HomeMy WebLinkAbout6729 Care planNATIONAL VEHICLE SERVICE CONTRACT
APPLICATION, TERMS & CONDITIONS
(All Vehicles up to and Including Transit and F 550 series)
REGISTRATION INFORMATION
PROTECT
Vehicle Identification Number
Signature Date
12/28/2015
Warranty Start Date
03/25/2015
❑ CPO
1 F I M 1 5 1 K 1 e
1 A I R
2
1 F
G
I C
1 1
6
7
2 9
Internet Sale
❑ Yes ® No
Current Mileage
3,124
Current Hours*
IPP Term
❑
❑ Incomplete (Cab/Chassis)
Plan Name
Deductible
Plan Term
Months Mileage Hours*
Plan Expiration - (Earliest of all 3)
Date Mileage Hours*
Limo/Livery Wrap
Surcharges: 11 12Month5/12,000 Miles ❑Turbocharger/Supercharger El Snowplow ®Commercial Use
❑
® Specialty-Emergency(Fire, Ambulance, Police pursuitunits -except Ford police Interceptor), Limo, Livery, Shuttle, Tow Truck)
❑Component Wrap
(Nan -CPO)
New Fran coverage; Core - PowertrainCANL, BaseCARE, ExtraCARE, PremiumCARE (Standard Deductible is $100)
LeaseCARE -New PremlumCARE with Wear Items on Ford and Lincoln vehicles -(Standard Deductible Is SO)
Rental Care - (RentaICARE- Standard Deductible is $0)
Super Duty Coverages -(Diesel EngineCARE, Diesel EngineCARE Plus - Standard Deductible is $100)
Used Plan Coverage: Core (PowertrainCARE, BaseCARE, ExtraCARE, PremiumCARE-Standard Deductible Is $100)
PLAN COVERAGE
® New Plan ❑ Used Plan
Plan Name
Deductible
Plan Term
Months Mileage Hours*
Plan Expiration -(Earliest of all 31
Date Mileage Hours*
Purchase
Price
SalesTax
Total Purchase Price
with SalesTax
PremiumCARE
$0
60
100,000
03/25/2020
100,000
Longview
$ 2,495.00
$ 199.60
$ 2,694.60
Options ❑ First Day Rental Delete ❑ Enhanced Rental ❑ Interior/Exterior Lighting Delete
Plan Name
Deductible
Plan Term
Months Mileage Hours*
Plan Expiration - (Earliest of all 3)
Date Mileage Hours*
Purchase
Price
SalesTax
Total Purchase Price
with SalesTax
P&A Code
S
$
$
Options ❑ First Day Rental Delete ❑ Enhanced Rental ❑ Interior/Exterior Lighting Delete
*Super Duty Coverages and Incomplete Vehicle Plan Coverages require Current Hours and
Expiration Hours for all vehicles with an hour meter.
Total
$ 2,495.00
$ 199.60
$ 2,694.60
DISCLOSURE IIVFORMATIUN
THE PURCHASE OF THIS AGREEMENT IS NOT REQUIRED IN ORDERTO PURCHASE, OR OBTAIN FINANCING FOR A MOTOR VEHICLE. YOU MAY PURCHASE THE SERVICE
CONTRACT BY CASH OR UNSECURED CREDIT CARD. IF YOU ELECT TO PURCHASE THIS AGREEMENT, IT GIVESYOU SPECIFIC LEGAL RIGHTS, WHICH MAY VARY FROM
STATE TO STATE.
I acknowledge receipt of a complete copy of this Application and the Terms and Conditions (the "Entire Agreement") at the time of signing and agree to all the terms and
conditions. I agree to maintain the covered vehicle In accordance with the manufacturer's stated periodic maintenance recommendations as a condition of receiving
coverage under this Agreement, except as otherwise orovided bylaw.
Mississippi Residents Only: By signing below, I agree to Washington Residents Only: By Initialing this box, I acknowledge I have reviewed with Dealer the
the binding arbitration language In the Mississippi Sectionsection of this Service Contract titled, What This Agreement Covers and What is Not Covered, Your
Responsibilities for Care of the Vehicle, Implied Warranty of Merchantitibillty and Your and Our Rights
to Cancel Agreement.
Signed by: STEVE
K FFITA5 COUNTY
State
I ELLENSBURG
DEALERSHIP IN
98926
307 W UMPTANUM ROAD
12/28/2015
NA
Dealers Ip Signature
Original Signed by: JENNIFER C STLE
Dealer Name
Columbia Ford, Inc.
Address 1
Address 2
700 -7th Avenue
City
State
Longview
WA
FOR OFFICE USE ONLY
Zip Code
Telephone No
98632
Em Flo ee Stars Id
P&A Code
0 0 2
1
5
4
9
9
6
0 1 B 1 6 0 2
ESP 8240 -Nat App/Provs (Oct 15) (Previous Editions May Not be Used)