HomeMy WebLinkAboutUntitled (4) Ford Extended Service Plan
P.O. Box 6045 RECEIVED
Dearborn, MI 48121
AUG 2 2 2016
City of Oak Park Height
AM PM
City Of Oak Park Heights
14168 Oak Park Blvd No.
Oak Park Heights, MN 55082
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NATIONAL VEHICLE SERVICE CONTRACTI
( ,;fyy, LINCOLN
_ APPLICATION,TERMS &CONDITIONS $
(All vehicles up to and including Transit and F-550) PROTECT
REGISTRATION INFORMATION
Vehicle Identification Number Signature Date Warranty Start Date
1 F M 5 K 8 ARXGGC 7 2 8 4 1 042616 042616 CPO
Internet Sale Current Mileage Current Hours* IPP Term Incomplete(Cab/Chassis)
1 I Yes I I No 1 I I
— Limo/Livery Wrap
Surcharges: 12 Months/12,000 Miles n Turbocharger/Supercharger Snowplow n Commercial Use
Specialty-Emergency(Fire,Ambulance,Police pursuit units-except Ford Police Interceptor),Limo,Livery,Shuttle,Tow Truck) Component Wrap
(Non-CPO)
New Plan Coverage:Core-PowertrainCARE,BaseCARE,ExtraCARE,PremiumCARE (Standard Deductible is$100)
LeaseCARE-New PremiumCARE with Wear Items on Ford and Lincoln vehicles-(Standard Deductible is$0)
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
XI New Plan In Used Plan
Plan Name A Deductible Plan Term Plan Expiration-(Earliest of all 3) Purchase Sales Tax Total Purchase Price
Months Mileage Hours* Date Mileage Hours* Price with SalesTax
PowertrainCARE 0 60 100,000 04-26-2021 100,000 $ $ $
Options I X I First Day Rental Delete Enhanced Rental I I Key Services X Interior/Exterior Lighting Delete
Plan Name B Deductible Plan Term Plan Expiration-(Earliest of all 3) Purchase Sales Tax Total Purchase Price
Months Mileage Hours* Date Mileage Hours* Price with SalesTax
$ $ $
Options First Day Rental Delete I I Enhanced Rental I I Key Services n Interior/Exterior Lighting Delete
*Super Duty and Incomplete Vehicle Plan Coverages require current hours and expiration hours Total $ $ $
for all vehicles with an hour meter.
DISCLOSURE INFORMATION
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 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 provided 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. section of this Service Contract titled,What This Agreement Covers and What is Not Covered,Your
Responsibilities for Care of the Vehicle,Implied Warranty of Merchantitibility and Your and Our Rights
to Cancel Agreement.
Signature(not valid without Signature)
SERVICE CONTRACT HOLDER/PURCHASER
Signature(Not Valid without Signature) Signature Date
042616
Name Address
City Of Oak Park Heights 14168 Oak Park Blvd No.
City State Zip Code E-mail Address Service Contract Lienholder Name
Oak Park Heights MN 55082
DEALERSHIP INFORMATION
Dealership Signature
Dealer Name
Ford Extended Service Plan
Address 1 Address 2
P.O.Box 6045
City State
Dearborn MI
Zip Code Telephone No
48121
Employee Stars Id P&A Code
I( 4 0 9 3 9 FOR OFFICE USE ONLY
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) CUSTOMER COPY
TERMS AND CONDITIONS
1A.INTRODUCTION&PARTIES(FORD MOTOR SERVICE COMPANY): MERCURY VEHICLES THAT HAVE NO NEW VEHICLE LIMITED' WARRANTY
In all states except CO,FL,ID,KS,and WA,all service contract obligations,including REMAINING AND ELIGIBLE USED COMPETITIVE MAKE VEHICLES(REGARDLESS „
the Application(this"Agreement")are between Ford Motor Service Company,the OF WARRANTY STATUS), Coverage BEGINS at the Signature Date and Current
Service Contract Provider (hereinafter referred to as"We", "Us"'or"Our") and the Mileage.Coverage ENDS at the earlier or the Number of Months Purchased or the
Service Contract Holder(hereinafter referred to as"You"or"Your' In the states of Number of Miles Purchased from the Signature Date and Current Mileage.
Colorado,Kansas,and Washington,all service contract obligations for Competitive 2B.INSURER"CUT-THROUGH"BENEFITS:If any insured service contract repair or
Make Vehicles,including the Application are between Us and You.You may contact reimbursement claim has not been completed within 60 days from the date You
Us at the following address: filed a claim with the Selling Dealer or Us or We are insolvent or financially impaired,
Ford Motor Service Company You may make a claim directly against The American Road Insurance Company for
Extended Service Plan Headquarters the cost of your repairs(including all sums which We are legally obligated to pay to
P.O.Box 6045 You), subject to the exclusions, deductions and limitations contained in this
Dearborn,Michigan 48121 Agreement and in the underlying policy of insurance. You may not make a
Toll-free number 800-521-4144 cutthrough claim against The American Road Insurance Company for a Compli-
FULL FAITH AND CREDIT STATEMENT:In all states except in 1C and 10 below,all mentary Plan.Complimentary plans are not offered in the states of Florida and New
service contract obligations under this Agreement are backed by the full faith and York.
credit of Ford Motor Service Company and are not guaranteed under a service 3. DEFINITIONS: In this Agreement, the following capitalized terms have the
contract reimbursement policy.Complimentary Plans are backed by the full faith meanings assigned to them:
and credit of Ford Motor Company. Branded Vehicle means a vehicle that has a valid certificate of title that indicates:
1B.INTRODUCTION&PARTIES(FORD MOTOR COMPANY OR SELLING DEALER): (i) a salvage title, (ii) that the vehicle was stolen or (iii) that an insurance carrier
In ID, all service contract obligations under this Agreement, are between Ford insuring the vehicle determined that the physical damage to the vehicle exceeded
Motor Company,the Service Contract Provider(hereinafter referred to as"We","Us", the value of the vehicle.
or "Our") and the Service Contract Holder (hereinafter referred to as "You" or Certified Pre-Owned (CPO) Vehicle Upgrade Coverage means a new core
"Your"). In the states of CO, KS, and WA, all service contract obligations on Ford, coverage on a Ford,Lincoln or Mercury vehicle purchased for an additional price
Lincoln and Mercury products are between US and YOU.You may contact us at the that may provide additional component coverage or longer term and mileage
following address: benefits beyond the manufacturer's certified warranty.
Ford Motor Company Commercial Use means the Vehicle is: (i) used primarily for business or gov-
Extended Service Plan Headquarters ernment purposes,by an individual or multiple drivers any government agency or
P.O.Box 6045 municipality; or It) designated by the Selling Dealer as a vehicle sold for
Dearborn,Michigan 48121 Commercial Use when reported to the vehicle's manufacturer. Ford, Lincoln or
You may contact the Selling Dealer at the address shown on the Application for the Mercury vehicles reported sold with delivery codes:"3","4","6","7","C","D","E","H",
Selling Dealer. "I","L","M","5","T",and"it"are vehicles used for Commercial Use.
FULL FAITH AND CREDIT STATEMENT:In ID all service contract obligations under Competitive Make Vehicle means any vehicle other than a Ford, Lincoln or
this Agreement are backed by the full faith and credit of Ford Motor Company.In Mercury vehicle.
the states of CO,KS,and WA all service contract obligations under this Agreement Component Wraps(Non-CPO)Coverage means new ExtraCARE or PremiumCARE
on Ford, Lincoln and Mercury products are backed by the full faith and credit of coverage for any component not covered under any existing Powertrain Warranty
Ford Motor Company and are not guaranteed under a service contract of 10 years or 100,000 miles or greater.
reimbursement policy.Complimentary Plans are also backed by the full faith and CORE Coverage means new or used PowertrainCARE, BaseCARE, ExtraCARE, and
credit of Ford Motor Company. PremiumCARE coverage.
1C.INTRODUCTION&PARTIES(Florida only):This service contract,including the Disappearing Deductible means a deductible option under which there is no
Application,(this"Agreement")on Ford, Lincoln and Mercury vehicles is between deductible charged for each Eligible Repair Visit when repairs or services are
Ford Motor Company(referred to in this Agreement as"We","Us",or"Our")and the performed by the Selling Dealer.
service contract holder (referred to in this Agreement as "You" or "Your"). Our Eligible Repair Visit means a single visit to a dealer or other repair provider for
Florida license number is 12118.You can contact Us at the address referenced in 18 service or repair of a failure to the Vehicle covered by this Agreement.
above. All service contract obligations on competitive make vehicles is between Emergency Service or Repair means necessary service or repair to an inoperable
The American Road Insurance Company and You. The Certificate of Authority Vehicle at a dealer or repair provider other than a Ford or Lincoln dealership.
Number is 09079 for The American Road Insurance Company.You can contact The Emergency Travel Expenses means the costs of Your meals, lodging, car rental
American Road Insurance Company at the address referenced in 1 D. and commercial transportation to Your destination and the return trip to retrieve
10. INSURED AGREEMENT STATEMENT: In the state of Connecticut, all service Your Vehicle after it is repaired.
contract obligations,on all Ford,Lincoln,Mercury and Competitive Make products Failure means a cessation of normal functioning of the Vehicle components
are fully insured and guaranteed by a policy of contractual liability insurance or covered by this Agreement that arise from defects in materials or workmanship or
service contract reimbursement insurance.In the states of CO,NE,WA and WI,all caused by normal wear and tear covered by this Agreement.
service contract obligations on Competitive Make Products are fully insured and Hours means an alternate measure of mileage to determine coverage plan exp-
guaranteed by a policy of contractual liability insurance or service contract iration for which 1 hour equals 25 miles, and applies to all Super Duty Coverage
reimbursement insurance.The policy is issued by: Plans and Incomplete Vehicle Plans.
The American Road Insurance Company Incomplete Vehicle means vehicles known as chassis cabs, stripped chassis and
P.O.Box 6045 cutaways. Incomplete for Ford vehicles means vehicles with the first three VIN
Dearborn,Michigan 48121 positions of 1 FB,1 FC, 1 FD,1 F6,2LI,2LJ,3FR and 5LD (except body types E14,E24,
Policy Number:81-3110-700-001 and all applicable endorsements. 524, E31, S31, E34, 534 , EIB, El E, E2E, E3B, E3E, 51E, S2E, S3B, and 53E). Only
1E.ADMINISTRATION: All service contract obligations under this Agreement are Chevrolet,Dodge,Ford and GMC vehicles are eligible for Incomplete Vehicle Plans.
administered by: LeaseCARE Coverage means new PremiumCARE coverage with Wear Items on
Ford Customer Service Division Ford and Lincoln vehicles.
16800 Executive Plaza Drive Limousine/Livery Wrap Coverage means new PremiumCARE coverage on any
Dearborn,Michigan 48126 Lincoln MKS,MKT,Navigator Limo,Navigator Livery or any vehicle used or operated
2. ENTIRE AGREEMENT: This Agreement, which includes the Application, is the for hire or funeral business.
complete and exclusive statement of the agreement and understanding between New Vehicle Limited Warranty means the manufacturer's original limited bumper
You and Us regarding the extended service contract and related benefits for Your to bumper warranty overing a new Vehicle or the parts and components of the new
vehicle. Vehicle.
2A. WHEN COVERAGE BEGINS AND ENDS: For NEW PLAN AGREEMENTS, Provider Fee means the consideration paid for a service contract.
Coverage begins at the New Vehicle Limited Warranty Start Date and Zero Miles or Reimbursement Insurance Policy means a policy of insurance that is issued to a
Hours. Coverage ends at the earlier of the Number of Months Purchased or the service contact provider for reimbursement of service contract obligations.
Number of Miles or actual or equivalent Hours purchased from the New Vehicle RentaICARE Coverage means reimbursement for vehicle rentals due to repairs
Limited Warranty Start Date or Zero Miles or Hours.For USED PLAN AGREEMENTS covered under the manufacturers'warranty or recalls.
ON ELIGIBLE FORD, LINCOLN OR MERCURY VEHICLES THAT HAVE NEW Retail Value of the Vehicle means the retail value of the Vehicle at the time of
VEHICLE LIMITED WARRANTY REMAINING AT THE TIME OF PURCHASE, repair or service, as determined by "National Auto Dealer's Association (N.A.D.A.)
Coverage begins at the Signature Date and Current Mileage.Coverage ENDS the Guide",taking into consideration the location,mileage and condition of the Vehicle.
earlier of the Number or Months Purchased or the Number of Miles Purchased from Scheduled Maintenance Services means all scheduled maintenance services at
the expiration of the New Vehicle Limited Warranty. ELIGIBLE FORD,LINCOLN OR the service intervals listed in the Scheduled Maintenance Guide for the Vehicle,
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 1 of 10
• TERMS AND CONDITIONS
including adherence to the normal or severe duty mileage and time requirements all Internal parts), universal and constant velocity joints, axle shafts, seals and
depending on vehicle usage. gaskets,and driveshafts.
Selling Dealer means the authorized Ford or Lincoln dealership that sold the 5B.COVERED ITEMS-"BaseCARE"
service contract represented by this Agreement. If You elected BaseCARE,You have PowertrainCARE coverage and coverage for the
Service Contract means a contract or agreement for consideration above the lease following additional items:
or purchase price of the Vehicle for a specific duration to perform the repair, Odometer & Speedometer - Coverage is provided for both the odometer and
replacement, or services for operational or structural failure due to a defect in speedometer,including all cables and connectors.
materials or workmanship,or normal wear and tear. Engine-Metal fuel lines,harmonic balancer and bolt,and diesel injector pump.
Service Contract Holder or Purchaser means a person who is the original Steering - Power steering pump, cooler and metal lines, couplings, seals and
purchaser or original holder of a service contract. gaskets,manual and power steering gear housing and all internal parts,including
Service Contract Provider or Provider means a person who is contractually linkages,control valve,column lock(tilt wheel),pulley assembly for power steering
obligated to the service contract holder under the terms of the service contract. pump,and the idler arm.
Signature Date means the date You signed the Application to this Agreement. Front Suspension - MacPherson struts, upper and lower control arms, stabilizer
Snow Plow Factory Option means any new and used F-150 (except 2011-2012 bar, linkage and bushings, tie rods, control arm shafts and bushings, upper and
model years), Ford F-250, F-350, F-450 and F-550 trucks that are equipped with lower ball joints,kingpins and bushings,spindle and spindle supports. NOTE:This
Snow Plow Prep Package models 53C,86M,473,or 627(7700 Payload Group-V),862, coverage includes only the items listed in this paragraph and does not include
863, 864, 62B, 62S, 63A, 68P and 47S or any snow plow package that is the either front end alignments or wheel balancing,unless the repair to such items
equivalent of the Snow Plow Prep Package models. is required in conjunction with the repair of a Failure.
Speciality means any vehicle classified as emergency (fire/ambulance), police Brakes- Master cylinder, calipers and wheel cylinders,combination valve, metal
(except Ford police interceptor),limousine,livery,shuttle or tow truck. lines and fittings,power brake booster,backing plates,springs,clips and retainers,
Super Duty Coverage means a Ford Super Duty Diesel EngineCARE and Ford Super self-adjusters, parking brake linkage and cables, brake pedal shaft. NOTE: This
Duty Diesel EngineCARE Plus coverage plan on an eligible Ford F-250,Ford F-550 coverage includes only the items listed in this paragraph and does not include
truck,a Ford E-250,Ford E-350,Ford E-450 or a Ford Excursion equipped with a 3.2L brake drums,rotors,linings or pads,unless the repair to such items is required
or a 6.7L Power Stroke engine. in conjunction with the repair of a covered Failure.
Vehicle means the vehicle identified in the Application by the VIN and in the State Air Conditioning-Compressor,condenser,evaporator,A/C compressor head,A/C
of Washington subject to registration under chapter 46.16 RCW. compressor clutch switch,A/C clutch and clutch bearings,compressor seals,pulley
Vehicle Identification Number (VIN) means the 17 alpha-numeric identifier and field coil.
assigned to a motor vehicle by the manufacturer. Electrical-Alternator,starter motor,voltage regulator,manually operated electrical
Warranty Start Date,for the New Vehicle Limited Warranty, means the date on switches, ignition switch, wiper motors, electronic ignition module, radiator fan
which the Vehicle was placed into service.If the Vehicle was used by the dealership relay,fuel pump, starter motor solenoid, wiring harnesses (excluding spark plug
as a demonstrator unit,the Warranty Start Date is the date the Vehicle was placed wires), and electrical components of a heated back glass. NOTE: Heated back
into service as a demonstrator unit. glass coverage is for electrical components only and does not include general
Wear Items means coverage for brake pads and linings,clutch disc,spark plugs, glass damage or breakage.
engine belts,coolant hoses,hose clamps and o-ring seals,wiper blades and shock 5C.COVERED ITEMS-"ExtraCARE"
absorbers/struts. If You elected ExtraCARE,You have PowertrainCARE and BaseCARE coverage and
Zero Miles means the starting mileage for the calculation of the expiration of all coverage for the following additional items:
New Vehicle Limited Warranties. For benefit determinations, all New Vehicle Engine-Flywheel ring gear,diesel lift pump and gas and diesel fuel injectors.
Limited Warranties are considered to begin with zero miles on the Vehicle. High Tech-Air conditioner accumulator,ETA pump hose assembly,anti-lock brake
4.DEDUCTIBLES: module and sensor, automatic temperature control, distributor cap and rotor,
STANDARD DEDUCTIBLES electronic air suspension (switch-vacuum pump. control-assembly suspension air
If You elected coverage with a Standard Deductible or Optional Deductible,We will spring, spring & solenoid assembly front suspension, air spring solenoid, o-ring
charge You that deductible for each Eligible Repair Visit,regardless of the number solenoid, left/right-front spring,dryer assembly, sensor-air level,airline protector,
of Failures to be repaired. spring-load leveling, control module-air suspension, sensor right/ left rear
OPTIONAL DEDUCTIBLES suspension leveling,air suspension quick connect,airline repair kit,switch-right/left
Deductible options are not available on Super Duty Coverages, LeaseCARE and rear suspension leveling,o-ring suspension air spring dryer,silencer-air suspension,
RentaICARE Coverages.The $200 Deductible option is not available on the CPO wire assembly air suspension switch,front spring air suspension and rear spring air
Upgrade Coverages,Component Wrap(Non-CPO)Coverages,and Limousine/Livery suspension),electronic instrument cluster(excluding the dash pad,clock,audio and
Wrap Coverages. The $50 Deductible is not available on Incomplete Vehicle visual equipment), fuel tank and lines, diesel injectors and lines, heater blower
Coverages.The$0 Deductible Option is not available on Used Core Plan Coverages. motor and core assembly, keyless entry system (excluding door handles), power
The Disappearing Deductible is not available on Incomplete Vehicle Coverages and seat motors, power window motors and regulators, power antenna, power door
Limousine/Livery Wrap Coverages. locks (excluding door handles and electronic key fobs),power door lock retainer
5.WHAT THIS AGREEMENT COVERS:Subject to the deductibles,exclusions and clip, radiator, radiator fan, radiator fan clutch or motor, speed control, engine
other limitations in this Agreement and depending on the Plan Coverage You mounts, transmission vacuum module and mounts, and external transmission
elected,service and repairs(including parts,labor costs and applicable taxes)will be module.
provided while You own the Vehicle. 5D.COVERED ITEMS-"PremiumCARE"If You elected PremiumCARE,all Failures
We will either: (a) service Your Vehicle; (b) repair or place covered Failures or(c) are covered EXCEPT for those items excluded in the Provision titled:"WHAT IS
reimburse You for the Vehicle's servicing in the event of an Emergency Service or NOT COVERED BY THIS AGREEMENT".
Repair,or for the repair or replacement of covered Failures and repairs needed to a 5E.COVERED ITEMS-NEW PLAN"LeaseCARE"
non-covered component caused by the Failure of a covered component.We may If you elected LeaseCARE,You have PremiumCARE coverage with Wear Items on
review the requested repair or service or inspect the Vehicle before performing any Ford and Lincoln vehicles only.
service or repairs. 5F.COVERED ITEMS- NEW PLAN"Component Wrap(Non-CPO)Coverage" If
5A.COVERED ITEMS-"PowertrainCARE" You elected Component Wrap(Non-CPO) Coverage,You have new ExtraCARE or
If You elected PowertrainCARE, the following items are covered except for PremiumCARE coverage for all components not covered under any existing
Component Wrap(Non-CPO)Coverages. Powertrain Warranty of 10 years or 100,000 miles or greater. Component Wrap
Engine - Cylinder block and all internal lubricated parts, seals and gaskets, the (Non-CPO) Coverage applies only to the original Service Contract Holder for the
cylinder heads,manifold(Exhaust,Intake and bolts),factory installed turbocharger/ selected coverage and is not transferable to any subsequent vehicle owner.
supercharger units, timing chain (gears or belt), flywheel, valve covers, oil pan, 5G.COVERED ITEMS-NEW PLAN"LIMOUSINE/LIVERY Wrap Coverage"If You
timing chain cover,oil pump,water pump,thermostat,thermostat housing. elected Limousine/Livery Wrap Coverage,You have PremiumCARE coverage on all
(EXCEPTIONS: CARBURETION AND FUEL INJECTION COMPONENTS ARE NOT components not covered under any ExtraCARE Limited Warranty.
COVERED). 5H. COVERED ITEMS - NEW PLAN "RentaICARE" If You elected RentaICARE
Transmission-Transmission case and all internal parts including torque converter coverage,We will reimburse You for the actual charges up to$30 per day(including
and transfer case(all internal parts),seals and gaskets. tax)on Ford,Mercury and Competitive Make vehicles and $45 per day(including
Front-Wheel Drive-Final drive housing and Rear Axle Housing for AWD(including tax)on Lincoln vehicles that You incur to rent a motor vehicle for up to (3)days
all Internal parts), universal and constant velocity joints,axle shafts, locking rings while Your Vehicle is being repaired provided,however:(i)the service or repair is:
(four-wheel drive vehicles), seals and gaskets, and automatic front locking hubs (1) covered under the New Vehicle Limited Warranty or (2) the result of a
(four-wheel drive). manufacturer's recall or customer satisfaction program and(ii)the vehicle must be
Rear-Wheel Drive-Drive axle housings and Front Axle Housing for 4X4(including rented from a Ford or Lincoln dealership or other commercial agency that rents or
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 2 of 10
TERMS AND CONDITIONS
leases motor vehicles as its principal business. RentaICARE coverage will begin records)as a result of a collision or a mechanical Failure covered by this Agreement
when You deliver the Vehicle to the Selling Dealer or other dealer that has a or the New Vehicle Limited Warranty,We will reimburse You up to $500 for the
franchise from an original equipment manufacturer. To determine the (3) day actual Emergency Travel Expenses You incur within the first 72 hours following the
coverage period,the first day of coverage is the day after You deliver Your Vehicle disablement.
for repair or service. If You elected RentaICARE Coverage with a plan term that 3.DESTINATION ASSISTANCE-If the Vehicle is disabled because of a collision or
exceeds 3 years or 36 months from the bumper to bumper New Vehicle Limited Failure covered by this Agreement or a New Vehicle Limited Warranty and You
Warranty,You will receive component coverage only under our PremiumCARE plan require transportation to Your destination,We will reimburse Your transportation
upon expiration of the earlier of 3 years or 36 months from the bumper to bumper costs up to$75.
New Vehicle Limited Warranty,for the additional plan term You selected. To receive reimbursement expenses under "EMERGENCY TRAVEL EXPENSE
51.COVERED ITEMS-Ford Super Duty Diesel EngineCARE If You elected Ford REIMBURSEMENT"and"DESTINATION ASSISTANCE",within twenty(20)days
Super Duty Diesel EngineCARE, the following items are covered: Crankcase, oil of the disablement,You must send to Ford/Lincoln Roadside at the address
cooler, cylinder block, cylinder heads, cylinder head gasket, EGR cooler, factory shown here in a written request for benefits that includes:(i)a statement of
installed turbocharger,fuel injection pump,fuel injection pressure regulator,fuel Your loss;(ii)the original receipts for Your expenses;(iii)a copy of the accident
injectors,internal lubricated parts,oil pump,timing chain cover,and timing chain report filed with the state or local police(if the disablement is caused by a
(gears or belt). collision); (iv) a copy of the repair order indicating the service or repairs
5J.COVERED ITEMS-Ford Super Duty Diesel EngineCARE Plus If You elected performed under this Agreement or the Vehicle's New Vehicle Limited
Ford Super Duty Diesel EngineCARE Plus, the following additional items are Warranty(if the disablement is due to a Failure).
covered:Flywheel,manifold(exhaust and intake),manifold and bolts,oil pan,seals 4.TOWING REIMBURSEMENT-If towing is necessary because a Failure occurs or
and gaskets,thermostat,thermostat housing,valve covers,and water pump. services provided by Your coverage are required,Ford/Lincoln Roadside will pay the
6.ADDITIONAL BENEFITS towing if the Vehicle is towed to the Selling Dealer or other Ford Motor Company
6A. ROADSIDE ASSISTANCE COVERAGE - Only available with the following franchised dealer.The amount of the cost to be reimbursed will depend upon the
NEW AND USED CORE PLAN COVERAGES, LEASECARE COVERAGES, coverage You select in the Application.The towing reimbursement is limited to
COMPONENT WRAP (NON-CPO) COVERAGES, LIMOUSINE/LIVERY WRAP $100 per incident on E and F-250 vehicle series and $200 per incident on E and
COVERAGES OR SUPER DUTY COVERAGE PLANS: F-350 vehicle series and higher.
For all New and Used Core Coverages, LeaseCARE Coverages, Component Wrap 5.KEY SERVICES OPTION-This option is available on all NEW AND USED CORE
(Non-CPO) Coverages, Limousine/Livery Wrap Coverages and Super Duty Cove- COVERAGES,LEASECARE COVERAGES,LIMOUSINE/LIVERY WRAP COVERAGES,
rages up to and including E and F-250 vehicle series and equivalent vehicle series, CPO UPGRADE COVERAGES OR COMPONENT WRAP(NON-CPO)COVERAGES
We contracted with Cross Country Motor Club,Inc.and Cross Country Motor Club of 1.If You purchased the Key Services option with the Coverages referenced above
California, Inc. ("Cross Country"), licensed automobile clubs, to provide roadside on Your Eligible Vehicle keys and/or key fobs are lost,stolen,damaged or destroyed
assistance to You as part of this Agreement.Cross Country's address is P.O. Box on vehicles up to and including E and F-250 vehicle series or any equivalent
9145, Medford,MA 02155. For all Super Duty Plans covering E and F-350 vehicle competitive make vehicle series, Ford/Lincoln Roadside will arrange for
series and higher and equivalent vehicle series,We contracted with National Motor replacement of Your Eligible Vehicle key and/or key fobs.The maximum benefit for
Club-RV,Inc.,National Motor Club-Group Services,Inc.and National Motor Club of Key Services will not exceed$500 per year(including keys and fobs,labor charges,
California, Inc.("National Motor"),licensed automobile clubs,to provide Roadside programming, registration, and taxes). We recommend that You return to Your
Assistance to You as part of this Agreement. National Motor's address is P.O.Box originating dealer or any other appropriate franchise dealer for Key Services.
141266, Irving, Texas 75014-1266. Cross Country and National Motor shall TO PROTECT CONSUMERS, KEY SERVICES RECOMMENDS THAT ALL ELIGIBLE
hereinafter be collectively referred to as "Ford/Lincoln Roadside." Roadside VEHICLE KEYS AND KEY FOBS REPORTED AS LOST, STOLEN, DAMAGED OR
Assistance includes: (i) Roadside Assistance Items, (ii) Emergency Travel Expense DESTROYED BE REPROGRAMMED BY YOUR ORIGINATING DEALER OR OTHER
Reimbursement,and(iii) Destination Assistance.The Roadside Assistance benefits APPROVED FRANCHISE DEALER.Key Services will not be eligible on all Incomplete
provided under this Agreement are available from Ford/Lincoln Roadside 24 hours Vehicles,Transit Vans/Wagons or E and F-3S0 vehicle series,on all 3500 series trucks
a day,7 days a week. and vans or higher and any equivalent Competitive Make Vehicles.
To request roadside assistance or for customer inquiries,call Ford Roadside at 2. To receive Key Services coverage, You must provide the following to Your
800-241-3673 or Lincoln Roadside at 800-521-4140. Service providers who originating Dealer or other appropriate franchise dealer:
provide Roadside Assistance are independent contractors and not employees, • A completed and signed Vehicle Ownership form;
agents or representatives of Cross Country,National Motor or Us. • A valid driver's license;
1.ROADSIDE ASSISTANCE ITEMS ITEMS COVERED:Roadside Assistance provides • One additional piece of identification relating to the Vehicle such as Vehicle Title
coverage of up to$100 in benefits for the following items(including the cost of the or Bill of Sale,valid Certificate of Registration or Registration, or valid proof of
service call and labor costs for services performed at the site of the disablement):(a) insurance for the Vehicle;and
lock-out assistance;(b)flat tire changes; (c) battery jump starts (electric Vehicle's • Your written consent authorizing Key Services on your behalf if request is made
main power cell batteries are not included in this coverage; (d) out of fuel by a third party agency.
assistance,which provides the delivery of gasoline or diesel fuel to You,including 3.To receive reimbursement for Key Services Coverage,please contact the provider
the cost of up to 2 gallons of fuel(5 gallons of diesel fuel for diesel engine vehicles), referenced in section 6A.
provided that coverage is limited to 3"no charge"service calls during a 12 month 6B.ROADSIDE ASSISTANCE COVERAGE ON LINCOLN VEHICLES ON AND AFTER
period; and (d) towing, when the Vehicle is disabled, provided this coverage is JANUARY 1,2016 -Available with the following NEW AND USED CORE PLAN
limited to one tow per disablement. COVERAGES, LEASECARE COVERAGES, COMPONENT WRAP (NON-CPO)
ITEMS NOT COVERED: Roadside Assistance does not provide coverage for: (a) COVERAGES,AND LIMOUSINE/LIVERY WRAP COVERAGE PLANS:
replacement parts, (b)gasoline or diesel fuel(except for an out of fuel assistance For all New and Used Core Coverages, LeaseCARE Coverages, Component Wrap
call provided in section 6.1(d)herein),(c)tire repair,(d)rental of towing equipment, (Non-CPO)Coverages,Limousine/Livery Wrap Coverages,We contracted with The
(e)storage fees;(1)fees for labor performed at a garage or service facility;or,(g)any American Automobile Association, Inc. and The Auto Club Group d/b/a AAA
"out of fuel" service request if the Vehicle is located at Your residence or an Wisconsin(together,"AAA"),an association of licensed automobile clubs,to provide
operating commercial fueling station;(h)impound towing or towing by a person roadside assistance to You as part of this Agreement.AAA's address is 1000 AAA
other than a licensed service station or garage; (i) the assistance of any private Drive, Mail Drop 99, Heathrow, FL 32746. The Roadside Assistance services
parties or(j)alternative fuel(such as compressed natural gas or liquid propane gas). provided by AAA supersedes all references to Lincoln Roadside in provisions 6A(1)
WHEN YOU CALL FOR SERVICE,YOU WILL BE CONNECTED WITH THE DISPATCHER through 6A(5). Roadside includes: (i) Roadside Assistance Items, (ii) Emergency
AND A SERVICE VEHICLE WILL BE SENT TO YOUR LOCATION.PLEASE PROVIDE THE Travel Expense Reimbursement, and (iii) Destination Assistance. The Roadside
DISPATCHER WITH: Assistance benefits provided under this Agreement are available from AAA, 24
1)Your name,address and the VIN; hours a day,7 days a week.
2)the exact location of the Vehicle;and, To request roadside assistance or for customer inquiries, call AAA at
3)the nature of Your emergency. 800-521-4140. Service providers who provide Roadside Assistance are
LIMIT OF LIABILITY:If You prefer to arrange Your own roadside assistance or towing, independent contractors and not employees,agents or representatives of AAA or
We will reimburse You up to$100 per disablement for the emergency expenses You Us.
actually incur,provided that within twenty(20)days of the disablement You send a 1. ROADSIDE ASSISTANCE ITEMS COVERED: Roadside Assistance provides
written request for Roadside Assistance benefits that includes a statement of Your coverage of up to$100 in benefits for the following items(including the cost of the
loss and the original receipts for Your expenses to Ford Roadside at the address service call and labor costs for services performed at the site of the disablement):(a)
shown herein. lock-out assistance; (b)flat tire changes; (c) battery jump starts (electric Vehicle's
2.EMERGENCY TRAVEL EXPENSE REIMBURSEMENT-If Your Vehicle is disabled main power cell batteries are not included in this coverage; (d) out of fuel
100 or more miles from Your residence (according to Ford/Lincoln Roadside assistance,which provides the delivery of gasoline or diesel fuel to You,including
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 3 of 10
TERMS AND CONDITIONS
the cost of up to 2 gallons of fuel, provided that coverage is limited to 3 "no COVERAGES, OR SUPER DUTY COVERAGES You may be eligible for rental car
charge"service calls during a 12 month period;and(d)towing of up to$100 on gas reimbursement if:(i)the servicing or repair facility determines that the service or
vehicles and up to$200 on hybrid vehicles,including vehicles with trailers attached, repair is:(a)covered under this Agreement or a New Vehicle Limited Warranty or(b)
when the Vehicle is disabled, provided this coverage is limited to one tow per covered under both this Agreement and the Manufacturers' Limited Warranty for
disablement and(e)winch out within 100 feet of paved or county maintained road. Powertrain, Safety and Emission coverages or a Ford Motor Company man-
ITEMS NOT COVERED: Roadside Assistance does not provide coverage for: (a) ufacturer's recall,and(ii)You rent the vehicle from a Ford or Lincoln dealership or
replacement parts, (b)gasoline or diesel fuel (except for an out of fuel assistance other commercial agency.
call provided in section 6B(1)herein),(c)tire repair,(d)rental of towing equipment, If You elect the First Day Rental Delete Option, an additional eligibility term for
(e)storage fees;(f)fees for labor performed at a garage or service facility;or,(g)any Rental Car Reimbursement is the Vehicle must be kept overnight by the repair
"out of fuel" service request if the Vehicle is located at Your residence or an facility because it was inoperable or would become inoperable if it was continued
operating commercial fueling station;(h) impound towing or towing by a person to be operated.
other than a licensed service station or garage; (i) the assistance of any private If You meet all of the eligibility requirements set forth herein,We will reimburse You
parties or(j)alternative fuel(such as compressed natural gas or liquid propane gas). for vehicle rental charges You actually incur up to$30 per day(including tax)for
WHEN YOU CALL FOR SERVICE,YOU WILL BE CONNECTED WITH THE DISPATCHER Ford,Mercury and Competitive Make Vehicles and $45 per day(including tax)for
AND A SERVICE VEHICLE WILL BE SENT TO YOUR LOCATION.PLEASE PROVIDE THE Lincoln vehicles for up to 10 days or until the repair is complete,whichever occurs
DISPATCHER WITH: first.Rental Car Reimbursement starts when the Vehicle is delivered to the Selling
1)Your name,address and the VIN; Dealer or other Ford Motor Company franchised dealer for service and the vehicle is
2)the exact location of the Vehicle;and, inoperable.Rental Car Reimbursement ends when the repair is completed.
3)the nature of Your emergency. 6D. FIRST DAY RENTAL OPTION - If Your Vehicle is a Ford, Lincoln or Mercury
LIMIT OF LIABILITY:If You prefer to arrange Your own roadside assistance or towing, Vehicle, You received First Day Rental with Your NEW OR USED CORE
We will reimburse You up to$100 per disablement for the emergency expenses You COVERAGES, LEASECARE COVERAGES, COMPONENT WRAP (NON-CPO)
actually incur on Lincoln gas vehicles and up to $200 on Lincoln hybrid vehicles, COVERAGES,OR CPO UPGRADE COVERAGE,We will reimburse You for vehicle
provided that within twenty (20) days of the disablement You send a written rental charges You actually incur up to$30 per day(including tax)for Ford,Mercury
request for Roadside Assistance benefits that includes a statement of Your loss and and Competitive Make Vehicles and$45 per day(including tax)for Lincoln vehicles
the original receipts for Your expenses to the AAA address shown herein. for up to 10 days or until the repair is complete,whichever occurs first.Rental Car
2.EMERGENCY TRAVEL EXPENSE REIMBURSEMENT-If Your Vehicle is disabled Reimbursement starts when the Vehicle is delivered to the Selling Dealer or other
100 or more miles from Your residence(according to AAA records)as a result of a Ford Motor Company franchised dealer for service.We will not reimburse You for
collision or a mechanical Failure covered by this Agreement or the New Vehicle any vehicle rental charge(s)incurred before the Signature Date of this Agreement
Limited Warranty, We will reimburse You up to $500 for the actual Emergency or upon completion of Your repair.
Travel Expenses You incur within the first 72 hours following the disablement. 6E.ENHANCED RENTAL OPTION:This option is available on all NEW AND USED
3.DESTINATION ASSISTANCE-If the Vehicle is disabled because of a collision or CORE COVERAGES, LEASECARE COVERAGES, CPO UPGRADE COVERAGES,
Failure covered by this Agreement or a New Vehicle Limited Warranty and You RENTALCARE COVERAGES AND SUPER DUTY COVERAGES.
require transportation to Your destination,We will reimburse Your transportation If You elected to purchase Enhanced Rental Option with any of the Coverages
costs up to$75. referenced above,We will reimburse You for vehicle rental charges You actually
To receive reimbursement expenses under "EMERGENCY TRAVEL EXPENSE incur up to $60 per day (including tax) for up to 10 days for all plans except
REIMBURSEMENT"and"DESTINATION ASSISTANCE",within twenty(20)days RentaICARE and for up to 3 days on RentalCare or until the repair is complete,
of the disablement,You must send to AAA at the address shown here in a whichever occurs first.Enhanced Rental Option starts when the Vehicle is delivered
written request for benefits that includes:(i)a statement of Your loss;(ii)the to the Selling Dealer or other Ford Motor Company franchised dealer for service.
original receipts for Your expenses;(iii)a copy of the accident report filed with 6F.INTERIOR/EXTERIOR LIGHTING OPTION-This option is available on New and
the state or local police(if the disablement is caused by a collision);(iv)a copy Incomplete PremiumCARE and LeaseCARE Coverages.If you purchased any of the
of the repair order indicating the service or repairs performed under this above coverages, You received Interior/Exterior Lighting coverage for electrical
Agreement or the Vehicle's New Vehicle Limited Warranty(if the disablement failures on incandescent bulbs,halogen bulbs,High Intensity Discharge(HID)and
is due to a Failure). LED lamp assemblies.
4.TOWING REIMBURSEMENT-If towing is necessary because a Failure occurs or 7.WHAT IS NOT COVERED BY THIS AGREEMENT:Unless stated otherwise(See
services provided by Your coverage are required,AAA will pay the towing if the STATE SPECIFIC provisions for additional exclusions or changes), this
Vehicle is towed to the Selling Dealer or other Lincoln Motor Company franchised Agreement does NOT cover:
dealer.The amount of the cost to be reimbursed will depend upon the coverage a)Repairs covered by manufacturer recalls,insurance or in-force warranty or
You select in the Application.The towing reimbursement is limited to $100 per warranty provided by an insolvent manufacturer or insurer;
incident on Lincoln gas vehicles and$200 on Lincoln hybrid vehicles. b)Service adjustments,cleaning not made with a covered repair and software
5.KEY SERVICES OPTION-This option is available on all NEW AND USED CORE upgrades;
COVERAGES,LEASECARE COVERAGES,LIMOUSINE/LIVERY WRAP COVERAGES, c) Repairs to any engine, transmission and final drive components for
CPO UPGRADE COVERAGES OR COMPONENT WRAP(NON-CPO)COVERAGES damages caused by an after-market(non-factory installed)part including but
1.If You purchased the Key Services option with the Coverages referenced above not limited to:turbocharger, supercharger,Compressed Natural Gas (CNG),
on Your Eligible Vehicle keys and/or key fobs are lost,stolen,damaged or destroyed Liquid Propane Gas(LPG),Nitrous Oxide fuel system modification or any other
on Lincoln vehicles AAA will arrange for replacement of Your Eligible Vehicle key performance enhancing powertrain components including but not limited to
and/or key fobs.The maximum benefit for Key Services will not exceed $500 per Ford racing parts or accessories;
year(including keys and fobs,labor charges,programming,registration,and taxes). d)Repairs caused by loss of lubricants or fluids or contamination of oil,fluids
We recommend that You return to Your originating dealer or any other appropriate or fuel and repairs caused by continued operation of the vehicle after loss of
franchise dealer for Key Services. lubricant or fluids or contamination of oil,fluids or fuel;
TO PROTECT CONSUMERS, KEY SERVICES RECOMMENDS THAT ALL ELIGIBLE e)Repairs caused by improper or unauthorized service procedures,collisions
VEHICLE KEYS AND KEY FOBS REPORTED AS LOST, STOLEN, DAMAGED OR or other physical damage to the Vehicle,damage caused by a foreign object,
DESTROYED BE REPROGRAMMED BY YOUR ORIGINATING DEALER OR OTHER unreasonable use or continued use with an obvious failure(including driving
APPROVED FRANCHISE DEALER. over curbs,overloading,or using the Vehicle as a stationary power source),
2. To receive Key Services coverage, You must provide the following to Your damage from fire or explosions,road hazards,other casualty losses,or losses
originating Dealer or other appropriate franchise dealer: due to negligence, racing or Failures caused by: (1) alterations or
• A completed and signed Vehicle Ownership form; modifications of the Vehicle,including the body,chassis,or components,after
• A valid driver's license; the Vehicle leaves the control of the manufacturer(any part or accessory that
• One additional piece of identification relating to the Vehicle such as Vehicle is not permanently affixed to the Vehicle at point of sale);(2)tampering with
Title or Bill of Sale,valid Certificate of Registration or Registration,or valid proof of the Vehicle or the emissions systems and components;(3)the installation or
insurance for the Vehicle;and use of any mechanical or electrical part not approved,certified or authorized
•
Your written consent authorizing Key Services on your behalf if request is by the Vehicle's manufacturer or any repair caused by after-market
made by a third party agency. (nonfactory approved) PCM reprogramming;or (4) any part designated for
3.To receive reimbursement for Key Services Coverage,please contact the provider "offroad only" that is not installed by the manufacturer, including, but not
referenced in section 6B. limited to, lift kits, oversized tires, aftermarket wheels that do not provide
6C. RENTAL CAR REIMBURSEMENT: AVAILABLE ON NEW AND USED CORE equivalent fit and function as the original equipment installed by the
COVERAGES, LEASECARE COVERAGES, COMPONENT WRAP (NON-CPO) manufacturer, roll bars, cellular phones, alarm systems, automatic starting
systems and performance-enhancing powertrain components;
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 4 of 10
TERMS AND CONDITIONS
f) Damage caused by the environment and pollution, including airborne upholstery,physical damage or cosmetic issues. NOTE: When LeaseCARE is
fallout,corrosion chemicals,debris,tree sap,salt,hail,windstorm,lightning, purchased,Wear Items are not excluded.
freezing,flooding,earthquake,snow or ice; w)Costs or expenses for the teardown,rental expense,inspection or diagnosis
g)Damage caused by theft,vandalism,terrorism,riot or acts of war; of Failures not covered by this Agreement.
h)Any vehicle plan that exceeds the hour parameter for coverage expiration. 8.REPAIR INFORMATION
i) Repairs or services caused by lack of required or recommended main- 8A. WHERE TO GO FOR REPAIRS: (1)To obtain repairs or services under this
tenance; Agreement on Ford,Lincoln and Mercury products,We require that You return to
j)Scheduled Maintenance Services; Your Selling Dealer or any other Ford or Lincoln franchised dealership in the United
k)Repairs needed to a covered part caused by the Failure of a non-covered States or Canada.On Competitive Make products,We recommend that You return
part; to Your Selling Dealer or other repair facility to obtain repairs or services to Your
I) Repairs to the Vehicle if the odometer or hour meter is altered, broken, vehicle.If Your Vehicle is a Ford or Mercury,call 800-392-FORD to find the nearest
repaired or replaced so that We cannot determine the actual mileage or hours Ford dealership. If the Vehicle is a Lincoln,call 800-521-4140 to find the nearest
on the Vehicle; Lincoln dealership. Call 800-521-4144 to determine if repairs or services to Your
m) Loss of use of the Vehicle, loss of income, special or consequential Competitive Make Vehicle are covered by this Agreement.(2)If the Vehicle should
damages, and personal expenses, such as motels, food, gas and mileage need Emergency Service or Repair in the United States or Canada,and the vehicle is
(except as provided by Roadside Assistance); inoperable,You may use other repair or service facilities if all local Ford or Lincoln
n) Rental vehicle charges or fees such as mileage charges, drop-off fees, dealerships within a 25 mile radius are closed.If the Vehicle should need Emergency
insurance,or gasoline; Service or Repair in Mexico, We require that You return to a Ford or Lincoln
o) Vehicles manufactured for sale outside the United States, District of Dealership for repairs or services. If the vehicle is inoperable,You may use other
Columbia or Canada; repair or service facilities if all Ford and Lincoln dealerships within a 25 mile radius
p) Repairs to the Vehicle necessary due to operation outside of the United are closed.(3)To request reimbursement,You must provide a copy of the repair
States, District of Columbia, Guam, Mexico, Puerto Rico, Virgin Islands, order and proof of payment to Your Selling Dealer or contact 1-800-321-7790.You
American Samoa,or Canada; have one year from the repair order open date or payment receipt date to request
q) Repairs made to the Vehicle that are required due to a condition that Your refund.
existed prior to the purchase or transfer of this Agreement; 8B.REPAIRS&MAINTENANCE SERVICES ARE MADE WITH AUTHORIZED NEW
r)Shop supplies and disposal of environmental wastes from the Vehicle or fuel OR REMANUFACTURED PARTS:All repairs will be made with Ford authorized new
used during the repair of Your Vehicle or storage fees; or remanufactured parts or other products We authorize.
s)A Vehicle is excluded from coverage if,(1)the New Vehicle Limited Warranty 8C.LOSS LIMITS: We will pay up to the current NADA Retail Value of the Vehicle
for the Vehicle or specified component parts are voided,in whole or part,(2) for all service contract repairs for CORE Coverages, LeaseCARE Coverages,
the Vehicle is a Branded or Salvaged Vehicle,or(3)if We cannot determine the Component Wrap (Non-CPO) Coverages, Limousine/Livery Wrap Coverages and
VIN. Super Duty Coverages for each Eligible Repair Visit.On a Ford or Lincoln vehicle,We
t)The following are not covered by this Agreement:Aston Martin, Bentley, will reimburse You fair and reasonable costs for parts and labor.On a Competitive
Bugatti, Ferrari, Fisker, Hummer, Lamborghini,Land Rover, Lotus,Maserati, Make vehicle,We will reimburse You up to the Manufacturer's Suggested Retail
Maybach, McLaren, Porsche, Rolls Royce, Saab, Suzuki, Tesla and Wheego. Price for parts and up to the retail time in a National Industry Labor Time manual for
Acura NSX,Audi: R8, R9, and any model with 8 or more cylinders, BMW:6 labor.
series, 7 series, M series, Z8 and 18, Cadillac: V series, and XLR, Chevrolet: 9.YOUR RESPONSIBILITIES FOR CARE OF THE VEHICLE:To obtain coverage or
Camaro ZL1, Corvette 427, Corvette Z06, and Corvette ZR1, Chrysler: SRT, reimbursement under this Agreement, You must: (i) properly operate the
Dodge:SRT,Stealth,and Viper,Ford:Foose F-150,GT,Mustang Cobra R,All Vehicle and (ii) provide proof of Scheduled Maintenance Services. Proof of
Roush Performance Modified Vehicles(except Stage land Stage 2,)Shelby GT Scheduled Maintenance Services includes maintenance records that show
350,Shelby GT 500KR,GTS,Supersnake,all Saleen modified vehicles,and all mileage, date of maintenance service, VIN and the maintenance that was
Transit Connect Electric,Honda:Civic Natural Gas and FCX Clarity,Jaguar:F- performed.Scheduled Maintenance Service requires periodic service checks
Type,XJ series and XK series,Jeep:SRT,Lexus:LF-A and RC F,Mercedes-Benz: based on mileage intervals and the make and model of Your vehicle.Please
AMG,CL Class,G Class,Kompressor,S Class,SL Class,and SLR Class,Nissan: review the Owner's Guide for Your Scheduled Maintenance Service
GT-R, and Volkswagen: Phaeton and any model with a W12 engine, taxis, requirements that are provided to You at the time of vehicle purchase.If You
vehicles used for competitive driving/racing/off-road use, all performance perform Your own Scheduled Maintenance Services,You must maintain a log
modified vehicles,4X2-equipped vehicles modified with 4X4 AWD capabilities, including date, mileage and description of each maintenance service and
fuel cell vehicles, incomplete vehicles(e.g.,chassis cabs,cutaways, stripped provide corresponding receipts for purchases of parts and fluids.
chassis (except Ford Chevrolet, Dodge and GMC). Additional exclusions for 10. INELIGIBLE OR EXCESS COVERAGE: If You were charged for coverage for
New and Used Core,LeaseCARE and Component Wrap(Non-CPO)Coverages which Your Vehicle is ineligible or coverage in excess of the maximum allowed
includes all trucks with the box removed or deleted.Additional Exclusions for under this Agreement, We will refund the excess charge. If You financed Your
Used Core Plans and Component Wrap (Non-CPO) Plans includes all Agreement We will send the refund to Your lender with instructions to credit Your
emergency vehicles (fire/ambulance), police vehicles, limousines, livery, loan. You will be notified of the refund and the termination of any ineligible or
shuttles,and tow trucks.LeaseCARE(Ford vehicles)also excludes all Lincoln excess coverage.
and Competitive Make vehicles. LeaseCARE(Lincoln Vehicles)also excludes all 11. CONTRACT MODIFICATIONS & CHANGES: If Your coverage under this
Ford and Competitive Make Vehicles. RentalCARE coverage (Ford, Mercury Agreement has not expired or been otherwise limited, it may be modified or
and Competitive Make) excludes Competitive Make Incomplete, Cab and changed by You,as shown below:
Chassis vehicles and all Lincoln vehicles. RentaICARE (Lincoln vehicles) NEW CORE COVERAGE AND SUPER DUTY PLANS:For all Ford,Lincoln or Mercury
excludes all Ford and Competitive Make Vehicles.Additional exclusions for Vehicles and Super Duty Vehicles, You may change Your coverage under this
Certified Pre-Owned Upgrade Coverages includes vehicles equipped with Agreement:
snow plows.Additional exclusions for Incomplete Vehicle coverages includes (i)before the expiration of the New Vehicle Limited Warranty;or
all Competitive Make(non-Ford)vehicles except Chevrolet,Dodge and GMC, (ii)within the first 90 days after the Signature Date,whichever date(i)or(ii)is later.
Ford E Series vehicles with body codes El B,El E,E2E,E3B,E3E,Sl E,S2E,S3B, For all Competitive Make Vehicles,You may change Your coverage under this
and S3E, and all Ford F-650 and higher vehicle series and any equivalent Agreement:
competitive make vehicle. (it)before the expiration of the first 3 years from the Warranty Start Date or within
u) Batteries of all types and cables, belts, hoses,hose clamps,brakes (front the first 36,000 miles from Zero Miles;whichever occurs first.or
hub,drums,shoes,linings,disc rotors,pads),manual transmission clutch disc, (iv)within the first 90 days after the Signature Date,whichever date in(iii)or(iv)is
exhaust system (includes catalytic converter), spark plugs, squeaks, rattles, later.
tires,tune-ups,wheel balancing,wheel alignment,all lamps and lights(LED On New Core Coverages,Component Wrap(Non-CPO)Coverages,and Super Duty
and HID lights,bulbs,sealed beam and lenses)except when purchased with Coverages,We will charge a fee for changes to coverage that are made 12 months
New or Incomplete PremiumCARE Interior/Exterior Lighting,fogging of lamp or 12,000 miles from the New Vehicle Limited Warranty Start Date or Zero Miles.
assemblies and shock absorbers.NOTE: When LeaseCARE is purchased,Wear USED CORE COVERAGE PLANS: You may change Your coverage under this
Items are not excluded. Agreement within the first 90 days after the Signature Date.
v)Service adjustments and cleaning,fixed(non-moving)body parts,bumpers, 11A.TRANSFERABILITY:You may transfer the remaining coverage of the Vehicle
glass,moldings,ornamentation,paint,rust,sheet metal,structural underbody under this Agreement,if You pay Us a$75 transfer fee and if You or the transferee
framework,side and rear view mirrors(glass and housing),water leaks,wind of this Agreement initiates the transfer process and provides the following items to
noise,weather strips,wheels,wheel studs,wheel covers,convertible top and any Ford or Lincoln dealership or Us at P.O.Box 6045,Dearborn,Michigan 48121
bow, fabric, liners, fasteners, carpets, dash pad, wiper blades, knobs, trim, within 180 days of the vehicle sale:
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 5 of 10
TERMS AND CONDITIONS
(I)a letter,signed by You,transferring this Agreement to the transferee; MN,MT,NC,NJ and TX,We may cancel this Agreement within 5 days prior written
(ii)a statement of the mileage on the Vehicle at the time of transfer;and notice,10 days prior written notice in WY,and 15 days prior written notice in MO,
(iii)the name and address of the transferee; NJ,NY and SC when sent to You at Your last known address.Prior written notice is
You may not transfer coverage if the Vehicle becomes a Branded Vehicle or is not required if cancellation is for any of the following reasons:
repossessed.Transferred Agreements may not be cancelled. (a)You failed to pay the purchase price of this Agreement;
12.CANCELLATION AND REFUND (b)You materially misrepresented any fact or circumstance to Us;or
(A)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: (c)You substantially breached Your duties under this Agreement regarding the Ve-
(1)If the Selling Dealer receives a written cancellation request,including a copy of hicle or its use.
Your Application,proof of payment and statement of the odometer reading,on or 14.04.ALABAMA:
before the 30th day from the Signature Date and no claims have been filed under 12A.(1)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND:
this Agreement, the Selling Dealer will cancel this Agreement and refund the If You have not made a claim, and the Selling Dealer did not receive notice of
purchase price You paid for this Agreement,minus a$75 processing fee for each cancellation within 30 days from the date the Selling Dealer mailed or delivered this
plan cancelled. Agreement to You,We will charge You a cancellation processing fee not to exceed
(2)If the Selling Dealer receives a written cancellation request,including a copy of $25.
Your Application,proof of payment and statement of the odometer reading,after 12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We
the 30th day or a claim has been filed at any time during the term of this Agreement may cancel this Agreement with five(5) days prior written notice sent to You at
from the Signature Date the Selling Dealer will divide the purchase price You paid Your last known address.Prior written notice is not required if cancellation is for any
for the Agreement by the number of miles or months of coverage provided by this of the following reasons:a)You failed to pay the purchase price for this Agreement;
Agreement,whichever is greater.The Selling Dealer will multiply this dollar amount orb)You materially misrepresented any fact or circumstance to Us.
by the remaining unused miles or months, whichever is less, and refund this 14.05 ALASKA:
amount("Pro Rata basis")to You or Your lender, minus a $75 processing fee for 12. CANCELLATION AND REFUND (A) YOUR RIGHT TO CANCEL THIS
each plan cancelled. AGREEMENT AND RECEIVE A REFUND:(2)If the Selling Dealer receives a written
(3) If the Selling Dealer is no longer in business,then You may submit a written cancellation request,including a copy of Your Application,proof of payment and
request to Us at the address referenced in 11A. statement of the odometer reading,after the 30th day or a claim has been filed at
(4) You may not cancel the options You purchased without canceling the entire any time during the term of this Agreement from the Signature Date the Selling
Agreement.If this Agreement expires under the time or mileage limitations,You are Dealer will divide the purchase price You paid for the Agreement by the number of
not entitled to a refund.If we provided this Agreement to You at no cost,You are miles or months of coverage provided by this Agreement,whichever is greater.The
not entitled to a refund. Selling Dealer will multiply this dollar amount by the remaining unused miles or
(5)If You have financed this Agreement,(a)any refund due under this Agreement months,whichever is less,and refund this amount("Pro Rata basis")to You or Your
will be made payable to the lienholder,up to the amount of the lien;and(b)only lender,minus a cancellation processing fee equal to the lesser of 7.0%or$75.00.
that portion of a refund due under this Agreement in excess of the amount of the 12 (B).OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:
lien will be paid to You.If this Agreement was not financed,any refund due under We may cancel this Agreement within five days of written notice sent to You at Your
this Agreement will be paid by check issued in Your name. last known address.Prior written notice is not required if cancellation is for any of
(B)OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We may the following reasons:(a)You failed to pay the purchase price of this Agreement;or
cancel this Agreement if You fail to comply with this Agreement.If We cancel this (b)You materially misrepresented any fact or circumstance to Us.If We cancel this
Agreement,We will refund the purchase price on a Pro Rata basis.If We provided Agreement,We will refund the purchase price on a Pro Rata basis.If We provided
this Agreement at no cost,You are not entitled to a refund. this Agreement at no cost,You are not entitled to a refund.
13.DISPUTE RESOLUTION&ARBITRATION:Either You or We may choose to have 14.06.CALIFORNIA:
any dispute related to this Agreement or the Application decided by non-binding 1A. CALIFORNIA LICENSE NUMBER DISCLOSURE: THE CALIFORNIA LICENSE
arbitration administered by the Better Business Bureau (BBB). You agree not to NUMBER OF FORD MOTOR SERVICE COMPANY IS OC41369.
consolidate or group Your dispute with other arbitration or disputes concerning 1E.CALIFORNIA DEPARTMENT OF INSURANCE CONTACT INFORMATION:If any
this Agreement or Application. promise made in this contract has been denied or has not been honored within 60
days after Your request,You may contact the California Department of Insurance at
You agree that You will not participate in any class arbitration concerning this
Agreement or Application.We do not agree to class arbitration.To learn about or 1-800-927-4357.
begin arbitration,or get a copy of the Arbitration Rules,You may contact BBB at 2C.SALES TAX:Sales tax is not applicable in California.
800-955-5100 or www.auto.bbb.org/extendedserviceplan. If there is a conflict 7.WHAT IS NOT COVERED BY THIS AGREEMENT
between the Rules and this Agreement,this Agreement shall govern.If You initiate q. Repairs made to the Vehicle that are required due to a
the arbitration process,BBB will charge You an arbitration filing fee of$50. condition that existed prior to the purchase of this
You may employ an attorney to represent You in the arbitration,but an attorney is
not required. We will not pay Your attorney fees if You use an attorney. This Agreement.
Agreement is subject to the Federal Arbitration Act, 9 U.S.C. §§1 et seq. The 8D.CLAIMS APPROVAL:A valid claim will not be denied based solely on a failure
arbitration decision shall be in writing with a supporting opinion. to obtain claim approval before commencing the repair if the repair facility
14.STATE SPECIFIC PROVISIONS:The following provisions are applicable in reasonably attempted to obtain approval.
the states set forth below and modify only those specific terms referenced.All 12A. (1) (A) YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
other terms and conditions are unchanged. REFUND:If the Selling Dealer receives a written cancellation request,including a
14.01 For Agreements in ALABAMA,ALASKA, HAWAII, MAINE, MINNESOTA, copy of Your Application,proof of payment and statement of odometer reading,on
MISSOURI,NEW JERSEY,NEW MEXICO,NEW YORK,SOUTH CAROLINA,TEXAS, or before the 60th day from the Signature Date and no claims have been filed under
WISCONSIN and WYOMING: this Agreement, the Selling Dealer will cancel this Agreement and refund the
12A.(6)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: purchase price You paid for this Agreement.
In New Mexico,if You have not received your refund amount within sixty(60)days (1)(B)If the Selling Dealer receives a written cancellation request,including a copy
of your cancellation request,and within forty five (45) days of Your cancellation of Your application,proof of payment and statement of the odometer reading,on
request in AL,AK,HI,ME,MN,MO,NJ,SC,TX,WI and WY,and within thirty(30 days) or before the 60th day from the Signature date and a claim has been filed under this
of Your cancellation request in NY,You are entitled to receive ten percent(10%)of Agreement, the Selling Dealer will divide the purchase price You paid for this
the refund amount outstanding for every month that the refund is delayed. Agreement by the number of miles or months of coverage provided by this
14.02 For Agreements in ALABAMA,ALASKA, HAWAII, MAINE, MINNESOTA, Agreement,whichever is greater.The Selling Dealer will multiply this dollar amount
MISSOURI,NEW JERSEY,NEW MEXICO,NEW YORK,SOUTH CAROLINA,TEXAS, by the remaining unused months or miles,whichever is greater,and refund this
VERMONT AND WYOMING: amount("Pro Rata"basis)to You or Your lender.
12A.(1)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: (2)If the Selling Dealer receives a written cancellation request,including a copy of
If the Selling Dealer receives a written cancellation request,including a copy of Your Your Application,proof of payment and statement of the odometer reading,after
Application,proof of payment and statement of the odometer reading,on or before the 60th day from the Signature Date the Selling Dealer will divide the purchase
the 30th day from the Signature Date and no claims have been filed under this price You paid for the Agreement by the number of miles or months of coverage
Agreement,the Selling Dealer will cancel this Agreement and refund the purchase provided by this Agreement,whichever is greater.The Selling Dealer will issue a Pro
price You paid for this Agreement. Rata refund to You or Your lender,minus a cancellation processing fee equal to the
14.03 For Agreements in HAWAII, MINNESOTA, MISSOURI, MONTANA, NEW lesser of$25 or 10%of the purchase price.
JERSEY, NEW YORK, NORTH CAROLINA, SOUTH CAROLINA, TEXAS AND 12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We
WYOMING: may cancel this Agreement at any time during the term of this Agreement if You fail
12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND: In HI, to pay the purchase price of this Agreement or for any material misrepresentation
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 6 of 10
TERMS AND CONDITIONS •
or fraud. We will provide written notice, stating the specific grounds for was not financed, any refund due under this Agreement will be paid by check
cancellation,to You at Your last known address.This Agreement will no longer be issued in Your name. You may not cancel the options You purchased without
valid five days after the postmark date of the notice.If any refund is owed,a Pro canceling the entire Agreement and We will not charge You a cancellation
Rata Refund will be issued to You or Your lender within thirty days of the processing fee.If this Agreement expires under the time or mileage limitations,You
cancellation date.If We cancel this Agreement for any of the reasons stated above, are not entitled to a refund.
We will honor any claims for repair or reimbursement if submitted to Us prior to the (B)OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We may
effective date of cancellation,if eligibility requirements are met. cancel this Agreement within 60 days from this Agreement's Signature Date for any
13.DISPUTE RESOLUTION&ARBITRATION-Either You or We may choose to have reason.After 60 days from this Agreement's Signature Date,We may cancel this
any dispute related to this Agreement,or the Application decided by non-binding Agreement only for the following reasons:a)If You failed to pay the purchase price
arbitration administered by the Better Business Bureau (BBB).To learn about or for this Agreement(in which case We must provide you notice of cancellation by
begin arbitration,or get a copy of the Arbitration Rules,You may contact BBB at certified mail);b)If You materially misrepresented any fact or circumstance to Us at
800-955-5100 or www.auto.bbb.org/extendedserviceplan. We will pay Your the time of sale of this Agreement; c) If You substantially breached Your duties
reasonable arbitration fees and expenses that are in excess of$125. under this Agreement to maintain or use the Vehicle as prescribed by the
You may employ an attorney to represent You in the Arbitration,but an attorney is Manufacturer; d) You failed to repair a tampered or disabled odometer on the
not required. We will not pay Your attorney fees if You use an attorney. If We Vehicle.If We cancel this Agreement,We will make a refund of not less than one
request arbitration,We will pay the arbitration filing fee. hundred percent (100%) of the unearned gross amount that You paid for this
This Agreement is subject to California law applicable to consumer contracts and Agreement (equally prorated basis) and We will not charge You a cancellation
the California Arbitration Act(CCP section 1280 et.seq.).Any arbitration decision processing fee.
shall be in writing with a supporting opinion. 13. DISPUTE RESOLUTION&ARBITRATION- If the parties fail to agree on any
14.07.CONNECTICUT: matter concerning this Agreement or the Application or You allege damages under
5. WHAT THIS AGREEMENT COVERS: If Your Vehicle is in Our custody being this Agreement or Chapter 634 of the Florida Statutes, then the matter shall be
repaired,the coverage under this Agreement will be extended until the repair to submitted to arbitration upon the written demand of either party.The parties may
Your Vehicle is complete if this Agreement expires within one year of purchase contact the Better Business Bureau(BBB)at 1-800-955-5100 or www.auto.bbb.org/
pursuant to the Application section titled"COVERAGE TERM AND COST". extendedserviceplan to learn about or begin arbitration.The arbitrator's decisions
8A.WHERE TO GO FOR REPAIRS:(3)In house service is not provided under this shall be nonbinding on You and Us,unless both parties mutually agree to accept
Agreement.You are responsible for any costs to transport the covered Vehicle for the arbitrator's decision as final.No suit shall be commenced in a federal,state or
service that exceed the towing allowances referenced in Section 6A. of this local court until such time as both You and We first address our disagreement in an
Agreement. arbitration proceeding pursuant to this Section 13.Each claim must be arbitrated
12A(6).YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: individually. If there is a conflict between the Rules and this Agreement, this
This Agreement is cancelable if the covered Vehicle is returned,sold,lost,stolen,or Agreement shall govern.
destroyed. We will pay Your reasonable arbitration fees and expenses that are in excess of
3.DISPUTE RESOLUTION &ARBITRATION: If You purchased this Agreement in $125. You may employ an attorney to represent You in the Arbitration, but an
Connecticut,You may pursue arbitration to settle disputes between You and Us. attorney is not required.We will not pay Your attorney fees if You use an attorney.If
You may mail your complaint to:State of Connecticut,Insurance Department,P.O. We request arbitration, We will pay the arbitration filing fee.This Agreement is
Box 816, Hartford, CT 06142-0816, Attention: Consumer Affairs. The written subject to the Federal Arbitration Act(9 U.S.C.section 1 et.seq.)and the arbitration
complaint must describe the dispute,identify the price of the product and cost of decision shall be in writing with a supporting opinion.
repair,and include a copy of this Agreement. 14.09.ILLINOIS:
14.08.FLORIDA: 5. WHAT THIS AGREEMENT COVERS: Unless specifically provided in this
2C. FRAUDULENT CLAIM NOTICE: Under the Code, any people who, with the Agreement,this Agreement does not cover"wear and tear".
intent to injure,defraud or deceive any insurer,knowingly files an application for 12(A)(1)&(2): YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
coverage or a statement of claim that contains false, incomplete or misleading REFUND: If the Selling Dealer receives a written cancellation request,including a
information is guilty of a felony of the third degree. copy of Your application,proof of payment and statement of the odometer reading,
2D. FLORIDA OFFICE OF INSURANCE REGULATION: The Florida Office of on or before the 30th day from the Signature Date and no claims have been filed
Insurance Regulation does not regulate the rates charged for any plans sold under this Agreement,the Selling Dealer will cancel this Agreement and refund the
pursuant to this Agreement.The Florida Office of Insurance Regulation does purchase price less a cancellation processing fee, not to exceed 10% of the
not regulate Maintenance plans.Maintenance plan coverage is optional and Agreement purchase price or$50,whichever is less.If the Selling Dealer receives a
may only be purchased in conjunction with the purchase of a motor vehicle written cancellation request,including a copy of Your application,proof of payment
service agreement plan.The purchase price of a Maintenance plan must be and statement of the odometer reading,after the 30th day or a claim has been filed
disclosed separate and apart from the premium of a motor vehicle service at any time during the term of this Agreement from the Signature Date,the Selling
agreement plan. Dealer will divide the purchase price You paid for the Agreement by the number of
4.DEDUCTIBLES,STANDARD AND OPTIONAL:In the event You have purchased miles or months of coverage provided by this Agreement,whichever is greater.The
the Disappearing Deductible option and Your Selling Dealer is no longer in Selling Dealer will multiply this dollar amount by the remaining unused miles or
business,You may take Your vehicle to any Ford or Lincoln dealership for repair or months,whichever is less,and refund this amount("Pro-Rata basis")to You or Your
service and Your Disappearing Deductible will be honored. lender,and a cancellation processing fee that is the lesser of 10%of the Agreement
11A.TRANSFERABILITY:You may transfer the remaining coverage of the Vehicle purchase price or$50 for each plan cancelled.
under this Agreement,if You pay Us a$40 transfer fee and if You or if the transferee 14.10.INDIANA:
of this Agreement initiates the transfer process and provides the following items to 2C. PROOF OF PAYMENT-Your proof of payment to the Selling Dealer,Admi-
any Ford or Lincoln Dealership or Us at P.O.Box 6045,Dearborn,Michigan 48121 nistrator or Service Contract Provider constitutes proof of payment to the Insurer
within 180 days of the vehicle sale: listed in provision 1.D.of this Agreement.
(i)a letter,signed by You,transferring this Agreement to the transferee; 2D. This service contract is not insurance and not subject to Indiana Insurance Law.
(ii)a statement of the mileage on the Vehicle at the time of transfer;and 14.11.LOUISIANA:
(iii)the name and address of the transferee; 12A.(1)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: If
You may not transfer coverage if the Vehicle becomes a Branded Vehicle or is the Selling Dealer receives a written notice of cancellation within thirty(30) days
repossessed.Transferred Agreements may not be cancelled. from the date this Agreement was delivered or mailed to You,Selling Dealer will
12.CANCELLATION AND REFUND provide You with a full refund less a$50 processing fee.
(A)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: If We (2) If You cancel this Agreement after 30 days from the date the Agreement was
or the Selling Dealer receive a written cancellation request,including a copy of Your delivered or mailed to You,You shall receive a refund on a"Pro-Rata"basis less a
Application,proof of payment and statement of the odometer reading,on or before $50 processing fee.For purposes of this section 12.A.(2),"Pro Rata basis"will be
the 60th day from the Signature Date,We will cancel this Agreement and refund the determined by dividing the purchase price You paid for the Agreement by the
purchase price You paid under this Agreement.If We or the Selling Dealer receive a number of miles or months of coverage provided by this Agreement,whichever is
written cancellation request, including a copy of Your Application, proof of greater, multiply this dollar amount by the remaining unused miles or months,
payment and statement of the odometer reading, after the 60th day from the whichever is less.
Signature Date,You will receive a refund of not less than 90%of the unearned pro 14.12.MAINE:
rata premium paid under this Agreement.If You have financed this Agreement,(a) 1.E.ADMINISTRATION: All service contract obligations in the state of Maine are
any refund due under this Agreement will be made payable to the lienholder,up to administered by:
the amount of the lien; and (b) only that portion of a refund due under this Percepta Philippines,LLC
Agreement in excess of the amount of the lien will be paid to You.If this Agreement P.O.Box 6045
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 7 of 10
TERMS AND CONDITIONS
Dearborn,Michigan 48121 THE SALE OF THE SERVICE CONTRACT, AN
Toll Free Number:800-521 4144 ARBITRATOR WILL RESOLVE THE DISPUTE. IF
12.CANCELLATION AND REFUND ARBITRATION IS SELECTED TO RESOLVE THE
(A)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: DISPUTE, BOTH PARTIES WAIVE THEIR RIGHTS TO
(2)If the Selling Dealer receives a written cancellation request,including a copy of
Your Application,proof of payment and statement of the odometer reading,after RESOLVE THE DISPUTE IN A COURT PROCEEDING.
the 30th day or a claim has been filed at any time during the term of this Agreement C. IN AN ARBITRATION, ONE OR MORE OF THE AR-
from the Signature Date the Selling Dealer will divide the purchase price You paid BITRATORS (WHO ARE NEUTRAL DECISION MAKERS)
for the Agreement by the number of miles or months of coverage provided by this RENDER A DECISION AFTER HEARING THE
Agreement,whichever is greater.The Selling Dealer will multiply this dollar amount ARGUMENTS FROM ALL PARTIES. ARBITRATION
by the remaining unused miles or months, whichever is less, and refund this TAKES THE PLACE OF A TRIAL AND DISPUTES ARE
amount("Pro Rata basis")to You Your lender. DECIDED BY ARBITRATION,NOT A JUDGE OR JURY.
126.2B.OUR RIGHT TO CANCEL THISHISAGREEMENT AND PROVIDE A REFUND: We
may cancel this Agreement at any time during the term of this Agreement within 15 D.YOU AND WE ARE BOUND BY THE DECISION OF THE
days prior written notice when sent to You at Your last known address.We will state ARBITRATOR AND THE RESULTS OF THE
the effective date of the cancellation and the specific grounds for cancellation.If ARBITRATION ARE BINDING AND FINAL AND MAY
any refund is owed,a Pro Rata Refund will be issued to You or Your lender within NOT BE APPEALED TO A COURT.
thirty days of the cancellation date. E. IF YOU NEED ADDITIONAL INFORMATION REGA-
14.13.MINNESOTA:
3.MINNESOTA USED VEHICLE NOTICE: RDING THE DISPUTE RESOLUTION AND ARBIT-
If,on the date You purchased a used Vehicle from a Minnesota Selling Dealer, RATION SECTION IN THE SERVICE CONTRACT
A)the Vehicle had fewer than 36,000 miles from Zero Miles,the Selling Dealer AGREEMENT, PLEASE CALL THE TOLL FREE
may be required to warrant the Vehicle for(i)at least 60 days after the date ASSISTANCE LINE AT 800-392-3673.
You purchased the Vehicle or(ii)2,500 miles,whichever occurs first. F. YOU HAVE 5 DAYS FROM DELIVERY OF THIS SE-
B) If, on the date You purchased a used Vehicle from a Minnesota Selling RVICE CONTRACT AGREEMENT TO REJECT THE
Dealer,the Vehicle had more than 36,000 miles but fewer than 75,000 miles SERVICE CONTRACT AGREEMENT IF YOU DO NOT
from Zero Miles,the Selling Dealer may be required to warrant the Vehicle for WANT TO ACCEPT THIS BINDING ARBITRATION
(i)at least 30 days after the date You purchased the Vehicle or(ii)1,000 miles,
whichever occurs first. PROVISION. IF YOU REJECT THE SERVICE CONTRACT
C) If, on the date You purchased a used Vehicle from a Minnesota Selling AGREEMENT, YOU DO NOT HAVE THE SERVICE
Dealer,the Vehicle had more than 75,000 miles from Zero Miles,the Selling CONTRACT COVERAGE IT PROVIDES AND YOU ARE
Dealer is not required to warrant the Vehicle. ENTITLED TO A FULL REFUND OF THE AMOUNT YOU
7. WHAT IS NOT COVERED BY THIS AGREEMENT: (Additional Exclusions or PAID. IF YOU DO NOT REJECT THE SERVICE
changes) CONTRACT AGREEMENT WITHIN 5 DAYS,YOU HAVE
f) Damage caused by the environment and pollution, including airborne fallout, ACCEPTED IT. WE WILL PAY YOUR TOTAL
chemicals, debris, tree sap, salt, hail, windstorm, lightning, freezing, flooding,
earthquake,snow or ice; REASONABLE ARBITRATION FEES AND EXPENSES.
j)Scheduled Maintenance Services, ARBITRATION PROCEEDINGS MUST COMMENCE NO
1.For New Vehicles-repairs resulting from the lack of required or recommended LATER THAN 120 DAYS AFTER THE FIRST
maintenance as contained in the Scheduled Maintenance Guide for your vehicle; NOTIFICATION BY YOU OR US OF AN ELECTION TO
2.For Used Vehicles-repairs resulting from the lack of required or recommended ARBITRATE A DISPUTE.UNLESS YOU AND WE AGREE
maintenance, provided that, at the time the used Vehicle came into Your
possession or control: 1) the Vehicle still retained its owner's manual;or, 2) You OTHERWISE, ALL ARBITRATION PROCEEDINGS WILL
were offered a copy of the owner's manual for an incremental charge of ten dollars BE CONDUCTED AT A LOCATION IN THE COUNTY OF
($10)or less;or YOUR RESIDENCE.
3)the maintenance requirements contained in the Scheduled Maintenance Guide 14.15.MISSOURI
were replaced with a new specific maintenance schedule. 12.(A)(2).YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND:
I)Repairs to the Vehicle if the odometer If the Selling Dealer receives a written cancellation request,including a copy of Your
1.has been tampered with,but only if the tampering occurs while the Vehicle is in Application, proof of payment and statement of the odometer reading,after the
Your possession or control;or 30th day or a claim has been filed at any time during the term of this Agreement
2. If You have failed to have a broken odometer repaired, if the odometer failed from the Signature Date the Selling Dealer will divide the purchase price You paid
while the Vehicle is in Your possession or control. for the Agreement by the number of miles or months of coverage provided by this
128.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We Agreement,whichever is greater.The Selling Dealer will multiply this dollar amount
may cancel this Agreement with(5)days prior written notice sent to You at Your by the remaining unused miles or months, whichever is less, and refund this
last known address.Prior written notice is not required if cancellation is for any of amount("Pro Rata basis")to You or Your lender,minus a$50 processing fee for each
the following reasons: plan cancelled.
a)You failed to pay the purchase price for this Agreement; 14.16.NEBRASKA:
b)You materially misrepresented any fact or circumstance to Us;or 13.DISPUTE RESOLUTION&ARBITRATION: You and We must mutually agree to
c)You substantially breached Your duties under this Agreement regarding the Ve- have any dispute related to this Agreement or the Application decided by
hide or its use. nonbinding arbitration administered by the Better Business Bureau (BBB). You
d)if the VIN cannot be established because of actions for which You are responsible. agree not to consolidate or group Your dispute with other arbitration or disputes
14.14.MISSISSIPPI concerning this Agreement or Application.You agree that You will not participate
1. ARBITRATION MAY ONLY PROCEED ON AN INDI- in any class arbitration concerning this Agreement or Application.To learn about or
VIDUAL.BASIS, AND MAY NOT BE CONSOLIDATED begin arbitration,or get a copy of the Arbitration Rules,You may contact BBB at
WITH OTHER ARBITRATIONS OR ACCORDED ANY 800-955-5100 or www.auto.bbb.org/extendedserviceplan. If there is a conflict
CLASS ACTION STATUS. between the Rules and this Agreement,this Agreement shall govern.
If You initiate the arbitration process,BBB will charge You an arbitration filing fee of
A. THIS SERVICE CONTRACT AGREEMENT, INCLUDING $50. You may employ an attorney to represent You in the arbitration, but an
THE APPLICATION, INVOKES ARBITRATION UNDER attorney is not required.We will not pay Your attorney fees if You use an attorney.
THE FEDERAL ARBITRATION ACT. EITHER YOU OR This Agreement is subject to the Federal Arbitration Act,9 U.S.C.SS 1 et seq.The
WE MAY ELECT BINDING ARBITRATION TO RESOLVE arbitration decision shall be in writing with a supporting opinion.
DISPUTES UNDER THIS SERVICE CONTRACT 2C.SPALNA
AGREEMENT. 2C.SPECCIAL NOTICE-RENEWABILITY:This Agreement is non-renewable.
7(t):Taxis,vehicles used for competitive driving/racing/offroad use,fuel cell
B. IF EITHER YOU OR WE DECIDE TO ARBITRATE A DI- vehicles,performance modified vehicles at point of sale(vehicles that qualify
SPUTE REGARDING ANY ASPECT OF THIS SERVICE for coverage that are later modified or altered with performance modified
CONTRACT AGREEMENT OR THE APPLICATION AND parts are covered except for the performance modified parts and failures or
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 8 of 10
TERMS AND CONDITIONS •
repairs resulting from the performance modified parts that were not Vehicle,or the VIN cannot be established)or,
permanently affixed at point of sale),4X2-equipped vehicles modified with e) We discover (1) an act or omission by You or (2) a violation by You of any ,
4X4 AWD capabilities and incomplete vehicles (e.g. Chasis, cabs, cutaways, condition of the Agreement that occurs during the term of the Agreement and that
stripped chassis)except Ford,Chevrolet,Dodge and GMC. substantially and materially increases the service required under this Agreement.
7(x):WHAT IS NOT COVERED BY THIS AGREEMENT:This Agreement will not be 14.20.NEW YORK:
issued for any Vehicle where the New Vehicle Limited Warranty is void at the time of 2C.SPECIAL NOTICE-FOR GENERAL INFORMATION,WE MAY BE CONTACTED
Application. If this Agreement is already in effect and the New Vehicle Limited AT 800-392-FORD.
Warranty on the vehicle becomes void, this Agreement will not automatically 14.21.NORTH CAROLINA:
exclude all coverage for the Vehicle. In such situations, the Agreement will not 12A. (1) & (2) YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
cover any services that would otherwise have been provided under the New Vehicle REFUND: If You cancel this Agreement,the Selling Dealer will refund the unearned
Limited Warranty, but the Agreement will cover any other service listed in the purchase price prorated based upon the lesser of the unused months or miles of
Agreement,unless such coverage is subject to other exclusions. coverages,minus a cancellation processing fee equal to the lesser of 10%or$75.00.
8A.(4).Prior approval may be necessary for services depending on the total cost of 14.22.OREGON:
the repair.If prior approval is required,Your servicing dealer will contact Ford ESP 2C.COMPLAINTS: Unresolved complaints can be addressed to the Department of
Consumer and Business Services,Oregon Insurance Division,Consumer Advocacy
Prior Approval Headquarters for authorization.
12 A.(1).YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND: Unit, 350 Winter Street NE, Room 300-2, Salem, Oregon 97301. The telephone
If the Selling Dealer receives a written cancellation request,including a copy of Your number is 1-888-877-4894.
Application,proof of payment and statement of the odometer reading,on or before 13.DISPUTE RESOLUTION AND ARBITRATION:If You and We cannot agree to a
the 30th day from the Signature Date and no claims have been filed under this claim settlement and You have exhausted all internal appeals, You and We may
Agreement,the Selling Dealer will cancel this Agreement and refund the purchase agree to have any dispute related to or arising from this Agreement or the
Application decided by non-binding arbitration administered by the Better Business
price You paid for this Agreement. We will refund the purchase price of the
Agreement within 45 days of written notice.If a full refund is not received within 45 Bureau(BBB).To learn about or begin arbitration,or get a copy of the Arbitration
days of Your written cancellation request,You are entitled to receive an additional Rules, You may contact BBB at 800-955-5100 or www.auto.bbb.org/
10%on the refund amount owed to You for each thirty day period. extendedserviceplan.We will pay Your reasonable arbitration fees and expenses
12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:If this that are in excess of $100. You may employ an attorney to represent You in
Agreement has been in effect for at least seventy(70) days,We cannot cancel it Arbitration,but an Attorney is not required.We will not pay Your attorney fees if
prior to either:(i) its stated term,or(ii)the one(1)year anniversary of its original You use an attorney.If We request arbitration,We will pay the arbitration filing fee.
This Agreement is subject to ORS 36.600-36.740.Arbitration will take place in the
effective date,whichever occurs first.We may,however,cancel this Agreement,at state of Oregon in accordance with Oregon laws unless You and We mutually agree
any time,within 15 days prior written notice when sent to You at Your last known to another location.All arbitration decisions shall be in writing with a supporting
address,if the cancellation is for any of the following reasons:
oa)You failed to paythepurchaseprice for this Agreement; 4.2ion.
9 14.23.SOUTH CAROLINA:
b)You materially misrepresented any fact or circumstance to Us; 2C.SPECIAL NOTICE-WHO YOU SHOULD CONTACT(SOUTH CAROLINA RESI-
c)You were convicted of a crime that results in an increase in the service required DENTS ONLY):Please direct all questions or complaints concerning this Agreement
under this Agreement; to Us at P.O. Box 6045, Dearborn, Michigan 48121. In the event that We do not
d)There is a material change in the nature or extent of the required service or repair timely resolve such matters,You may contact the South Carolina of Insurance at
to be substantially and materially increased beyond that contemplated at the time either: Post Office Box 100105, Columbia, South Carolina, 29202-3105, or (800)
this Agreement was issued(such as the Vehicle is a Branded,Totaled or Salvaged 768-3467.
Vehicle,or the VIN cannot be established);or 14.24.TEXAS:
e)We discover(1)an act or omission by You,or(2)a violation by You of any co- 2C.SPECIAL NOTICE-FOR GENERAL INFORMATION,WE MAY BE CONTACTED
ndition of the Agreement that occurs during the term of the Agreement and that AT 800-392-FORD.
substantially and materially increases the service required under this Agreement. 2D. COMPLAINTS: Unresolved complaints concerning a provider or questions
13.DISPUTE RESOLUTION&ARBITRATION:Either You or We may choose to have concerning the registration of a service contract provider may be addressed to the
any dispute related to this Agreement or the Application decided by nonbinding Texas Department of Licensing and Regulation,P.O.Box 12157,Austin,Texas 78711,
arbitration administered by the Better Business Bureau (BBB). You agree not to telephone number 512-463-6599 or 800-803-9202.
consolidate or group Your dispute with other arbitration or disputes concerning 12.(A).YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND:
this Agreement or Application.You agree that You will not participate in any class (2).If the Selling Dealer receives a written cancellation request,including a copy of
arbitration concerning this Agreement or Application. To learn about or begin Your Application,proof of payment and statement of the odometer reading,after
arbitration, or get a copy of the Arbitration Rules, You may contact BBB at the 30th day or a claim has been filed at any time during the term of this Agreement
800-955-5100 or www.auto.bbb.org/extendedserviceplan. If there is a conflict from the Signature Date the Selling Dealer will divide the purchase price You paid
between the Rules and this Agreement,this Agreement shall govern. for the Agreement by the number of miles or months of coverage provided by this
If You initiate the arbitration process,BBB will charge You an arbitration filing fee of Agreement,whichever is greater.The Selling Dealer will multiply this dollar amount
$50. You may employ an attorney to represent You in the arbitration, but an by the remaining unused miles or months, whichever is less, and refund this
attorney is not required.We will not pay Your attorney fees if You use an attorney. amount("Pro Rata basis")to You or Your lender,minus a$50 processing fee for each
This Agreement is subject to the Federal Arbitration Act,9 U.S.C.SS 1 et seq.The plan cancelled.
arbitration decision shall be in writing with a supporting opinion. (6) The right to cancel this Agreement is not transferable to subsequent Service
14.18.NEW HAMPSHIRE: Contract Holders.
2C.SPECIAL NOTICE TO NEW HAMPSHIRE RESIDENTS ONLY: Please direct all 14.25.WASHINGTON:
questions or complaints concerning this Agreement to Us at P.O. Box 6045, 2B. INSURER CUT-THROUGH BENEFITS:You are not required to wait sixty(60)
Dearborn,Michigan 48121.In the event You do not receive satisfaction under this days to file a claim for service or other benefit owed pursuant to this Agreement
contract,You may contact the New Hampshire Insurance Department at either:21 directly with the insurer of this Agreement.
South Fruit Street,Suite 14,Concord,New Hampshire 03301,or(800)852-3416. 7.WHAT IS NOT COVERED BY THIS AGREEMENT:
14.19.NEW MEXICO: i) Repairs to a covered part caused by the lack of required or recommended
12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND: If this maintenance.
Agreement has been in effect for at least seventy(70) days,We cannot cancel it 10. INELIGIBLE OR EXCESS COVERAGE: If You were charged for coverage for
prior to either:i) its stated term,or,ii)the one(1)year anniversary of its original which Your vehicle is ineligible or coverage in excess of the maximum allowed
effective date,whichever occurs first.We may,however,cancel this Agreement at under this Agreement, We will refund the excess charge. If You financed Your
any time,with fifteen(15)days prior written notice sent to You at your last known Agreement We will send the refund to Your lender with instructions to credit Your
address,if the cancellation is for any of the following reasons: loan.We may cancel this Agreement within 60 days of this Agreement being mailed
a)You failed to pay the purchase price for this Agreement; or delivered to You for ineligible or excess coverage.You will be notified of the
b)You materially misrepresented any fact or circumstance to Us; refund and the termination of any ineligible or excess coverage.
c)You were convicted of a crime that results in an increase in the service required 12A.YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND:
under this Agreement; (1) If You have not made a claim under this Agreement and the Selling Dealer
d)there is a material change in the nature or extent of the required service or repair receives written notice of cancellation within 30 days after this Agreement was
that occurs after the Signature Date that causes the required service or repair to be delivered or mailed to You,the Selling Dealer will provide you with a full refund of
substantially and materially increased beyond that contemplated at the time this the purchase price paid.(2)If You have not made a claim under this Agreement and
Agreement was issued(such as the New Vehicle Limited Warranty of the Vehicle has You cancel this Agreement 30 days after the date this Agreement was delivered or
been voided, in whole or in part, the Vehicle is a Branded,Totaled or Salvaged
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 9 of 10
TERMS AND CONDITIONS
mailed to You,You shall receive a pro rata refund of the unearned purchase price This Agreement is subject to the Federal Arbitration Act,9 U.S.C.§§1 et seq.The
based upon the unused months or miles of coverage remaining,whichever is less, arbitration decision shall be in writing with a supporting opinion.
minus a$25 cancellation processing fee.(6)If the Selling Dealer does not pay You 14.26.WYOMING:
the full refund amount within 30 days of Our receipt of Your cancellation request, 1A.In the State of Wyoming,the Service Contract Provider is Ford Motor Service
You are entitled to receive an additional 10%based on the refund amount owed to Company doing business as American Road Administrative Company.
You. 13. DISPUTE RESOLUTION & ARBITRATION: Any arbitration taking place in
12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We Wyoming will comply with the Wyoming Uniform Arbitration Act.At the time of any
may cancel this Agreement only within 60 days of this Agreement being mailed or disagreement between You and Us; in a separate written agreement,the parties
delivered if You fail to comply with this Agreement.If We cancel this Agreement, may voluntarily agree to submit their matters of difference to arbitration and that
We will refund the purchase price on a Pro Rata basis. If We provided this the results of arbitration are binding on the parties without the right of appeal.
Agreement at no cost,You are not entitled to a refund.
12C.WHO ISSUES REFUND PAYMENTS: Refund payments will be made by the
Selling Dealer,your lienholder,The American Road Insurance Company or Us.
13.DISPUTE RESOLUTION&ARBITRATION:You and We must mutually agree to
have any dispute related to this Agreement or the Application decided by binding
arbitration administered by the Better Business Bureau (BBB). You agree not to
consolidate or group Your dispute with other arbitration or disputes concerning
this Agreement or Application.You agree that You will not participate in any class
arbitration concerning this Agreement or Application. To learn about or begin
arbitration, or get a copy of the Arbitration Rules, You may contact BBB at
800-955-5100 or www.auto.bbb.org/extendedserviceplan. If there is a conflict
between the Rules and this Agreement,this Agreement shall govern.
If you initiate the arbitration process,BBB will charge You an arbitration filing fee of
$50. You may employ an attorney to represent You in the arbitration, but an
attorney is not required.We will not pay Your attorney fees if You use an attorney.
This Agreement is subject to the Federal Arbitration Act,9 U.S.C.§§1 et seq.The
arbitration decision shall be in writing with a supporting opinion. Arbitration
proceedings concerning this Agreement,the Application and the sale or solicitation
thereof will be held at a location in the closest proximity to Your permanent
residence.
13A.CIVIL ACTION: The State of Washington is the jurisdiction of any civil action
in connection with this Service Contract.
14.26.WISCONSIN:
1.E.ADMINISTRATION:All service contract obligations in the state of Wisconsin
are administered by:
COVERAGE/CLAIMS
CANCELS/TRANSFERS
Percepta Philippines,LLC
P.O.Box 6045
Dearborn,Michigan 48121
Toll Free Number:800-521-4144
STATE FILINGS
The American Road Insurance Company
P.O.Box 6045
Dearborn,Michigan 48121
2C. WISCONSIN DISCLOSURE: THIS CONTRACT IS SUBJECT TO LIMITED
REGULATION BY THE OFFICE OF THE COMMISSIONER OF INSURANCE.
12A.YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A REFUND:
(1)If the Selling Dealer receives a written cancellation request,including a copy of
Your Application,proof of payment and statement of the odometer reading,on or
before the 30th day from the Signature Date the Selling Dealer will cancel this
Agreement and refund the purchase price You paid for this Agreement.
(6)If the Selling Dealer receives a written cancellation request,including a copy of
Your Application,proof of payment and statement of the odometer reading,after
the 30th day from the Signature Date,the Selling Dealer will divide the purchase
price You paid for the Agreement by the number of miles or months of coverage
provided by this Agreement,whichever is greater.The Selling Dealer will multiply
this dollar amount by the remaining unused miles or months,whichever is less,and
refund this amount("Pro-Rata"basis)to You or Your Lender.
12B.OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A REFUND:We
may cancel this Agreement within five(5)days of providing prior written notice to
You at Your last known address if:
a)You fail to pay the purchase price of this Agreement
b)You materially misrepresent any fact or circumstance to Us
c)You substantially breach Your duties under this Agreement regarding the Vehic-
le or its use.If We cancel this Agreement,We will refund the purchase price on a Pro
Rata basis. If We provided this Agreement at no cost,You are not entitled to a
refund.
13.DISPUTE RESOLUTION&ARBITRATION:You or We must mutually agree to
have any dispute related to this Agreement or the Application decided by
nonbinding arbitration administered by the Better Business Bureau(BBB).To learn
about or begin arbitration,or get a copy of the Arbitration Rules,You may contact
BBB at 800-955-5100 or www.auto.bbb.org/extendedserviceplan. If there is a
conflict between the Rules and this Agreement,this Agreement shall govern.
If You initiate the arbitration process,BBB will charge You an arbitration filing fee of
$50. You may employ an attorney to represent You in the arbitration, but an
attorney is not required.We will not pay Your attorney fees if You use an attorney.
ESP 8240-Nat App/Provs W/Key(Oct 15)(Previous Editions May Not be Used) Page 10 of 10
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DATE Ffr
fieaul.
— ailt NO ICE INV
..,.
0 •:!:01'''-1:
,ktzliiig,',,
gYr MARCH 24,2016
AqE3
GC 7 2 8 41 0
!,:ilfiei i YEAR
MAKE
VEHICLE IDENTIFICATION NO
1 Fm51(8AruCGGC 7 2 8 4 1 2016 FORD
,.......,.,
SHIPPING WEIGHT ......
BODY TYPE 4 54 8 LBS
,..,
113 EXPLORER POLICE AWD 4DR
CYLS
SERIES OR MODEL
V.:p H R( A,E) IN IR NOm
1( "''''''' 33S 93 "6342 LBS 6 K8A.t. RI6
'fiflir=?.11:. NOMINAL TONNAGE 1/2
...........
I,the undersigned authorized representative of the companyfirm or corporation named belovi./,hereby cer-
tify that the new vehicle described above is the property of tke said company firm; or corporation and Is
,*.,:lii.:,.1:1';.• transferred on the above date and under the Invoice Number indicated to the following distributor or dealer. :::;:,:.,,:si,,,\I..
NAME OF DISTRIBUTOR,DEALER,ETD P.0. NUMBER OAKPARKHE I G 0/2:,
ii.J63::.s1
fei,ig. --"••
Ogg," Nelson Auto Center, Inc.
. ..,
gitl., ‘ lmk
10E.,
P 0. BOX 338 -..d.i.V.
le,ro Fergus Falls MN 56538
p....3..iil•- ,. ..
figil,
5 8 B4 04 '•it'.i-r.'.
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It is further certified that this was the first transfer of such new motor vehicle in ordinary trade and commerce.
MEMO DATA ,.... , . ._ ..... .
FORD MOTOR COMPANY
FINANCE SOURCE 6 6 0 55 .... j.„.,. j
rP't;tiit' BY cellitL/Mitel- ••-••• (-1924.1"-rf ..... ,
BANK OF AMERICA ONATHAN E OSGOOD,SECRETARY ' (AGENT)
.,,...,,,.
4161 Piedmont Pkwy,
... ...... -..•''';"1.
Greensboro NC DEARBORN, MICHIGAN
CITY-STATE ......„,
27410
1„1:11.141 1111111111111 111 111 III 1111111111111111111111111111111 1111111111111111111 1111111111 1111111111111
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.........
1
I` Each undersigned seller c tifies to the best of his knowledge,information and bell f under penalty of law that the vehicle is new and has not been registered in
1 this or any state at the time of delivery and the vehicle is not subject to any security interests other than those disclosed herein and warrant title to the vehicle.
FDR VALUE RECEIVED I TRANSFER THE VEHICLE DESCRIBED ON I HE FACE OF THIS CERTIFICATE TO
cc .NAME OF ?. --- '
--
Si PURCHASER(S):: f.
w 2 ADDRESS
b D
0 Z I certify to/the
best/of my kriowle ge that the o ometer reading is
gZ iUe„, 'J'/ (JLI'i iC.i" (! ,� /, No Tenths
�w DEALER BY: `'�J
FCO Z NAME OF DEALERSHIP DEALERS LICENSE NUMBER Being duly sworn upon oath says tl t the statements set
E7 State of - forth are true and correct.Subsc ed and sworn to me
n N
p G County of__--- before ihis� day of
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION Notary Public
m N NAME OF
ui at w PURCHASER(S _
w g ADDRESS -
0 Z I certify to the best of my krm wiedge that the odometer reading`is
CO w DEALER Na Tenths
0[ m:Z : BY: 'F- II
CC NAME OF DEALERSHIP DEALERS LICENSE NUMBER Doing duly sworn upon oath says that the statements set Z :
gt 'C7 State of �, forth are true and correct Subscribed and sworn to me
p Q County of_ before this day of.
2,k Notary Public Q
CL USF NOTARIZATIONONLV IF REQUIRED IN TITLING JURISDICTION
U ¢M NAME OF
CI) ww PURCHASER(S),. w,
•
CC w g ADDRESS ; i
p oD O
J .
Z I certify to the best of my knowledge that the odometer reading is ~
z _ No Tenths 6,
J D LLL DEALER BY:
�1 m'� NArv1E OFDCALERSI�IP DEALERS LICENSE NUMBER Being duly sworn upon null.says.that the state,nents set
( a C7 state of forth are true and correct.Subscribed and sworn to me
5 tom before thisday of Z p 4. County of. eY-e
to USE NOTARIZAT ON ONLY IF REQUIRED IN TITLING JURISDICTION --- Notary Pubr,c Ca
Z m a NAME OF Q.
F.. s w PURGHASER(S) Q .
.
O wg ADDRESS
Z 0 Z I certify to the best of my krtOwledge that the odometer reading is. __ W'
No Tenths
L s Si DEALER ,. —BY 0
0..
Ca Fm 7 ' NAME OF DEALERSHIP DEALERS LICENSE NUMBER Being duly sworn upon oath says that the statements set 0
a State of K forth are true and correct.Subscrbed and sworn to me O
O N m before this day of_ —
0 p C r County of_ Y — 0
USE NOTARIZATION ONLY IF REQUIRED IN TITLING JURISDICTION — Notary Public
= Federal Law requires you to slate the odometer mileage in connection with the transfer of ownership.Failure to complete or providing a false statement may result
n fines and/or imprisonment
w I certify to the best of my knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following staternents is checked Odometer
m Reading _ No Tenths U The mileage stated is in excess of its mechai tical limits.U Thu odometer reading is not the actual mileage
vrn-i y WARNING ODOMETER DISCREPANCY
Signatures)of Seller(s)_
A Date of Statement
rn�+ _ Date of Sale _
W. Printed Names)of Seller(s'� Dealer's No Being duly sworn upon oath segs lilat the statements set
Ej
forth are true arid correct Subscribed and sworn to me
m' Signature of Purchaser(s) i. before this day of
wlr
20 Om Printed Name(s)of PU �
rcha3er(s) -
a Notary Public
p Company Name(If A,pplica(5Ie)_
Siatebf
Address of Purchaser(s) County ol.
USE NOTARIZATION IF REQUIRED IN TI FLING JURISDICTION
W. 1st lien in favor of
-J whose address is — —
2 2nd lien in favor of( —_ - — 04 ...
LU whose address is ---
-