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<br />RECEIVED I
<br />!
<br />I
<br />.l ~; 1 20 ·' c~iv 'eo
<br />.. MAl~TENANCE PLAN APPLICATION,
<br />TERMS & CONDITIONS
<br />NEW ANO USED VEHICLES
<br />1· llTAS coui nv s 1-1 E~fr , .... I m
<br />I,, ti..CC0Jil111 ~ JUN 07 2bt8 ~ Ill LINCOLN
<br />KITTITAS CQUNT~· SHERIFF PROTl!CT
<br />ACC(?UNT~G
<br />Slgnaturo Dale
<br />08/08/2018
<br />warranty 8\alt Data
<br />04/1Q/'Z018 [ igj Oas/Hybrid
<br />lnt,met Sale ..---, Current MIieage
<br />-0 Yes· 18.] No ,I 10 D Electric ----=--------------.,...,..------------~----,..----.-f surcharges D 12 Monlh/12,000 MUea (PMP Only -Nol appacabla ror CPO) . • ! D
<br />0Dleael
<br />D 38. monlhs/38,0()0 rnlres (Ford and CompedUve Maka or 48 mon\h/60,000 mlles (Lincoln vehlolos)'(PMP Only• Not CPO
<br />appllcabli, for CPO) · : • 0 Snow Plow (PMP Only• Nol applloabli ror PMP e, PMP L, PMP BL or PMP CPQ) : Incomplete
<br />[81 Speolalty .• Erner11encylOre, ambulance-, 110noo (except Ford Po llca lnlen:eptOf}°), llmo , llvury, ahulllo, towi D Medium Duty
<br />lrilok& • (Gae/Hybrid , Olasel and Lincoln Prem ium Molnlonanco Plans Only) ,
<br />PREMIUM MAINTENANCE PLANS : Gas/Hybrid, Electrlc, Diesel, Lincoln, Black Label, lncemple'te (Cab/Chassis), Medium Duty, CPO -(Standard $0 DeducUble) . _ i :
<br />LIMITED, BASIC AND ENGINE MAgTENANCE PLANS : Gae/HVbrld ahd Dlesel-.(standa r:d $0 OeducUbleb
<br />For P. remlum Maintenance Plans PMP) coverage BEGIN. s at lhe New Vehicle Limited Warranty Start ate end Zero MIies .
<br />Coverage ENDS at THE EARLi.ER F jhe Number _ oJ Years Pur:qhased, the Number of MIies Pµrchased or '-'Pon completion. of
<br />the Maxtrnum Number of Se. rvlce ln!erva a Purchasetl from the New Vehicle Limited Warranty Sta.~ Date or Zero Mffes. 1 For LIMITED BASIC AND ENGfNE Maintenance Plans coverage BEGINS at the Slgnatyre Date ·and Current Mileage.
<br />Coverage ENbS at THE EA~LIER OF the NUmber of Years Purchased, 'the Number otMlles Purchased or upon cempletlon of
<br />the Maximum Number of Service Intervals Purchased from the Signature Date or Current MIieage. ·
<br />PLAN COVERAGE j
<br />Plan Name Planierm Plan Expiration (Ea1llor of) Pur~h111ej Bales Tax Total PurchaH
<br />Months -MIieage Date Mileage Pi'h:1 . Price with Sale& Tax
<br />I Premium Maintenance 72 110~00 04(10/2024 1100000 $ 2680,00 : $ 222.44 $ 2902.44
<br />Premium Maintenance D F111t Day Ranlal ·(f'!o/ opp/lc,w/o o,n B/eale Label 2018 Model Maintenance 0 Ful ~Syntha\lo OIi (Not appllcab/o on tully Plan Options Yean, and Prior, lncompf(JJ/J o,: Modlum Otlly Plana) Plan Options ' E/lip/rio, 01'0, BMP and EMP}
<br />D Riek Up am! Dellvery Option (Lincoln only-excluding Fleet I I
<br />l
<br />vehicles) !
<br />Service Intervals D 3,ooo• (8J 6,000 07.600_ 0 10,000+ Service visits
<br />•Not avallable on PMP Plana, + only service Interval avallable for PMP Electrlo 20 I
<br />I
<br />DISCLOSURE INFORMATION . I .
<br />NOT~j THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER'.TO PURCHASE, OR OBTAIN
<br />FINANCING FOR A MOTOR VEHICLE. I
<br />l flOkoowledge re;~t ofha !mpfeJe pop! of this Mafnten_?c"f1 Plan (the App/lca~~'P'1 Termsi-and Cond11Qns1~co,nstltuteJhe h"En1 tiro1 Mafnle ance Plan at tie Ima of.s,g_TJTmJ ~nd fJQTJJfJ to a tno IEJrms sna oona tons . I agree /Q l mafn arn e oovEJra ve toe n aooo a.nee with r 'f' manu r:turer's SUI aa perto7ildoo main enence reoommenda ons as a conctll/on o rece v(ng covEJrage under tnls atntenance 1an except as othaPM se provide by"faw. . : ,
<br />MAINTENA LAN/PURCHASER
<br />Name
<br />KlmTAS COUNTY
<br />City
<br />ELLENSBURO
<br />Columbla Ford, Inc,
<br />Address 1 .
<br />700•71h Avenue
<br />City
<br />Longview
<br />Z1p Code
<br />98632
<br />Employee Stars r I o I o I· 2 4 I
<br />Zip Code
<br />98926
<br />Address 2
<br />Slate
<br />"WA
<br />Telephone ·No
<br />FPLP 81124 • MNTC (Oct 17) (Previous EdlUons May Not be Used)
<br />.. .
<br />8
<br />Address
<br />307 W UMPTANUM RD
<br />E-mail Address
<br />Signature Dale
<br />06/06/2018
<br />Maintenance Plan Uenholder Name
<br />FOR OFFICE USE ONLY
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