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NATIONAL VEHICLE SERVICE CONTRACT APPLICATION, TERMS & CONDITIONS (All vehicles up to and including Transit and F-550) REGISTRATION INFORMATION KITTITAS COUNTY SHERIFF ACCOUNTING 1A ❑ + TL N C O L N PROTECT 1 t5 -o (1c Vehicle Identification Number Signature Date 07/20/2017 Warranty Start Date 05/11/2017 ❑CPO 1 1 F I T I F W 1 1 E I F 1 5 1 H j K I p 1 2 0 7 3 4 Internet Sale Current Mileage Current Hours* IPP Term Incomplete ❑ Yes ❑X No 218 $ 292.74 ❑ (Cab/Chassis) Surcharges : ❑ Limo/Livery Wrap ❑ 12 Months/12,000 Miles ❑ 36 months/36,000 miles (Ford and Competitive Make or 48 months/50,000 miles (Lincoln vehicles) Plan Term ❑ Turbocharger/Supercharger ❑ Snowplow ❑X Commercial Use ❑ Specialty - Emergency (Fire, Ambulance) ❑ Component Wrap Specialty - Emergency (Fire, Ambulance, Police pursuit units - except Ford Police Interceptor), Limo, Livery, Shuttle, Tow Truck) (Non -CPO) New Plan Coverage : Core-PowertrainCARE, BaseCARE, ExtraQARE, PremiumCARE (Standard Deductible is $100) Leto s@CARE - New PremiumCARE with Wear Items - (Standard Deductible is $0) Rental Care - (RentalCARE- Standard Deductible is $0) Super Duty Coverages - (Diesel EngineCARE, Diesel EngineCARE Plus - Standard Deductible is $100) Used Plan Coverage: Core (Powe�rtrainCARE, BaseCARE. ExtraCARE, PremiumCARE - Standard Deductible is $100) PLAN COVERAGE Inl New Plan n Used Plan Plan Name A Deductible Plan Term Plan Expiration - (Earliest of all 3) Purchase Sales Tax Total Purchase Price State Zip Code Months Mileage Hours* Date Mileage Hours* Price WA with Sales Tax PremiumCARE $100 60 125000 05/2022 125000 $ 3485.00 $ 292.74 $ 3777.74 Options ❑X First Day Rental Delete ❑ Enhanced Rental ❑ Key Services Delete (New Plans only) ❑ Interior/Exterior Lighting Delete (New Plans only) ❑ Key Services Opt -In (Used Plans only) ❑ Interior/Exterior Lighting Opt -In (Used Plans only) ❑ PDL (Lincoln Only) Plan Name B Deductible Plan Term Plan Expiration - (Earliest of all 3) Purchase Sales Tax Total Purchase Price Months Mileage Hours* Date Mileage Hours* Price with Sales Tax $ $ $ Options ❑ First Day Rental Delete ❑ Enhanced Rental ❑ Key Services Delete (New Plans only) ❑ Interior/Exterior Lighting Delete (New Plans only) ❑ Key Services Opt -In (Used Plans only) ❑ Interior/Exterior Lighting Opt -In (Used Plans only) ❑ PDL (Lincoln Only) *Super Duty and Incomplete Vehicle Plan Coverages require current hours and expiration Total $3485.00 $292,74 $ 3777.74 hours for all vehicles with an hour meter. 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 ELECT TO PURCHASE THIS AGREEMENT, IT GIVES YOU SPECIFIC LEGAL RIGHTS, WHICH MAY VARY FROM STATE TO STATE. I acknowledge receipt of a complete copy of this Application and Terms and 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 stated periodic maintenance recommendations as a condition of receiving coverage under this Agreement, except as otherwise provided by law. Mississippi Residents Only: By signing below, I agree to the Washington Residents Only: By initiating this box, I acknowledge I have reviewed binding arbitration language in the Mississippi Section. 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, Implied rra i4aatitibillty and Your and Our Rights to Cancel Agreement, Signature (not valid wit Signature) fiFRVlr:F r.nNTR .T wynppl Pl1Rr.HASFR Signature (Nat Valid wit f ur Signature Date // g / i S / - rrx=0T7-- - `7 Name Address KITTITAS COUNTY 307 W UMPTANUM RD City State Zip Code E-mail Address Service Contract Lienholder Name 1 ELLENSBURG WA 98926 NONE DEALERSHIP INFORMATION Dealership Signature BETH SHEETS Dealer Name Columbia Ford, Inc. Address 1 Address 2 700 -7th Avenue City State Longview WA Zip Code Telephone No 98632 Employee Stars Id 0 1 0 1 2 1 4 7 1 7 5 1 4 P&A Code 0 1 B 1 6 1 0 1 2 ESP 8240 -Nat ADD/Provs W/Kev(July 17) (Previous Editions Mav Not Be Used)