HomeMy WebLinkAbout6730 Care planNATIONAL VEHICLE SERVICE CONTRACT
APPLICATION, TERMS & CONDITIONS
(Ali Vehicles up to and Including Transit and F 550 series)
REGISTRATION INFORMATION
TI. NCO LN
PROTECT
Vehicle Identification Number
Signature Date
12/28/2015
Warranty Start Date
03/25/2015
❑CPO
1
F
I M 1 5 K
8
A R
9
F
G C
1
fi
7
3
0
Internet Sale
❑ Yes ® No
Current Mileage
2,987
Current Hours*
IPP Term
❑
❑ incomplete(cab/Chassis)
Plan Expiration - (Earliest of all 3)
Date Mileage Hours*
Purchase
Price
I SalesTax
Total Purchase Price
with SalesTax
Surcharges: ❑ 12Months/12,000 Miles ❑ Turbocharger/Supercharger ❑ Snowplow ® Commercial Use
❑Limo/Livery Wrap
® Specialty -Emergency(Fire, Ambulance, Police pursuitunits -except Ford police Interceptor), Limo, Livery, Shuttle, Tow Truck)
❑Component Wrap
(Non -CPO)
New rlan LOverage ; Lore. rowertralnLAHt, Ha5el.AHE, LxtraCAHL, PremiumCARE (Standard DedOctible Is $100)
LeaseCARE -New Prem!UMCARE 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 3)
Date Mileage Hours*
Purchase
Price
SalesTax
Total Purchase Price
with SalesTax
PremiumCARE
$0
60
100,000
State
0325/2020
100,000
Service Contract Lienholder Name
$ 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*
o
Plan Expiration - (Earliest of all 3)
Date Mileage Hours*
Purchase
Price
I SalesTax
Total Purchase Price
with SalesTax
Columbia Ford, Inc.
Address 1
Address 2
700 -7th Avenue
$
Is
$
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 iNFO IMAI IIJN
THE PURCHASE OF THIS AGREEMENT IS NOT REQUIRED IN ORDER TO 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 GIVES YOU 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 Ac reement'7 at the time of sianino and agree to all the terms and
conainons. I agree to maintain the covered vehicle in accordance with the manufacturer's stated periodic maintenance recommerrdations as a condition of receiving
coveraae under this Agreement except as otherwise orovided by law.
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 Section. on of this Service Contract titled, What This Agreement Covers and What is Not Covered, Your
Responsibilities for Care of the Vehicle, Implied Warranty of Merchantitlbility and Your and Our Rights
Signature (not valid without Signature) to Cancel Agreement.
CF RVIrC rnIMTR arT LJnl IICR I of loru aeoo
Signature (Not Valid without Signature)
Signature Date
Original Signed by: STEVE PANATTONI
1228/2015
Name
Address
KITTITAS COUNTY
307 W UMPTANUM ROAD
City
State
Zip Code
E-mail Address
Service Contract Lienholder Name
ELLENSBURG
WA
98926
NA
DEALERSHIP INFORMATION
Dealership Signature
Original Signed by: JENNIF CASTLE
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 to ee Stars Id
P&A Code
0 0 2
1
5
4
9
9
6
0 1 8 1 6 0 2
ESP 8240 -Nat App/Provs (Oct 15) (Previous Editions May Not be Used)