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MAINTENANCE PLAN APPLICATION, TERMS & CONDITIONS NEW AND USED VEHICLES REGISTRATION INFORMATION RECEIVED KITTITAS COUNTY SHERIFF ACCOUNTING t<� � LINCOLN PROTECT rd5o 11 oS Vehicle Identification Number "ViN" 1 F T 7 W 2 B 6 7 17 Dig Its H E D 4 5 3 8 7 Signature Date 07/20/2017 Warranty Start Date 05/30/2017 ❑X Gas/Hybrid Internet Sale IPP Term Current Mileage ❑ Diesel ❑ Yes X❑ No ❑ 0 337 ❑ Electric Surcharges 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) ❑ CPO ❑ 36 months/36,000 miles (Ford and Competitive Make or 48 month/50,000 miles (Lincoln vehicles) (PMP Only - Not WA applicable for CPO) ❑Incomplete ❑ Snow Plow (PMP Only - Not applicable for PMP E, PMP L, PMP BL or PMP CPO) X❑ Specialty - Emergency (fire, ambulance, all police pursuit units (except Ford Police Interceptor)), Ilmo, livery, shuttle, tow E] Medium Duty trucks - (Gas/Hybrid, Diesel and Lincoln Premium Maintenance Plans Only) PREMIUM MAINTENANCE PLANS : Gas/Hybrid, Electric, Diesel, Lincoln, Black Label, Incomplete (Cab/Chassis), Medium Duty, CPO - (Standard $0 Deductible LIMITED, BASIC AND ENGINE MAINTENANCE PLANS: Gas/H brid and Diesel- (Standard $0 Deductible) For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warrant Start Date and Zero Miles. Coverage ENDS 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 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 Mires Purchased or upon completion of the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage. PLAN COVERAGE Plan Name Plan TermI Plan Expiration (Earlier of) I PurchaIse Sales Tax Total Purchase Months Mileage Date Mileage f Price Price with Sales Tax Premium Maintenance 60 125000 05/30/2022 1125000 $ 3135.00 $ 263.34 $ 3398.34 Premium Maintenance k Maintenance ❑ First Day Rental {Not applicable on 81ack �at)e12016 Model ❑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) ❑ 110,000+ Service visits .� 25 Service Intervals ❑ 3,000" ❑X 5,000 ❑ 7,500 "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 acknowledge ckno cede Pial'} alof he f complete cop andis Mies to aa1 the Ilan (the�A plication, Terms and Conditions constitute the "Entire lime of rF g, dpconditions. 1 agree to maintain MsI covered vehicle in accordance with the mann acturees statyd periodic maintenance recommendations as a condition o receiving coverage under this Maintenance Plan except as otherwise provided by law. MAINTENANCE PLAN/PURCHASER Signature (Not Valid without na u Signature Date( Name Address KITTITAS COUNTY 307 W UMPTANUM RD City State Zip Code E-mail Address Maintenance Plan Lienholder Name ELLENSBURG WA 98926 NONE IEALERSHIP INFORMATI Dealership Signature BETH SHEETS Dealer Name Columbia Ford, Inc. Address 1 700 -7th Avenue City Longview Zip Code 98632 Employee Stars Id 0 0 1 2 4 1 7 1 7 5 1 4 Address 2 State WA Telephone No P&A Code C o-1- 8 L6 Lol 21 ESP 8324 - MNTC (Oct 16) (Previous Editions May Not be Used) FOR OFFICE USE ONLY