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MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />KITTITAS COUNTY SHERIFF 1-70.,) <br />nnrIni ie.i-r KIf, <br />� L I N C O L N <br />PROTECT <br />Vehicle Identification Number "VIN" <br />17 Digits) ..S <br />gnature Date <br />Warranty Start Date <br />Gas/Hybrid <br />Total Purchase <br />State <br />WA <br />Zip Code <br />98632 <br />Months Mileage <br />Date <br />Mileage <br />Price <br />0 <br />Price with Sales Tax <br />Premium Maintenance <br />7 <br />72 <br />100000 <br />1 F M <br />5 <br />K 8 <br />A <br />R <br />7 <br />H <br />G <br />C <br />8 <br />7 <br />3 <br />3 2 <br />07/13/2017 <br />05/30/2017 <br />Internet Sale <br />IRP Term <br />Current Mileage <br />Diesel <br />0 Yes [ No <br />1:1 F:,:= <br />187 <br />Electric <br />Surcharges n 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) <br />El 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 />E] Incomplete <br />u 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) <br />Medium Duty <br />y <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 $0 Deductible) <br />For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warranty Start bate and Zero Miles. <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles. <br />For LIMITED BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage, <br />Coverage ENbS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage. <br />PLAN COVERAGE <br />Plan Name <br />Plan Term <br />Plan Expiration (Earlier of) <br />Purchase <br />Sales Tax <br />Total Purchase <br />State <br />WA <br />Zip Code <br />98632 <br />Months Mileage <br />Date <br />Mileage <br />Price <br />0 <br />Price with Sales Tax <br />Premium Maintenance <br />7 <br />72 <br />100000 <br />05/30/2023 <br />100000 <br />$ 2680.00 <br />$ 225,12 <br />$ 2905,12 <br />Premium Maintenance <br />E] 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 />7 3,000* 0 5,000 7,500 710,11, 00+ <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 an (conditions, I 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 />IVIAIN I tNAN(;t FLAN/NUI <br />Signature (Not Valid without Signature) <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 A _ 98926 T_ NONE <br />IIFAI 1=I -QWIP lMl:r)1?MaT1r1A1 <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 T <br />o F8 6 0 2 <br />0 <br />0 <br />2 <br />4 <br />7 <br />7 <br />ESP 8324 - MNTC (Oct 16) (Previous Editions May Not be Used) <br />