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NATIONAL VEHICLE SERVICE CONTRACT APPLICATION, TERMS & CONDITIONS (All Vehicles up to and including Transit and F 550 series) REGISTRATION INFORMATION Vllhlcl e ldentlflcatlon Numbu r [l J F[T [7]W [2 [B J 6]6 [G[E [C [2 [5 [1 1 1 1 2 J Internet Sale RECEIVED ~ I FORD PROTECT KITTITAS COUNTY SHERIFF AC C O U I,JT,~ ..... Signature Date Warranty Start Date 05/04/2016 05/04/2016 DCPO Current Hours* IPP Term '[ Current Mileage o Incomplete (CablChassis) 0 Yes ~ No 59 0 D o Limo/Livery Wrap Commercial Use Surcharges: 0 12 Months/12,OOO Miles o TurbochargerlSupercharger o Snowplow [gJ 0 Specialty -Emergency (Fire, Ambulance, Police pursuit units -except Ford police Interceptor), Limo, Livery, Shuttle, Tow Truck) o com~onent Wrap ( on-CPO) New Plan Coverage: Core -PowertralnCARE, BaseCARE, ExtraCARE, PremiumCARE (Standard Deductible IS $100) LeaseCARE -New PremiumCARE with Wear Items on Ford and Lincoln vehicles -(Standard Deductible Is $0) Rental Care -(RentaICARE-Standard Deductible is $0) Super Duty Coverages -(Diesel EngineCARE, Diesel EngineCARE Plus -Standard Deductible is $100) Used Plan Coverage: Core (PowertrainCARE, BaseCARE, ExtraCARE, PremiumCARE -Standard Deductible is $ 1 00) PLAN COVERAGE r8J New Plan 0 Used Plan Plan Name A Deductible Plan Term Plan Expiration -(Earliest of all 3) Purchase Months Mileage Hours* Date Mileage Hours* Price PremiumCARE $100 60 1125,000 I 05/04/2021 1125,000 I $ 3,540 .00 Sales Tax Total Purchase Price with SalesTax $ 304.44 $ 3,844.44 Options o First Day Rental Delete o Enhanced Rental o InteriorlExterlor Lighting Delete Plan Name B Deductible PlanTerrn Plan Expiration -(Earliest of all 3) Purchase Sales Tax Total Purchase Price Months Mileage Hours* Date Mileage Hours* Price with SalesTu J J I I $ $ $ Options o First Day Rental Delete o Enhanced Rental o Interior/Exterior Lighting Delete *Super Duty Coverages and Incomplete Vehicle Plan Coverages require Current Hours and I Expiration Hours for all vehicles with an hour meter. Total $ 3,540 .00 $ 304.44 $ 3,844.44 DISCLOSURE INFORMATION THE PURCHASE OF THIS AGREEMENT IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN FINANCING FOR A MOTOR VEHICLE. YOU MAY PURCHASE THE SERVICE CONTRACT BY CASH OR UNSECURED CREDIT CARD. IF YOU ELECTTO PURCHASE THIS AGREEMENT, IT GIVES YOU SPECIFIC LEGAL RIGHTS, WHICH MAY VARY FROM STATE TO STATE. I acknowledge rece ipt of a complete copy of this Application and the Terms and Conditions (the "Entire Agreement") at the time of signing and agree to all the terms and conditions. I agree to maintain the covered vehicle in accordance with the manufacturer's stated periodic maintenance recommendations as a condition of receiving cov r 'II. U 'I m ell t lh II. ~ vld b l w. 'Mississippi Residents Only: By signing below, I agree to the binding arbitration language in the Mississippi Section. Signature (not valid without Signature) Washington Residents Only: By Initialing this box, I acknowledge I have reviewed with Dealer the section of this Service Contract titled, What This Agreement Covers and What is Not Covered, Your Responsibilities for Care of the Vehicle,lmplied Warranty of Merchantltibility and Your and Our Rights to Cancel Agreement. SERVICE CONTRACT HOLDER I PURCHASER Name KIITITAS COUNTY SHERIFF'S OFFICE City ELLENSBURG DEALERSHIP INFORMATIQN State WA /J Oea lershlpSlgnature . ,c.~ Original Signed by : B /D 0~ ,., \/ Dealer Name L--.-/ Corwin Ford Tri-Cities Address 1 1225 North Autoplex Way City Pasco Zip Code 99301 EmP lree Stars Id I I I I I I I I I Zip Code 98926 Address 2 State WA Telephone No P&ACnde I 0 I 6 I ESP 8240-Nat App/Provs (Oct 15) (Previous Editions May Not be Used) Signature Date 05/0412016 Address 307 UMPTANUM RD "E-maiT Address Service Contract Lienholder Name FOR OFFICE USE ONLY 4 I 6 I 7 I