Laserfiche WebLink
MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />E �'1 u.,, 3 V IFE <br />KITTITAS COUNTY SHERIFF <br />ACCOUNTING I r7 o'?, <br />$ L I N COL N <br />PROTECT <br />Vehicle Identification m� IN" <br />17 Digits)� <br />Signature Date <br />Warranty Start Date <br />Gas/Hybrid Y <br />X GasIH brad <br />Total Purchase <br />KITTITAS COUNTY <br />307 W UMPTANUM RD <br />Months Mileage <br />Date <br />Mileage <br />Price <br />Maintenance Plan Lienholder Name <br />price with Sales Tax <br />Premium Maintenance <br />98926 <br />72 <br />100000 <br />05/30/2023 <br />1 <br />F <br />M <br />5 <br />K$ <br />❑ First Day Rental (Not applicable on Black Label 2016 Model <br />A <br />[R 1 9 <br />H G C <br />8 <br />7 <br />3 <br />3 <br />3 <br />07/13/2017 <br />05/30/2017 <br />0 <br />Internet Sale <br />IPP Term <br />Current Mileage <br />E] Diesel <br />❑ Yes L^J No <br />❑ C= <br />226 <br />[] Electric <br />Surcharges [] 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) <br />❑ CPO <br />❑ 36 months/36,000 miles (Ford and Competitive Make or 48 month/50,000 miles (Lincoln vehicles) (PMP Only - Not <br />Service visits <br />applicable for CPO) <br />El Snow Plow (PMP Only - Not applicable for PMP E, PMP L, PMP BL or PMP CPO) <br />[] Incomplete <br />Specialty - Emergency (fire, ambulance, all police pursuit units (except Ford Police Interceptor)), Iimo, livery, shuttle, tow <br />trucks Lincoln <br />Medium Duty <br />❑ y <br />- (Gas/Hybrid, Diesel and Premium 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 ENGINE MAINTENANCE PLANS : Gas/Hybrid and Diesel- (Standard $0 Deductible) <br />For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warranty Start Date and Zero Miles. <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles. <br />For LIMITED, BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage, <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage, <br />PLAN COVERAGE <br />Plan Name <br />Plan Term <br />Plan Expiration (Earlier of) <br />Purchase <br />Sales Tax <br />Total Purchase <br />KITTITAS COUNTY <br />307 W UMPTANUM RD <br />Months Mileage <br />Date <br />Mileage <br />Price <br />Maintenance Plan Lienholder Name <br />price with Sales Tax <br />Premium Maintenance <br />98926 <br />72 <br />100000 <br />05/30/2023 <br />100000 <br />$ 2680.00 <br />$ 225,12 <br />$ 2905,12 <br />Premium Maintenance <br />❑ First Day Rental (Not applicable on Black Label 2016 Model <br />Maintenance <br />❑ Full Synthetic 011 (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 />0 <br />0_ <br />2 1 <br />4T <br />vehicles) <br />1 <br />4 <br />Service Intervals <br />❑ 3,000* X❑ 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 />1 acknowledge receipt of a complete copy of this Maintenance Plan (the A plica#ion'Te <br />rms and Conditions constitute the "entire <br />Maintenance Plan) at the time of signing and agree to, all the terms andaconditions, /agree to ,maintain ti7e 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 />MAINTENANCE PLAN/PURCHASER <br />Signature (Not Valid without Signature) <br />Signature Date <br />G7=20-1-7— <br />)7/1,3122&17-Name <br />Name <br />Address <br />KITTITAS COUNTY <br />307 W UMPTANUM RD <br />City <br />State <br />Zip Code <br />E-mail Address <br />Maintenance Plan Lienholder Name <br />ELLENSBURG <br />WA <br />98926 <br />NONE <br />Dealership Signature <br />Dealer Name <br />Columbia Ford, Inc. <br />Address 1 <br />Address 2 <br />700 -7th Avenue <br />City <br />State <br />Longview <br />WA <br />Zip Code <br />Telephone No <br />98632 <br />FOR OFFICE USE ONLY <br />Employee Stars Id^ <br />P&A Code <br />Lo $ 6 o z 1 <br />0 <br />0_ <br />2 1 <br />4T <br />5T5_ <br />1 <br />4 <br />ESP 8324 - MNTC (Oct 16) (Previous Editions May Not be Used) <br />