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MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW A~AO USEO VEHICLES <br />RECE\VED I <br />MlS I '1 2ms RE9EIVE• 1 a""'" ~ cour TY S HE.niff JUN O 7 2018 · <br />Kli11TAS 1 , , ~ I PROTECT <br />AC COt:, • T\,,...,. KITTITAS CG>UNTY SHERIFF <br />1 9 8 4 4 <br />8Ignatllro Dato <br />06/06/2018 <br />Internet Sale IPP Term Current MIieage <br />18] Oas/Hybrid <br />QDleael <br />0 Yea Iv! No O I" 10. iaJ • D Electric t----,----;::::=-------,---.--------------------'----..--1 Surcharges O 12 Month/12,000 Milos {PMP Only• Not appllaable for CPO) ! D D 38 monlha/3.~,ooo mllea (Ford and Compollllve Make o~ 48 monlhl50,000 mlle9 (Unco!n vohlcles) {PMP Only. Not CPO <br />applicable for CPO) D 0 Snow Plow (PMP Only· Not applicable fotPMP E, PMP L, PMP BL .or PMP CPO) . Incomplete <br />~Specialty· Ernerg1m13Y. tflre 1 ambulance, poflce (BXCf!Pl Ford_ Pollco Interceptor)), llmo, llvary, shutlle, tow OM di "-•ty tiiJcks • (Gas/HyJJild 1 Dlosel and Unboln Pramfum Melntan!ince Plana Only) : e um .,., <br />PREMIUM ;INTENANCE PLANS : Gas/Hyb~d, Electrlc, Diesel, Llncoln, Black Label, Incomplete (Cab/Chassis), Medium Duty, <br />cPo <br />1 <br />ggtan ard $0 DeducUble\ · 1 <br />LIMI , B SIC AND Ef.!GlNe MAgTENANCE PLANS : Gas/Hybrid and Dl~sel-(standard $Cl Deduotlbleb <br />For Premium Mafntenan-9e P_li!n& PMP.) ,cover:age BEGIN_S at lhe New v _ehlole Limited War.rantv Start 1:1te and Zero MIies, <br />·coverage ENDS at THE l:ARLIER. F the Number of Years Puroh_a.sed, the Number of MIies Purcnased or uP,on completlon of <br />the MaXlmum Number of Service Intervals Purchase9 from the New V:ehlcle Utnlted WarrantM Start Date or Zero Miles. <br />For LIMITED BASIC AND ENGINE Maintenance Plans coverage 6EGINS at the S ~nature Date and Current MIieage. <br />Coverage ENbs al THE EARLIER <br />1 <br />OF the Number of Years Pllro.hased 1 the Number of M es Purchased or upon completioh of <br />the Ma~mum Number of Service ntervals Purchased ft_oin the Signature Date or Current Ml eage. · <br />PLAN COVERAGE ; <br />Plan Name Plan Torm Plan Expiration (Ea rH at of) Purc;hase Sain Tax Total Purchase <br />Montha MIieage Dato MIieage ~flco I Price with Sales Tax <br />Premium Maintenance 72 1100000 04/10/2024 1100000 <br />, I <br />$ 2680.00 I $ 222.44 8 2902.44 <br />Premium Maintenance D First Day Ranlal (Not appHaable on Bleck Label 2016 Model Maintenance -• Ful Synthetic OIi .(Not spplfoab/e qn fully Plan Options Years fll1d Prior, Incomplete or Medium Duty Plans) Plan Options Elactlfo, CPO, BMP and E:MP) <br />D Pick Up and Delivery Option (Lincoln only-excluding Fleet <br />vehicles) · I <br />Service Intervals D s,ooo• ·igi _6,000 0 7,600 0 10,000+ Service visits <br />"Not avall11ble on PMP .Plans. +only service Interval avallable for PMP Electric 20 I <br />DISCLOSURE INFORMATION · . -! <br />NO_' TE: THE PURCHASE OF T1J:IIS MAINTE_NANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN <br />FINANCING FOR ·A MOTOR VEnlCLE , . I . <br />kfa~~i?f~tga~r:8fl;PJt°lh_ i 9frff'lbt:,ggf,Yg ~£Aa1~:,:kntn, :ow:t1::ut:n~Cl:i~tl£1Ji/1':J!l~~ns{._t<:,gg,~!1f!R8th°~ii~:J:Jh:e;;fcrt;~ acoo . ffnpe wilh' t e manuliii:turo, :p 13ta.lk pert.owe; ma ntenanoa recommenclaVons as S" conclli,on o?'reoefv,ng coverage under mis etnc,mance tan ex<;ept as otne,w/se provldea tiy law. , . <br />MAINTEN P URCHASER . , . <br />Signature (Not «lid wl o lgnatu ) Signature Date <br />Name <br />KITTITAS COUNTY <br />Olly <br />ELLENSBURG <br />Jll)llet-Name <br />e'olumble Ford, lno. <br />Address 1 <br />700-7th Avenue <br />City <br />Longview · <br />pCode <br />98632 <br />Employee Siers Id <br />Zip Code <br />98928 <br />Address 2 <br />Slate <br />WA <br />Te!ephone No <br />P&ACode <br />Address <br />307 W UMPTANUM RD <br />E•mall Address <br />I O I 8 I 6 I O I 2 <br />FPI P R."1?4 • MNT~ IOrJ 17, IPrR\llnllR Ftllllnn<i MAV Nnl h .. 1 laDtl\ <br />06/06/2018 <br />Malntsnance Plan Uenholder am11 <br />FOR OFFICE USE ONLY