />Original Signed by: ST <br />Name <br />KITIIT AS COUNTY <br />City <br />ELLENSBURG <br />DEALERSHIP INFORMATION <br />Dealership Signature <br />Original Signed by : JEN NIFER CASTLE <br />Dealer Name <br />Columbia Ford, Inc. <br />Address 1 <br />700-7th Avenue <br />lity <br />Longview <br />Zip Code <br />98632 <br />Employee Stars Id <br />ESP 8324 -MNTC (Oct 15) (Previous Editions May Not be Used) <br />Address <br />307 W UMPTANUM ROAD <br />Zip Code <br />98926 <br />Address 2 <br />St at e <br />WA <br />Telephone No <br />P&ACode <br />E-mail Address <br />Signature Date <br />12/28/2015 <br />Maintenance Plan Lienholder Name <br />NA <br />FOR OFFICE USE ONLY