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NATIONAL 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)