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MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />Vehicle Identification Number ("VIN") 117 Dian <br />Internet Sale <br />R'ECEIV'ED <br />KITTITAS COUNTY SHERIFF <br />ACCOUNTING Y It e— <br />Warranty Start Da <br />05/11/2017 <br />Signature Date <br />0 7 3 4 07/20/2017 <br />IPP Term Current Mileage <br />(jilak T L I N C O L N <br />PROTECT <br />O Gas/Hybrid <br />❑ Diesel <br />❑ Yes ["] No❑� 218 ❑ Electric <br />Surcharges 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) ❑CPO <br />36 months/36,000 miles (Ford and Competitive Make or 48 month/50,000 miles (Lincoln vehicles) (PMP Only - Not <br />applicable for CPO) <br />❑ Snow Plow (PMP Only - Not applicable for PMP E, PMP L, PMP BL or PMP CPO) incomplete <br />Specialty - Emergency (fire, ambulance, all police pursuit units (except Ford Police Interceptor)), limo, livery, shuttle, tow <br />trucks - (Gas/Hybrid, Diesel and Lincoln Premium Maintenance Plans Only) ❑ Medium Duty <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 ENGINE MAINTENANCE PLANS : Gas/Hybrid and Diesel- (Standard $0 Deductible <br />For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warranty Start ate and Zero Miles. <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purdhased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles, <br />For LIMITED, BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage. <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage, <br />PLAN COVERAGE <br />Plan Name <br />Plan Term <br />Plan Expiration (Earlier of) <br />Purchase <br />Sales Tax <br />Total Purchase <br />State <br />WA <br />Zlp Code <br />98632 <br />Months Mileage <br />Employee Stars Id_ <br />Mileage <br />Price <br />o 1 <br />price with Sales Tax <br />Premium Maintenance <br />7 <br />60 <br />125000 <br />_Date <br />05/2022 <br />0 <br />125000 <br />$ 3135.00 <br />$ 263.34 <br />$ 3398.34 <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'" L^1 5,000 ❑ 7,500 ❑ 10,000+ <br />Service visits <br />*Not available on PMP Pians. +only service interval available for PMP Electric <br />25 <br />11J1QVL.V0UMr_ Ir4rvmjvif' i iv[V <br />NOTE: THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN <br />FINANCING FOR A MOTOR VEHICLE. <br />l acknowledge p <br />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 to all the terms an conditions. l agree to maintain the covered vehicle in <br />accordance with the manufacturer's stated periodic maintenance recommendations as a condition of receiving coverage under <br />this Maintenance Plan except as otherwise provided by law. <br />1AIN I ENANGE PLAN/PURL <br />Signature (Not Valid without Signature) <br />MEA-THER-S`elBERT <br />Signature Date <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 NONE <br />nQA1 Q®QUID 1K1Cn0nnAr1nK1 <br />Dealership Signature <br />BETH SHEETS <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 />Zlp Code <br />98632 <br />Telephone No <br />Employee Stars Id_ <br />P&A Code <br />0 8 6 0 2 <br />a <br />o 1 <br />2 <br />14 <br />7 <br />7 <br />5 <br />� <br />ESP 8324 - MNTC (Oct 16) (Previous Editions May Not be Used) <br />