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MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />KITTITAS COUNTY SHERIFF <br />ACCOUN,rING <br />"iSDD_ � LI NCOI.N <br />PROTECT <br />F -d56 I`los <br />Vehicle Identification Number"VIN'VIN"17 <br />Di Its <br />Signature Date <br />Warranty Start Date <br />d <br />0 Gas/Hybrid <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 />60 <br />125000 <br />05/30/2022 <br />1 <br />F <br />T 7 W <br />2 B <br />6 <br />7 <br />H <br />E <br />D <br />4 <br />5 <br />3 <br />8 <br />7 <br />07/20/2017 <br />05/30/2017 <br />0 <br />0 <br />2 <br />2 <br />4 <br />7 <br />vehicles) <br />5 <br />1 <br />4 <br />Service Intervals <br />[] 3,000* 5,000 ❑ 7,500 [-110,000+ <br />Service visits <br />*Not available on PMP Plans, <br />+only service interval available for PMP Electric <br />25 <br />Internet Sale <br />IPP Term <br />Current Mileage <br />E] Diesel <br />0 Yes QX No <br />Q <br />337 <br />Electric <br />Surcharges [:] 12 Month/12,000 Miles (PMP Only - Not applicable for CPO) <br />CPO <br />0 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 />❑ Plow Only Not for PMP E, PMP L, PMP BL PMP CPO) <br />Incomplete <br />now (PMP - applicable or <br />XS pecalty - Emergency (fire, ambulance, all police pursuit units (except Ford Police Interceptor)), limo, livery, shuttle, tow <br />❑Medium Duty <br />trucks - (Gas/Hybrid, Diesel and Lincoln 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 ENGIN MAINTENANCE PLANS : Gas/Hybrid and Diesel- (Standard $0 Deductible) <br />For Premium Maintenance Plans (PMP) coverage BEGINS at the New Vehicle Limited Warranty Start Date and Zero Miles, <br />Coverage ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the New Vehicle Limited Warranty Start Date or Zero Miles. <br />For LIMITED BASIC AND ENGINE Maintenance Plans coverage BEGINS at the Signature Date and Current Mileage, <br />Coverage ENbS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of <br />the Maximum Number of Service Intervals Purchased from the Signature Date or Current Mileage. <br />PLAN COVERAGE <br />Plan Name <br />Plan Term <br />Plan Expiration (Earlier of) <br />Purchase <br />Sales Tax <br />Total Purchase <br />KITTITAS COUNTY <br />307 W UMPTANUM RD <br />Months Mileage <br />Date <br />Mileage <br />Price <br />Maintenance Plan Lienholder Name <br />Price with Sales Tax <br />Premium Maintenance <br />98926 <br />60 <br />125000 <br />05/30/2022 <br />125000 <br />$ 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 />0 <br />0 <br />2 <br />2 <br />4 <br />7 <br />vehicles) <br />5 <br />1 <br />4 <br />Service Intervals <br />[] 3,000* 5,000 ❑ 7,500 [-110,000+ <br />Service visits <br />*Not available on PMP Plans, <br />+only service interval available for PMP Electric <br />25 <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 />l acknowledge receipt of a complete copy of this Maintenance Plan (the Application, Terms and Conditions constitute the "Entire <br />Maintenance Plan) at the time of signing and agree to all the terms and 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 />MAINTENANCE PLAN/PURCHASER <br />Signature (Not Valid without Signature) <br />Signature Date <br />RE—ATHER=SEIBEf-2T <br />i 2B <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 />I_ A r I I:A] \ IM61WTI Ell el <br />Dealership Signature <br />BETH SHEETS <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 l <br />P& Code —� <br />0 8 6 0 2 <br />0 <br />0 <br />2 <br />2 <br />4 <br />7 <br />7 <br />5 <br />1 <br />4 <br />ESP 8324 - MNTC (Oct 16) (Previous Editions May Not be Used) <br />