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RECEIVED MAINTENANCE PLAN APPLICATION, TERMS & CONDITIONS ~ I FORD PROTECT NEW AND USED VEHICLES REGISTRATION INFORMATION KITTITAS CO UNTY SHERIFF ACC O UNTING Vehicle Iden t ifica tion Num ~r ,"VIN ") (.17 Olgl ts) Sign ature Da te I Warranty Start Date 1 1 1 F I T I 7 1 w I 2 1 BI6 1 6 1 G I E I C I 2 1 5 J l 1 1 1 2 J 05/04/2016 05/04/2016 Internet Sale Current Mileage 0 Yes IZI No 59 Surcharges o 12 Month/12,000 Miles (PMP Only -Not applicable for CPO) o Snow Plow (PMP Only -Not applicable for PMP E, PMP L, PMP BL or CPO) IZI SpeCial%-Emergency (fire, ambulance, all police), limo, livery, shuttle, tow trucks - (Gas/Hy rid, Diesel and Uncoln Premium Maintenance Plans Only) IZI Gas/Hybrid o Diesel o Electric o CPO o Incomplete o Medium Duty . -. PREMIUM MAINTENANC E PLANS : Gas/Hy bri d, Electnc, D iesel, Lincol n, Black Label, Incomplete (Cab/ChassIs), Medium Duty. (PO - (Sta ndard ~O Ded uctible) LIMITED, BASIC AND ENGIN E MAINTENANCE PLANS: Gas/H y brid and DieSe l-(Standard SO Deductible) For Premiu m Mai ntenance Plans (PMP ) covera g e BEGINS at the New Vehicl e limited Warran t y St art Dat e and Zero Miles. Coverage ENDS at TijE EARLI ER OF the Number o f Years PurchCl sed, ,t he Number of Miles Purchased or upo n completion of t he Maximum Number ,of Service Lnt ervals Purc hase d from th e Ne w Vehicle LImited Warra n ty Start Date o r Zero Miles, - For LIMITED, BASIC AND ENGINE Mai ntenance Plans coverage BEG I NS at the Signat ure Date .and CUrrent M il eage. Coverage ENDS at THE EARLIER OF t he Nu m ber o f Years Pu rc hased. the Nu m ber of M il es Pu rchase d o r upon com pleti o n o f the Max imum Num b er of Service Intervals Purc hased fro m the Sig nature Dat e or Curre nt M ileage. PLAN COVERAGE Plan Name Plan Term Plan Expiration (Earlier of) Purchilse Price Sales Tax Total Purchilse Months Mileage Date Mileage Price with Silles TiIX Premium Maintenance 60 1125000 05/0412021 1125000 $ 3,135 .00 $ 269 .61 $ 3,404.61 Premium Mai~tenance I 0 First Day Rental (Not available on Incomplete or Plan Options Medium Duty Plans) Milinten~nce I 0 Full Synthetic Oil (Not available on Lincoln, Black Label, Electric, Plan Options CP Incomplete Plans and Medium Duty) Service Intervals Service visits o 3,000' IZI 5,000 0 7,500 0 10,000+ 25 "Not available on PMP Plans. +only service interval available for PMP Electric DISCLOSURE INFORMATION NOTE: THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN FINANCING FOR A MOTOR VEHICLE. I acknowle dge rec eipt of a comple te copy of this Mainte nance Pl an (the Application, Terms and Condlrl ons constitute the. ''Entire Maintenance Plan'? ot the time of sign ing and agr.ee to all tft e terms an d co nditions. I ag ree to main tain the covered ve hicle in acc ordance with the manufactu rer's stare d periodiC maintenance reco mm endatIon s as a co ndition of rec eiving co verage under this Mainten ance Plan except as otherwise provided by law. MAINTENANCE PLAN/PURCHASER KITIITAS COUNTY SHERIFF 'S OFFICE Cty ELLENSBURG DEALERSHIP INFORMATION State WA Dealership Signature /""L OriginaI S lgne~~ Dealer Name~ .. -" Corwin Ford Tri-Cities Address 1 1225 North Autoplex Way n ty Pasco Zip Code 99301 Employee Stars Id I I I I I I I I I I ESP 8324 -MNTC (Oct 15) (Previous Editions May Not be Used) Address 307 UMPTANUM RD Zip Code 98926 Address 2 State WA Telephone No P&ACode I o I 6 I 4 I 6 Signature Date /0 05/04/2016 E-mail Address Maintenance Plan lienholder Name FOR OFFICE USE ONLY [ 7 I