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MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />RECEIVED <br />L 1 N C Q L N <br />JUN 0 7 2018 <br />PROTECT <br />KITTITAS COUNTY SHERIFF <br />C_C..r) K1TIKIf] <br />Vehicle Identification Number "VIN" 17 Digits) <br />Signature Date <br />Warranty Start Date <br />Gas/Hybrid <br />Sales Tax <br />15 <br />Address 2 <br />Months Mileage <br />Date <br />Mileage <br />Price <br />price with Sales Tax <br />Premium Maintenance <br />72 <br />100000 <br />04/10/2024 <br />100000 <br />1 F <br />MM <br />$ 2902.44 <br />K1 <br />8 <br />11 A <br />I R <br />9 1 J <br />I G <br />I B <br />I 1 1 <br />9 <br />8= <br />❑ Pick Up and Delivery Option (Lincoln only -excluding Fleet <br />06/06/2018 <br />04/10/2018 <br />Internet Sale <br />IPP Term <br />Current Mileage <br />❑ Diesel <br />❑ Yes []X No <br />❑ [==— <br />10 <br />❑ Electric <br />Surcharges E] 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) <br />❑ 36 months/36,000 miles (Ford and Competitive Make or 48 month/50,000 miles (Lincoln vehicles) (PMP Only - Not <br />CPO <br />applicable for CPO) <br />❑ Snow Plow (PMP Only - Not applicable for PMP E, PMP L, PMP BL or PMP CPO) <br />[_1 incomplete <br />Specialty - Emergency (fire, ambulance, police (except Ford Police Interceptor)), limo, livery, shuttle, tow <br />trucks Diesel Lincoln Premium <br />❑ Medium Duty <br />- (Gas/Hybrid, and Maintenance Plans Only) <br />PREMIUM MAINTENANCE PLANS : Gas/Hybrid, Electric, Diesel, Lincoln, Black Label, Incomplete (Cab/Chassis), Medium Duty, <br />CPO - (Standard $0 Deductible <br />LIMITED, BASIC AND ENGIN MAINTENANCE PLANS : Gas/Hybrid and Diesel- (Standard $0 Deductible <br />For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warranty Start ate and Zero Miles. <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles. <br />For LIMITED BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage. <br />Coverage ENbS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage, <br />PLAN COVERAGE <br />Plan Name <br />Plan Term <br />Plan Expiration (Earlier of) <br />Purchase <br />Sales Tax <br />Total Purchase <br />Address 2 <br />Months Mileage <br />Date <br />Mileage <br />Price <br />price with Sales Tax <br />Premium Maintenance <br />72 <br />100000 <br />04/10/2024 <br />100000 <br />$ 2680.00 <br />$ 222,44 <br />$ 2902.44 <br />Premium Maintenance <br />❑ First Day Rental (Not applicable on Black Label 2016 Model <br />Maintenance <br />❑Full Synthetic oil (Not applicable on fully <br />Plan Options <br />years and Prior, Incomplete or Medium Duty Plans) <br />Plan Options <br />Electric, CPO, BMP <br />and EMP) <br />❑ Pick Up and Delivery Option (Lincoln only -excluding Fleet <br />vehicles) <br />Service Intervals <br />❑ 3,000* 0 5,000 ❑ 7,500 ❑ 10,000+ <br />Service visits <br />*Not available on PMP Plans. +only service interval available for PMP Electric <br />20 <br />DISCLOSURE INFORMATION <br />NOTE: THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN <br />FINANCING FOR A MOTOR VEHICLE. <br />I acknowledge receipt of a complete copy of this Maintenance Plan (the A plication, Terms and Conditions constitute the "Entire <br />Maintenance Plan) at the time of signing and agree toall the terms andpcoilditions. I agree to maintain the covered vehicle in <br />accordance with the manufacturer's stated periotic maintenance recommendations as a condition of receiving coverage under <br />this Maintenance Plan except as otherwise provided by law, <br />MAIN -1 ENANGE PLAN/PU <br />Signature (Not Valid without Signature) <br />Signature Date <br />06/06/2018 <br />Name Address <br />KITTITAS COUNTY 307 W UMPTANUM RD <br />City State Zip Code E-mail Address Maintenance Plan Lienholder Name <br />ELLENSBURG WA 98926 <br />nFAI 1=0Q 1D Iw11Znl?nAATInK1 <br />Dealership Signature <br />FOR OFFICE USE ONLY <br />Dealer Name <br />Columbia Ford, Inc. <br />Address 1 <br />700 -7th Avenue <br />Address 2 <br />City <br />Longview <br />State <br />WA <br />Zip Code <br />98632 <br />Telephone No <br />Employee Stars Id <br />P&A Code <br />0 8 1 6 0 2 <br />0 <br />1 2 <br />1 4 <br />7 <br />7 <br />5 <br />1 <br />4 <br />FPI P 8374 - RANT(. ((lrt 17) (Pravinim Priitinnc AAnv Nnt ha I Igarh <br />