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MAINTENANCE PLAN APPLICATION, TERMS & CONDITIONS NEW AND USED VEHICLES REGISTRATION INFORMATION i.- I;i ,._/.I, ACCOUNTING L N C O L N PROTECT Vehicle Identification Number "VIN" 1 F M 5 K $ A R 9 17 D[ Its H G C B 1 7 3 1 3 1 3-' Signature Date Warranty Stant Date 07/13/2017 05/30/2017 ❑X Gas/Hybrid Internet Sale IPP Term Current Mileage ❑Diesel ❑ Yes No ❑ 226 ❑ Electric Surcharges 12 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) ❑CPO i� 36 months/36,000 miles (Ford and Competitive Make or 48 month/50,000 miles (Lincoln vehicles) (PMP Only - Not 72 applicable for CPO) Incomplete ❑ Snow Plow (PMP Only - Not applicable for PMP E, PMP L, PMP BL or PMP CPO) $ 2680.00 Specialty - Emergency (fire, ambulance, all police pursuit units (except Ford Police Interceptor)), limo, livery, shuttle, tow trucks - (Gas/Hybrid, Diesel and Lincoln Premium Maintenance Plans Only) ❑ Medium Duty PREMIUM MAINTENANCE PLANS : GaslHybrid, Electric, Diesel, Lincoln, Black Label, Incomplete (Cab/Chassis), Medium Duty, CPO - (Standard $0 Deductible LIMITED, BASIC AND ENGINE MAINTENANCE PLANS: Gas]Hybrid and Diesel- [Standard $0 Deductible) For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle limited Warranty Start Date and Zero Miles. Coverage ENDS at THE EARLIER F the Number of Years Purchased, the Number of Miles Purchased or upon completion of the Maximum Number of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles. For LIMITED BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage. Coverage ENbS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage. PLAN COVERAGE Plan Name Plan Term Plan Expiration (Earlier of) Purchase Sales Tax Total Purchase Address 2 700 -7th Avenue Months Mileage Date Mileage Price State Price with Sales Tax Premium Maintenance 72 100000 05/30/2023 100000 $ 2680.00 $ 225.12 $ 2905.12 Premium Maintenance ❑ First Day Rental (Not applicable on Black Label 2416 Model Maintenance ❑Full Synthetic Oil (Not applicable on fully Plan Options Years and Prior, Incomplete or Medium Duty Plans) Plan Options Electric, CPO, BMP and EMP) Pick Up and Delivery Option (Lincoln only -excluding Fleet vehicles) Service Intervals ❑ 3,000"X❑ 5,000 ❑ 7,500 ❑ 10,000+ Service visits "Not available on PMP Plans. +only service interval available for PMP Electric 20 DISCLOSURE INFORMATION NOTE: THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN FINANCING FOR A MOTOR VEHICLE. 1 acknowledge receipt of a complete copy of this Maintenance Plan (the Application, Terms and Conditions constitute the "Entire Maintenanc Plan') at the time of signing and agree to. all the terms andel onditions. ! agree to main ain the covered vehicle in accordance with the manufacturer's stated periodic maintenance recommendations as a condition Vain coverage under this Maintenance Plan except as otherwise provided by late. MAINTE N/PURCHASER Signatu of Va' itho Signature) Signature Date 01-13[241.7 Name Address KITTITAS COUNTY 307 W UMPTANUM RD City State Zip Code E-mail Address _ Maintenance Plan Lienholder Name ELLENSBURG WA 98926 NONE n1=A1 PRCf-IIP IIUIFf%PRAAT1nN Dealership Signature Dealer Name Columbia Ford, Inc. Address 1 Address 2 700 -7th Avenue City State Longview WA Telephone No Zip Code 98632 Em Io ee Stars Id P&A Code 0 0 2 4 7 7 5 1 4 Lo -Le -L6 o 2 1 FOR OFFICE USE ONLY ESP 8324 - MNTC (Oct 16) (Previous Editions May Not be Used) L_