Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
MAINTENANCE PLAN APPLICATION, <br />TERMS & CONDITIONS <br />NEW AND USED VEHICLES <br />REGISTRATION INFORMATION <br />Vehicle Identification Number ("VIN") (17 Digits) <br />I 11 F I MI 5 1 K 1 8 1 A I R 1 9 1 F I G 1 C 1 1 I 6 1 7 1 3 1 0 I <br />Internet Sale <br />D Yes ~ No <br />Surcharges 0 12 Month112 ,0 00 Miles (PMP Only -Not applicable for CPO ) <br />Signature Date <br />12/28 /201 5 <br />Current Mileage <br />29 87 <br />0 Snow Plo w (PMP Only -Not applicable for PMP E, PMP L, PMP BL or CPO) <br />~ Specialty -Emergency (fire , ambulance, all police), limo, livery, shuttle, tow trucks - <br />(Gas /Hybrid, Diesel and lincoln Premium Maintenance Plans Only) <br />~ I ffi L I NCOLN <br />PROTECT <br />I Warranty Start Date k8J Gas/Hybrid <br />03/25 /201 5 <br />D Diesel <br />D Electric <br />DCPO <br />D Incomplete <br />D Medium Duty <br />PREMIUM MAINTENANCE PLANS: Gas /Hybrid, Electric, Diesel, Lincoln, Black Label , Incomplete (Cab /ChasSIS), Medium Duty, CPO - <br />(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. Coverage <br />ENDS at THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of the Maximum Number <br />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 . Coverage ENDS at <br />THE EARLIER OF the Number of Years Purchased, the Number of Miles Purchased or upon completion of the Maximum Number of Service <br />Intervals Purchased from the Signature Date or Current Mileage. <br />PLAN COVERAGE <br />Plan Name Plan Term Plan Expirat ion (Earlier of) Purchase Price Sales Tax Total Purchase <br />Months Mileage Date Mileage Price with Sales Tax <br />Premium Maintenance 72 1100000 03 /25 /2021 1100000 $ 2,4 80 .00 $ 198.40 $ 2,678.40 <br />Premium Mai~tenance I 0 First Da y Rental (Not availab le on Incomplete or <br />Plan Options Medium Duty Plans) <br />Mainten~nce I D Full Sy nthetic Oil (Not available on Lincoln, Black Label, Electric, <br />Plan Options CP Incomplete Plans and Medium Duty) <br />Service Intervals Service visits o 3,000' k8J 5,000 o 7,500 o 10,000+ 20 <br />'Not available on PMP Plans. + onl y service interval available for PMP Electric <br />DISCLOSURE INFORMATION <br />NOTE: THE PURCHASE OF THIS MAINTENANCE PLAN IS NOT REQUIRED IN ORDER TO PURCHASE, OR OBTAIN FINANCING FOR A <br />MOTOR VEHICLE. <br />I acknowledge receipt of a complete copy of this Maintenance Plan (the Application, Terms and Conditions constitute the "Entire Maintenance <br />Plan") at the time of signing and agree to all the terms and conditions . I agree to maintain the covered vehicle in accordance with the <br />manufacturer's stated periodic maintenance recommendations as a condition of receiving coverage under this Maintenance Plan except as <br />otherwise provided by law. <br />MAINTENANCE PLAN/PURCHASER <br />Signature (Not Valid without Signature) <br />Original Signed by: STEVE PANATIONI <br />'KITIITAS COUNTY <br />City <br />ELLENSBURG I /" <br />DEALERSHIP INFORM~TION <br />State <br />WA <br />Dealership Sigj.atur~~~ <br />Original SigneX JENN FER \A~~LE ~. <br />Dealer Namedy \J ~ <br />Columbia Ford, c. <br />Address 1 <br />700-7th Avenue <br />City <br />Longview <br />Zip Code <br />98632 <br />Employee Stars Id <br />I o I 0 I 2 I 1 I S I 4 I 9 I 9 I 6 I <br />ESP 8324 -MNTC (Oct 15) (Previous Editions May Not be Used) <br />Zip Code <br />98926 <br />Address 2 <br />State <br />WA <br />Telephone No <br />P&A Code <br />I o I 8 I 6 I <br />E-mail Address <br />o I 2 I <br />Signature Date <br />12 /28/2015 <br />Maintenance Plan lienholder Name <br />NA <br />FOR OFFICE USE ONLY