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NATIONAL VEHICLE SERVICE CONTRACT <br />APPLICATION, TERMS & CONDITIONS <br />(All vehicles up to and including Transit and F-550) <br />REGISTRATION INFORMATION <br />RECEIVED <br />JUL18 K'd <br />KITTITAS COUNTY SHERIFF <br />ACCOUNTING <br />17a% <br />1A ❑ -+- <br />LIN 1. L N <br />PROTECT <br />Vehicle Identification Number <br />Signature Date <br />07/13/2017 <br />Warranty Start Date <br />05/30/2017 <br />1:1 CPO <br />1 I F I M 1 5 K <br />8 1 A I R 1 5 1 H I G I C <br />8 <br />1 77= <br />' <br />Internet Sale <br />Current Mileage <br />Current Hours* <br />IPP Term <br />Incomplete <br />Yes QX No <br />5 <br />60 <br />ElEl(Cab/Chassis) <br />Surcharges : <br />0 Limo/Livery Wrap <br />E] 12 Months/12,000 Miles F—] 36 months/36,000 miles (Ford and Competitive Make or 48 months/50,000 miles (Lincoln vehicles) <br />$ 3450.00 <br />0 Turbocharger/Supercharger E] Snowplow Q Commercial Use 0 Specialty - Emergency (Fire, Ambulance) <br />Component Wrap <br />Specialty - Emergency (Fire, Ambulance, Police pursuit units - except Ford Police Interceptor), Limo, Livery, Shuttle, Tow Truck) <br />(Non -CPO) <br />New Plan Coverage : Core - PowertrainCARE, BaseCARE, Extra CARE, Prem lumCARE (Standard Deductible is $100) <br />LeaseCARE - New PremiumCARE with Wear Items - (Standard Deductible is $0) <br />Rental Care - (RentaICARE- Standard Deductible is $O) <br />Super Duty Coverages - (Diesel EngineCARE, Diesel EnginaCARE Plus - Standard Deductible is $100) <br />Used Plan Coverage: Core (PowertrainCARE, BaseCARE, ExtraCARE, PremiumCARE - Standard Deductible is $100) <br />PLAN COVERAGE n New Plan n Used Plan <br />Plan Name A <br />Deductible <br />Plan Term <br />Plan Expiration - (Earliest of all 3) <br />Purchase <br />Sales Tax <br />Total Purchase Price <br />307 W UMPTANIUM RD <br />City State <br />Months Mileage Hours* <br />Date Mileage Hours* <br />Price <br />ELLENSBURG WA <br />with Sales Tax <br />PremiumCARE <br />$0 <br />60 <br />100000 <br />1 05/30/2022 <br />100000 <br />1 <br />$ 3450.00 <br />$ 289.80 <br />$ 3739.80 <br />Options QX First Day Rental Delete F—] 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) ❑ PDL (Lincoln Only) <br />Plan Name B <br />Deductible <br />Plan Term <br />Plan Expiration - (Earliest of all 3) <br />Purchase <br />Sales Tax I <br />Total Purchase Price <br />7 1 7 1 5 1 1 1 4 <br />Months Mileage Hours* <br />Date Mileage Hours* <br />Price <br />with Sales Tax <br />$ <br />$ <br />$ <br />Options F] 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) PDL (Lincoln Only) <br />*Super Duty and Incomplete Vehicle Plan Coverages require current hours and expiration Total $3450.00 $289.80 $ 3739.80 <br />hours for all vehicles with an hour meter. <br />L� <br />DISCLOSURE INFORMATION: <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 initialing this box, I acknowledge I have reviewed <br />binding arWration language in the Mississippi Section. with Dealer the section of this Service Contract titled. What This Agreement Covers <br />4 <br />Not Covered, Your Responsibilities for Care of the Vehicle, Implied <br />rcanty of Merchantitibllityand Your and Our Rights to Cancel Agreement. <br />Signature (not valid without Signature) <br />CRRVI C:F rUlz "TRAr.T 14rAl nF:P f P1IRC_NASFR <br />Signature w out Signa <br />Signature Date <br />-7GU 8 l > s l 1.-7 <br />Name <br />Address <br />KITTITAS COUNTY <br />307 W UMPTANIUM RD <br />City State <br />Zip Code <br />E-mail Address <br />Service Contract Lienhoider Name <br />ELLENSBURG WA <br />98926 <br />City <br />NONE <br />DEALERSHM INFORMATION <br />❑ealershi <br />Dealer game <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 1 B 1 6 1 0 2 <br />0 0 1 <br />2 1 <br />4 1 <br />7 1 7 1 5 1 1 1 4 <br />ESP 8240 -Nat App/Provs W/Key(July 17) (Previous Editions May Not Be Used) <br />7 <br />