HomeMy WebLinkAboutUntitled (5) Ford Extended Service Plan
P.O. Box 6045 RECEIVED
Dearborn, MI 48121
City of Oak Park Heights
.--_____AM PM
City Of Oak Park Heights
14168 57th St N
Oak Park Heights, MN 55082-6409
-065
/ e
rf
342 - 160 - 2017
NATIONAL VEHICLE SERVICE CONTRACT
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 FM5K8AR6HGC8627 0 051717 051717 CPO
Internet Sale Current Mileage Current Hours* IPP Term n Incomplete
Yes ❑ No 1 (Cab/Chassis)
Surcharges: Limo/Livery Wrap
n 12 Months/12,000 Miles n 36 months/36,000 miles(Ford and Competitive Make or 48 months/50,000 miles(Lincoln vehicles)
n Turbocharger/Supercharger n Snowplow Commercial Use n Specialty-Emergency(Fire,Ambulance) n Component Wrap
n Specialty-Emergency(Fire,Ambulance,Police pursuit units-except Ford Police Interceptor),Limo,Livery,Shuttle,Tow Truck) (Non-CPO)
New Plan Coverage:Core-PowertrainCARE,BaseCARE,ExtraCARE,PremiumCARE (Standard Deductible is$100)
LeaseCARE-New PremiumCARE with Wear Items-(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 New Plan n 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 05-17-2022 100,000 $ $ $
Options n First Day Rental Delete n Enhanced Rental I I Key Services 13-1( Interior/Exterior Lighting Delete PDL(Lincoln Only)
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 n Enhanced Rental Key Services n Interior/Exterior Lighting Delete n PDL(Lincoln Only)
*Super Duty and Incomplete Vehicle Plan Coverages require current hours and expiration Total $ $ $
hours 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 Terms and
Conditions(the"Agreement")at 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 the Washington Residents Only:By initialing this box,I acknowledge I have reviewed
binding arbitration language in the Mississippi Section. with Dealer the 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
051717
Name Address
City Of Oak Park Heights 14168 57th St N
City State Zip Code E-mail Address Service Contract Lienholder Name
Oak Park Heights MN 55082-6409
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
4 0 9 3 9 FOR OFFICE USE ONLY
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) CUSTOMER COPY
TERMS AND CONDITIONS
1A.INTRODUCTION&PARTIES(FORD MOTOR SERVICE COMPANY): Coverage begins at the Signature Date and Current Mileage.Coverage ENDS
In all states except CO, FL, ID, KS, and WA, all service contract obligations, the earlier of the Number or Months Purchased or the Number of Miles
including the Application (this "Agreement") are between Ford Motor Service Purchased from the expiration of the New Vehicle Limited Warranty.
Company,the Service Contract Provider(hereinafter referred to as"We", "Us' ELIGIBLE FORD, LINCOLN OR MERCURY VEHICLES THAT HAVE NO
or"Our")and the Service Contract Holder(hereinafter referred to as"You"or NEW VEHICLE LIMITED WARRANTY REMAINING AND ELIGIBLE USED
"Your"). In the states of Colorado, Kansas, and Washington, all service COMPETITIVE MAKE VEHICLES (REGARDLESS OF WARRANTY
contract obligations for Competitive Make Vehicles, including the Application STATUS), Coverage BEGINS at the Signature Date and Current Mileage.
are between Us and You.You may contact Us at the following address: Coverage ENDS at the earlier or the Number of Months Purchased or the
Ford Motor Service Company Number of Miles Purchased from the Signature Date and Current Mileage.
Extended Service Plan Headquarters 2B. INSURER "CUT-THROUGH" BENEFITS: If any insured service contract
P.O. Box 6045 repair or reimbursement claim has not been completed within 60 days from the
Dearborn, Michigan 48121 date You filed a claim with the Selling Dealer or Us or We are insolvent or
Toll-free number 800-521-4144 financially impaired, You may make a claim directly against The American
FULL FAITH AND CREDIT STATEMENT: In all states except in 1C and 1D Road Insurance Company for the cost of your repairs(including all sums which
below,all service contract obligations under this Agreement are backed by the We are legally obligated to pay to You), subject to the exclusions, deductions
full faith and credit of Ford Motor Service Company and are not guaranteed and limitations contained in this Agreement and in the underlying policy of
under a service contract reimbursement policy. Complimentary Plans are insurance.You may not make a cut through claim against The American Road
backed by the full faith and credit of Ford Motor Company. Insurance Company for a Complimentary Plan. Complimentary plans are not
1B. INTRODUCTION & PARTIES (FORD MOTOR COMPANY): In ID, all offered in the states of Florida and New York.
service contract obligations under this Agreement, are between Ford Motor 3. DEFINITIONS: In this Agreement, the following capitalized terms have the
Company,the Service Contract Provider(hereinafter referred to as"We","Us", meanings assigned to them:
or"Our")and the Service Contract Holder(hereinafter referred to as"You"or Branded Vehicle means a vehicle that has a valid certificate of title that
"Your"). In the states of CO, KS, and WA, all service contract obligations on indicates: (i) a salvage title, (ii) that the vehicle was stolen or (iii) that an
Ford, Lincoln and Mercury products are between US and YOU. You may insurance carrier insuring the vehicle determined that the physical damage to
contact us at the following address: the vehicle exceeded the value of the vehicle.
Ford Motor Company Certified Pre-Owned (CPO)Vehicle Upgrade Coverage means a new core
Extended Service Plan Headquarters coverage on a Ford, Lincoln or Mercury vehicle purchased for an additional
P.O. Box 6045 price that may provide additional component coverage or longer term and
Dearborn, Michigan 48121 mileage benefits beyond the manufacturer's certified warranty.
You may contact the Selling Dealer at the address shown on the Application Commercial Use means the Vehicle is: (i)used primarily for business or gov-
for the Selling Dealer. ernment purposes,by an individual or multiple drivers any government agency
FULL FAITH AND CREDIT STATEMENT: In ID all service contract or municipality; or (ii) designated by the Selling Dealer as a vehicle sold for
obligations under this Agreement are backed by the full faith and credit of Ford Commercial Use when reported to the vehicle's manufacturer. Ford, Lincoln or
Motor Company. In the states of CO, KS, and WA all service contract Mercury vehicles reported sold with delivery codes: "3", "4", "6", "7", "C", "D",
obligations under this Agreement on Ford, Lincoln and Mercury products are "E","H","I","L","M","5","T",and"#"are vehicles used for Commercial Use.
backed by the full faith and credit of Ford Motor Company and are not Competitive Make Vehicle means any vehicle other than a Ford, Lincoln or
guaranteed under a service contract reimbursement policy. Complimentary Mercury vehicle.
Plans are also backed by the full faith and credit of Ford Motor Company. Component Wraps (Non-CPO) Coverage means new ExtraCARE or
1C. INTRODUCTION & PARTIES (Florida only): This service contract, PremiumCARE coverage for any component not covered under any existing
including the Application, (this "Agreement") on Ford, Lincoln and Mercury Powertrain Warranty.
vehicles is between Ford Motor Company (referred to in this Agreement as CORE Coverage means new or used PowertrainCARE, BaseCARE,
"We", "Us", or "Our") and the service contract holder (referred to in this ExtraCARE,and PremiumCARE coverage.
Agreement as"You"or"Your"). Our Florida license number is 12118.You can Disappearing Deductible means a deductible option under which there is no
contact Us at the address referenced in 1B above. All service contract deductible charged for each Eligible Repair Visit when repairs or services are
obligations on competitive make vehicles is between The American Road performed by the Selling Dealer.
Insurance Company and You.The Certificate of Authority Number is 09079 for Eligible Repair Visit means a single visit to a dealer or other repair provider
The American Road Insurance Company. You can contact The American for service or repair of a failure to the Vehicle covered by this Agreement.
Road Insurance Company at the address referenced in 1D. Emergency Service or Repair means necessary service or repair to an
1D. INSURED AGREEMENT STATEMENT: In the state of Connecticut, all inoperable Vehicle at a dealer or repair provider other than a Ford or Lincoln
service contract obligations, on all Ford, Lincoln, Mercury and Competitive dealership.
Make products are fully insured and guaranteed by a policy of contractual Emergency Travel Expenses means the costs of Your meals, lodging, car
liability insurance or service contract reimbursement insurance. In the states of rental and commercial transportation to Your destination and the return trip to
CO, NE, WA and WI, all service contract obligations on Competitive Make retrieve Your Vehicle after it is repaired.
Products are fully insured and guaranteed by a policy of contractual liability Failure means a cessation of normal functioning of the Vehicle components
insurance or service contract reimbursement insurance. The policy is issued covered by this Agreement that arise from defects in materials or workmanship
by: or caused by normal wear and tear covered by this Agreement.
The American Road Insurance Company Hours means an alternate measure of mileage to determine coverage plan
P.O.Box 6045 expiration for which 1 hour equals 25 miles, and applies to all Super Duty
Dearborn,Michigan 46121 Coverage Plans and Incomplete Vehicle Plans.
Policy Number:81-3110-700-001 and all applicable endorsements. Incomplete Vehicle means vehicles known as chassis cabs, stripped chassis
1E.ADMINISTRATION: All service contract obligations under this Agreement and cutaways. Incomplete for Ford vehicles means vehicles with the first three
are administered by: VIN positions of 1FB, 1FC, 1FD, 1F6, 2LI, 2LJ, 3FR and 5LD (except body
Ford Customer Service Division types E14, E24, S24, E31, S31, E34, S34 , E1B, E1E, E2E, E3B, E3E, S1E,
16800 Executive Plaza Drive S2E, S3B, and S3E). Only Chevrolet, Dodge, Ford and GMC vehicles are
Dearborn,Michigan 48126 eligible for Incomplete Vehicle Plans.
2. ENTIRE AGREEMENT: This Agreement, which includes the Application, is Internal Lubricated Parts means parts within the engine block that are part of
the complete and exclusive statement of the agreement and understanding the reciprocating/moving assembly including crankshaft, camshaft pistons,
between You and Us regarding the extended service contract and related connecting rods, valve train components (i.e. valves, springs, keepers,
benefits for Your vehicle. rockers, lash adjusters, tappets/lifters, piston rings, oil pump, oil pressure
2k WHEN COVERAGE BEGINS AND ENDS: For NEW PLAN regulator and and piston wrist pins).
AGREEMENTS, Coverage begins at the New Vehicle Limited Warranty Start LeaseCARE Coverage means new PremiumCARE coverage with Wear
Date and Zero Miles or actual or equivalent Hours. Coverage ends at the Items.
earliest of the Number of Months Purchased or the Number of Miles or actual Limousine/Livery Wrap Coverage means new PremiumCARE coverage on
or equivalent Hours purchased from the New Vehicle Limited Warranty Start any Lincoln Continental, MKS, MKT, Navigator Limo, Navigator Livery or any
Date or Zero Miles or Hours. For USED PLAN AGREEMENTS ON ELIGIBLE vehicle used or operated for hire or funeral business.
FORD, LINCOLN OR MERCURY VEHICLES THAT HAVE NEW VEHICLE New Vehicle Limited Warranty means the manufacturer's original limited
LIMITED WARRANTY REMAINING AT THE TIME OF PURCHASE, bumper to bumper warranty overing a new Vehicle or the parts and
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 1 of 11
TERMS AND CONDITIONS
components of the new Vehicle. the Vehicle before performing any service or repairs.
Provider Fee means the consideration paid for a service contract. 5A.COVERED ITEMS- "PowertrainCARE"
Reimbursement Insurance Policy means a policy of insurance that is issued If You elected PowertrainCARE, the following items are covered except for
to a service contact provider for reimbursement of service contract obligations. Component Wrap(Non-CPO)Plan Coverages.
RentaICARE Coverage means reimbursement for vehicle rentals due to Engine-Cylinder block and Internal Lubricated Parts, seals and gaskets, the
repairs covered under the manufacturers'warranty or recalls. cylinder heads, manifold (Exhaust, Intake and bolts), factory installed
Retail Value of the Vehicle means the retail value of the Vehicle at the time turbocharger/supercharger units, timing chain (gears or belt), flywheel, valve
of repair or service, as determined by"National Auto Dealer's Association(N. covers, oil pan, timing chain cover, oil pump, water pump, thermostat,
A.D.A.)Guide",taking into consideration the location, mileage and condition of thermostat housing.
the Vehicle. (EXCEPTIONS: CARBURETION AND FUEL INJECTION COMPONENTS
Scheduled Maintenance Services means all scheduled maintenance ARE NOT COVERED).
services at the service intervals listed in the Scheduled Maintenance Guide for Transmission - Transmission case and all internal parts including torque
the Vehicle, including adherence to the normal or severe duty mileage and converter and transfer case(all internal parts),seals and gaskets.
time requirements depending on vehicle usage. Front-Wheel Drive - Final drive housing and Rear Axle Housing for AWD
Selling Dealer means the authorized Ford or Lincoln dealership that sold the (including all Internal parts),universal and constant velocity joints,axle shafts,
service contract represented by this Agreement. locking rings (four-wheel drive vehicles), seals and gaskets, and automatic
Service Contract means a contract or agreement for consideration above the front locking hubs(four-wheel drive).
lease or purchase price of the Vehicle for a specific duration to perform the Rear-Wheel Drive - Drive axle housings and Front Axle Housing for 4X4
repair, replacement, or services for operational or structural failure due to a (including all Internal parts), universal and constant velocity joints,axle shafts,
defect in materials or workmanship,or normal wear and tear. seals and gaskets,and driveshafts.
Service Contract Holder or Purchaser means a person who is the original 5B.COVERED ITEMS-"BaseCARE"
purchaser or original holder of a service contract. If You elected BaseCARE,You have PowertrainCARE coverage and coverage
Service Contract Provider or Provider means a person who is contractually for the following additional items:
obligated to the service contract holder under the terms of the service contract. Odometer&Speedometer-Coverage is provided for both the odometer and
Signature Date means the date You signed the Application to this Agreement. speedometer,including all cables and connectors.
Snow Plow Factory Option means any new and used F-150 (except Engine - Metal fuel lines, harmonic balancer and bolt, and diesel injector
2011-2012 model years), Ford F-250, F-350, F-450 and F-550 trucks that are pump.
equipped with Snow Plow Prep Package models 53C, 86M,473,or 627(7700 Steering-Power steering pump, cooler and metal lines,couplings, seals and
Payload Group-V), 862, 863, 864, 62B, 62S, 63A, 68P and 47S or any snow gaskets, manual and power steering gear housing and all internal parts,
plow package that is the equivalent of the Snow Plow Prep Package models. including linkages, control valve, column lock(tilt wheel), pulley assembly for
Speciality means any vehicle classified as emergency(fire/ambulance),police power steering pump,and the idler arm.
(except Ford police interceptor), limousine, livery, shuttle or tow truck Front Suspension - MacPherson struts, upper and lower control arms,
on all Coverages except Incomplete Vehicle Coverage Plans. Specialty for stabilizer bar,linkage and bushings,tie rods,control arm shafts and bushings,
Incomplete Vehicle Coverage Plans means Emergency (fire and ambulance) upper and lower ball joints, kingpins and bushings, spindle and spindle
vehicles. supports. NOTE: This coverage includes only the items listed in this
Super Duty Coverage means a Ford Super Duty Diesel EngineCARE and paragraph and does not include either front end alignments or wheel
Ford Super Duty Diesel EngineCARE Plus coverage plan on an eligible 2016 balancing,unless the repair to such items is required in conjunction with
Model Year or Newer Ford F-250,Ford F-550 truck,a Ford E-250,Ford E-350, the repair of a Failure.
Ford E-450 or a Ford Excursion equipped with a 3.2L or a 6.7L Power Stroke Brakes - Master cylinder, calipers and wheel cylinders, combination valve,
engine. metal lines and fittings,power brake booster,backing plates,springs,clips and
Vehicle means the vehicle identified in the Application by the VIN and in the retainers, self-adjusters, parking brake linkage and cables, brake pedal shaft.
State of Washington subject to registration under chapter 46.16 RCW. NOTE:This coverage includes only the items listed in this paragraph and
Vehicle Identification Number (VIN) means the 17 alpha-numeric identifier does not include brake drums, rotors, linings or pads, unless the repair
assigned to a motor vehicle by the manufacturer. to such items is required in conjunction with the repair of a covered
Warranty Start Date,for the New Vehicle Limited Warranty, means the date Failure.
on which the Vehicle was placed into service. If the Vehicle was used by the Air Conditioning - Compressor, condenser, evaporator, NC compressor
dealership as a demonstrator unit, the Warranty Start Date is the date the head, NC compressor clutch switch, NC clutch and clutch bearings,
Vehicle was placed into service as a demonstrator unit. compressor seals,pulley and field coil.
Wear Items means coverage for brake pads and linings, clutch disc, spark Electrical - Alternator, starter motor, voltage regulator, manually operated
plugs,engine belts,coolant hoses,hose clamps and o-ring seals,wiper blades electrical switches, ignition switch, wiper motors, electronic ignition module,
and shock absorbers/struts. radiator fan relay, fuel pump, starter motor solenoid, wiring harnesses
Zero Miles means the starting mileage for the calculation of the expiration of (excluding spark plug wires), and electrical components of a heated back
all New Vehicle Limited Warranties. For benefit determinations, all New glass. NOTE: Heated back glass coverage is for electrical components
Vehicle Limited Warranties are considered to begin with zero miles on the only and does not include general glass damage or breakage.
Vehicle. 5C.COVERED ITEMS-"ExtraCARE"
4.DEDUCTIBLES: If You elected ExtraCARE, You have PowertrainCARE and BaseCARE
STANDARD DEDUCTIBLES coverage and coverage for the following additional items:
If You elected coverage with a Standard Deductible or Optional Deductible, Engine-Flywheel ring gear,diesel lift pump and gas and diesel fuel injectors.
We will charge You that deductible for each Eligible Repair Visit,regardless of High Tech-Air conditioner accumulator, ETA pump hose assembly,anti-lock
the number of Failures to be repaired. brake module and sensor, automatic temperature control, distributor cap and
OPTIONAL DEDUCTIBLES rotor, electronic air suspension (switch-vacuum pump, control-assembly
Deductible options are not available on Super Duty Coverages, LeaseCARE suspension air spring,spring&solenoid assembly front suspension,air spring
and RentaICARE Coverages. The $200 Deductible option is not available on solenoid, o-ring solenoid, left/right-front spring, dryer assembly, sensor-air
the CPO Upgrade Coverages, Component Wrap (Non-CPO) Coverages, and level, airline protector, spring-load leveling, control module-air suspension,
Limousine/Livery Wrap Coverages. The $50 Deductible is not available on sensor right/left rear suspension leveling,air suspension quick connect,airline
Incomplete Vehicle Coverages. The $0 Deductible Option is not available on repair kit, switch-right/left rear suspension leveling, o-ring suspension air
Used Core Plan Coverages. The Disappearing Deductible is not available on spring dryer, silencer-air suspension, wire assembly air suspension switch,
Incomplete Vehicle Coverages and Limousine/Livery Wrap Coverages. front spring air suspension and rear spring air suspension), electronic
5. WHAT THIS AGREEMENT COVERS: Subject to the deductibles, instrument cluster (excluding the dash pad, clock, audio and visual
exclusions and other limitations in this Agreement and depending on the Plan equipment),fuel tank and lines,diesel injectors and lines,heater blower motor
Coverage You elected, service and repairs (including parts, labor costs and heater control assembly, and core assembly, keyless entry system(excluding
applicable taxes)will be provided while You own the Vehicle. door handles), power seat motors, power window motors and regulators,
We will either: (a)service Your Vehicle; (b)repair or replace covered Failures power antenna, power door locks(excluding door handles and electronic key
or(c)reimburse You for the Vehicle's servicing in the event of an Emergency fobs), power door lock retainer clip,radiator,radiator fan, radiator fan clutch or
Service or Repair, or for the repair or replacement of covered Failures and motor, speed control, engine mounts, transmission vacuum module and
repairs needed to a non-covered component caused by the Failure of a mounts,and external transmission module.
covered component.We may review the requested repair or service or inspect 5D. COVERED ITEMS-"PremiumCARE" If You elected PremiumCARE, all
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 2 of 11
TERMS AND CONDITIONS
Failures are covered EXCEPT for those items excluded in the Provision coverage;(d)out of fuel assistance,which provides the delivery of gasoline or
titled:"WHAT IS NOT COVERED BY THIS AGREEMENT". diesel fuel to You, including the cost of up to 2 gallons of fuel (5 gallons of
5E.COVERED ITEMS-NEW PLAN"LeaseCARE" diesel fuel for diesel engine vehicles), provided that coverage is limited to 3
If you elected LeaseCARE, You have PremiumCARE coverage with Wear "no charge"service calls during a 12 month period; and (d)towing,when the
Items. Vehicle is disabled, provided this coverage is limited to one tow per
5F. COVERED ITEMS - NEW PLAN "Component Wrap (Non-CPO) disablement.
Coverage" If You elected Component Wrap(Non-CPO)Coverage, You have ITEMS NOT COVERED: Roadside Assistance does not provide coverage for:
new ExtraCARE or PremiumCARE coverage for all components not covered (a) replacement parts, (b) gasoline or diesel fuel (except for an out of fuel
under any existing Powertrain Warranty. Component Wrap (Non-CPO) assistance call provided in section 6.1(d) herein), (c)tire repair, (d) rental of
Coverage applies only to the original Service Contract Holder for the selected towing equipment,(e)storage fees;(f)fees for labor performed at a garage or
coverage and is not transferable to any subsequent vehicle owner. service facility;or,(g)any"out of fuel"service request if the Vehicle is located
5G.COVERED ITEMS-NEW PLAN"LIMOUSINE/LIVERY Wrap Coverage" at Your residence or an operating commercial fueling station; (h) impound
If You elected Limousine/Livery Wrap Coverage, You have PremiumCARE towing or towing by a person other than a licensed service station or garage;
coverage on all components not covered under any ExtraCARE Limited (i) the assistance of any private parties or (j) alternative fuel (such as
Warranty. compressed natural gas or liquid propane gas). WHEN YOU CALL FOR
5H. COVERED ITEMS - NEW PLAN "RentaICARE" If You elected SERVICE, YOU WILL BE CONNECTED WITH THE DISPATCHER AND A
RentaICARE coverage, We will reimburse You for the actual charges up to SERVICE VEHICLE WILL BE SENT TO YOUR LOCATION. PLEASE
$30 per day(including tax)on Ford and Competitive Make vehicles and $45 PROVIDE THE DISPATCHER WITH:
per day (including tax) on Lincoln vehicles that You incur to rent a motor 1)Your name,address and the VIN;
vehicle for up to (3) days while Your Vehicle is being repaired provided, 2)the exact location of the Vehicle;and,
however:(i)the service or repair is:(1)covered under the New Vehicle Limited 3)the nature of Your emergency.
Warranty or (2) the result of a manufacturer's recall or customer satisfaction LIMIT OF LIABILITY:If You prefer to arrange Your own roadside assistance or
program and(ii)the vehicle must be rented from a Ford or Lincoln dealership towing,We will reimburse You up to$100 per disablement for the emergency
or other commercial agency that rents or leases motor vehicles as its principal expenses You actually incur, provided that within twenty (20) days of the
business. RentaICARE coverage will begin when You deliver the Vehicle to disablement You send a written request for Roadside Assistance benefits that
the Selling Dealer or other dealer that has a franchise from an original includes a statement of Your loss and the original receipts for Your expenses
equipment manufacturer. To determine the (3) day coverage period, the first to Ford Roadside at the address shown herein.
day of coverage is the day after You deliver Your Vehicle for repair or service. 2. EMERGENCY TRAVEL EXPENSE REIMBURSEMENT-If Your Vehicle is
If You elected RentaICARE Coverage with a plan term beyond the 3 years or disabled 100 or more miles from Your residence(according to Ford Roadside
36 months from the New Vehicle Limited Warranty, You will receive records) as a result of a collision or a mechanical Failure covered by this
component coverage only under our PremiumCARE plan upon expiration of Agreement or the New Vehicle Limited Warranty,We will reimburse You up to
the earlier of 3 years or 36 months from the New Vehicle Limited Warranty,for $500 for the actual Emergency Travel Expenses You incur within the first 72
the additional plan term You selected. hours following the disablement.
51.COVERED ITEMS-Ford Super Duty Diesel EngineCARE If You elected 3. DESTINATION ASSISTANCE - If the Vehicle is disabled because of a
Ford Super Duty Diesel EngineCARE, the following items are covered: collision or Failure covered by this Agreement or a New Vehicle Limited
Crankcase, oil cooler, cylinder block, cylinder heads, cylinder head gasket, Warranty and You require transportation to Your destination, We will
EGR cooler, factory installed turbocharger, fuel injection pump, fuel injection reimburse Your transportation costs up to$75.
pressure regulator, fuel injectors, internal lubricated parts, oil pump, timing To receive reimbursement expenses under "EMERGENCY TRAVEL
chain cover,and timing chain(gears or belt). EXPENSE REIMBURSEMENT"and"DESTINATION ASSISTANCE",within
5J. COVERED ITEMS - Ford Super Duty Diesel EngineCARE Plus If You twenty (20) days of the disablement, You must send to Ford/Lincoln
elected Ford Super Duty Diesel EngineCARE Plus, the following additional Roadside at the address shown here in a written request for benefits that
items are covered: Flywheel, manifold (exhaust and intake), manifold and includes: (i) a statement of Your loss; (ii) the original receipts for Your
bolts, oil pan, seals and gaskets, thermostat, thermostat housing, valve expenses; (iii)a copy of the accident report filed with the state or local
covers,and water pump. police (if the disablement is caused by a collision); (iv) a copy of the
6.ADDITIONAL BENEFITS repair order indicating the service or repairs performed under this
6A. ROADSIDE ASSISTANCE COVERAGE (FORD AND COMPETITIVE Agreement or the Vehicle's New Vehicle Limited Warranty (if the
MAKE VEHICLES) - Only available with the following NEW AND USED disablement is due to a Failure).
CORE PLAN COVERAGES, LEASECARE COVERAGES, COMPONENT 4. TOWING REIMBURSEMENT - If towing is necessary because a Failure
WRAP (NON-CPO) COVERAGES, LIMOUSINE/LIVERY WRAP occurs or services provided by Your coverage are required, Ford/Lincoln
COVERAGES OR SUPER DUTY COVERAGE PLANS: Roadside will pay the towing if the Vehicle is towed to the Selling Dealer or
For all New and Used Core Coverages, LeaseCARE Coverages, Component other Ford Motor Company franchised dealer. The amount of the cost to be
Wrap (Non-CPO) Coverages, Limousine/Livery Wrap Coverages and Super reimbursed will depend upon the coverage You select in the Application. The
Duty Coverages up to and including E and F-250 vehicle series and equivalent towing reimbursement is limited to $100 per incident on E and F-250 vehicle
vehicle series, We contracted with Cross Country Motor Club, Inc. and Cross series and$200 per incident on E and F-350 vehicle series and higher.
Country Motor Club of California, Inc. ("Cross Country"), licensed automobile 5.KEY SERVICES OPTION-This option is available on all NEW AND USED
clubs,to provide roadside assistance to You as part of this Agreement. Cross CORE COVERAGES, LEASECARE COVERAGES, LIMOUSINE/LIVERY
Country's address is P.O. Box 9145, Medford, MA 02155. For all Super Duty WRAP COVERAGES, CPO UPGRADE COVERAGES OR COMPONENT
Plans covering E and F-350 vehicle series and higher and equivalent vehicle WRAP(NON-CPO)COVERAGES:
series, We contracted with Pinnacle Motor Club, Inc., Coach Net RV Motor 1. If You purchased the Key Services option with the Coverages referenced
Club, Inc. in California and Coach Net Motor Club, Inc. in Massachusetts above on Your Eligible Vehicle keys and/or key fobs are lost,stolen,damaged
(together, "Coach Net") licensed automobile clubs, to provide Roadside or destroyed on vehicles up to and including E and F-550 vehicle series or any
Assistance to You as part of this Agreement. Coach Net's address is P.O. Box equivalent competitive make vehicle series, Ford Roadside will arrange for
141266, Irving, Texas 75014-1266. Cross Country and Coach Net shall replacement of Your Eligible Vehicle key and/or key fobs. The maximum
hereinafter be collectively referred to as "Ford Roadside." Roadside benefit for Key Services will not exceed $500 per year (including keys and
Assistance includes: (i) Roadside Assistance Items, (ii) Emergency Travel fobs, labor charges, programming, registration, and taxes). We recommend
Expense Reimbursement, and (iii) Destination Assistance. The Roadside that You return to Your originating dealer or any other appropriate franchise
Assistance benefits provided under this Agreement are available from Ford dealer for Key Services.
Roadside 24 hours a day,7 days a week. TO PROTECT CONSUMERS, KEY SERVICES RECOMMENDS THAT ALL
To request roadside assistance or for customer inquiries, call Ford ELIGIBLE VEHICLE KEYS AND KEY FOBS REPORTED AS LOST,STOLEN,
Roadside at 800-241-3673. Service providers who provide Roadside DAMAGED OR DESTROYED BE REPROGRAMMED BY YOUR
Assistance are independent contractors and not employees, agents or ORIGINATING DEALER OR OTHER APPROVED FRANCHISE DEALER.
representatives of Cross Country,Coach Net or Us. 2. To receive Key Services coverage, You must provide the following to Your
1. ROADSIDE ASSISTANCE ITEMS COVERED: Roadside Assistance originating Dealer or other appropriate franchise dealer:
provides coverage of up to$100 in benefits for the following items(including • A completed and signed Vehicle Ownership form;
the cost of the service call and labor costs for services performed at the site of • A valid driver's license;
the disablement):(a)lock-out assistance;(b)flat tire changes;(c)battery jump • One additional piece of identification relating to the Vehicle such as Vehicle
starts (electric Vehicle's main power cell batteries are not included in this
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 3 of 11
TERMS AND CONDITIONS
Title or Bill of Sale, valid Certificate of Registration or Registration, or valid occurs or services provided by Your coverage are required, AAA will pay the
proof of insurance for the Vehicle;and towing if the Vehicle is towed to the Selling Dealer or other Lincoln Motor
Your written consent authorizing Key Services on your behalf if request is Company franchised dealer. The amount of the cost to be reimbursed will
made by a third party agency. depend upon the coverage You select in the Application. The towing
6B. ROADSIDE ASSISTANCE COVERAGE (LINCOLN VEHICLES) - reimbursement is limited to $100 per incident on Lincoln gas vehicles and
Available with the following NEW AND USED CORE PLAN COVERAGES, $200 on Lincoln hybrid vehicles.
LEASECARE COVERAGES, COMPONENT WRAP (NON-CPO) 5.KEY SERVICES OPTION-This option is available on all NEW AND USED
COVERAGES,AND LIMOUSINE/LIVERY WRAP COVERAGE PLANS: CORE COVERAGES, LEASECARE COVERAGES, LIMOUSINE/LIVERY
For all New and Used Core Coverages, LeaseCARE Coverages, Component WRAP COVERAGES, CPO UPGRADE COVERAGES OR COMPONENT
Wrap (Non-CPO) Coverages, Limousine/Livery Wrap Coverages, We WRAP(NON-CPO)COVERAGES
contracted with The American Automobile Association, Inc.and The Auto Club 1. If You purchased the Key Services option with the Coverages referenced
Group d/b/a AAA Wisconsin (together, "AAA"), an association of licensed above on Your Eligible Vehicle keys and/or key fobs are lost,stolen,damaged
automobile clubs, to provide roadside assistance to You as part of this or destroyed on Lincoln vehicles AAA will arrange for replacement of Your
Agreement. AAA's address is 1000 AAA Drive, Mail Drop 99, Heathrow, FL Eligible Vehicle key and/or key fobs. The maximum benefit for Key Services
32746. Roadside includes: (i) Roadside Assistance Items, (ii) Emergency will not exceed $500 per year (including keys and fobs, labor charges,
Travel Expense Reimbursement, and (iii) Destination Assistance. The programming,registration,and taxes).We recommend that You return to Your
Roadside Assistance benefits provided under this Agreement are available originating dealer or any other appropriate franchise dealer for Key Services.
from AAA, 24 hours a day,7 days a week. TO PROTECT CONSUMERS, KEY SERVICES RECOMMENDS THAT ALL
To request roadside assistance or for customer inquiries, call AAA at ELIGIBLE VEHICLE KEYS AND KEY FOBS REPORTED AS LOST,STOLEN,
800-521-4140. Service providers who provide Roadside Assistance are DAMAGED OR DESTROYED BE REPROGRAMMED BY YOUR
independent contractors and not employees,agents or representatives of AAA ORIGINATING DEALER OR OTHER APPROVED FRANCHISE DEALER.
or Us. 2. To receive Key Services coverage,You must provide the following to Your
1. ROADSIDE ASSISTANCE ITEMS COVERED: Roadside Assistance originating Dealer or other appropriate franchise dealer:
provides coverage of up to$100 in benefits for the following items (including A completed and signed Vehicle Ownership form;
the cost of the service call and labor costs for services performed at the site of A valid driver's license;
the disablement):(a)lock-out assistance;(b)flat tire changes;(c)battery jump One additional piece of identification relating to the Vehicle such as
starts (electric Vehicle's main power cell batteries are not included in this Vehicle Title or Bill of Sale,valid Certificate of Registration or Registration,or
coverage; (d)out of fuel assistance,which provides the delivery of gasoline or valid proof of insurance for the Vehicle;and
diesel fuel to You, including the cost of up to 2 gallons of fuel, provided that Your written consent authorizing Key Services on your behalf if request
coverage is limited to 3 "no charge" service calls during a 12 month period; is made by a third party agency.
and (d) towing of up to $100 on gas vehicles and up to $200 on hybrid 6C. RENTAL CAR REIMBURSEMENT: AVAILABLE ON NEW AND USED
vehicles, including vehicles with trailers attached, when the Vehicle is CORE COVERAGES, LEASECARE COVERAGES, COMPONENT WRAP
disabled, provided this coverage is limited to one tow per disablement and (e) (NON-CPO) COVERAGES, OR SUPER DUTY COVERAGES You may be
winch out within 100 feet of paved or county maintained road. eligible for rental car reimbursement if: (i) the servicing or repair facility
ITEMS NOT COVERED: Roadside Assistance does not provide coverage for: determines that the service or repair is:(a)covered under this Agreement or a
(a) replacement parts, (b) gasoline or diesel fuel (except for an out of fuel New Vehicle Limited Warranty or(b)covered under both this Agreement and
assistance call provided in section 6B (1) herein), (c)tire repair, (d) rental of the Manufacturers' Limited Warranty for Powertrain, Safety and Emission
towing equipment, (e)storage fees; (f)fees for labor performed at a garage or coverages or a Ford Motor Company manufacturer's recall, and (ii)You rent
service facility;or,(g)any"out of fuel"service request if the Vehicle is located the vehicle from a Ford or Lincoln dealership or other commercial agency.
at Your residence or an operating commercial fueling station; (h) impound If You elect the First Day Rental Delete Option,an additional eligibility term for
towing or towing by a person other than a licensed service station or garage; Rental Car Reimbursement is the Vehicle must be kept overnight by the repair
(i) the assistance of any private parties or (j) alternative fuel (such as facility because it was inoperable or would become inoperable if it was
compressed natural gas or liquid propane gas). WHEN YOU CALL FOR continued to be operated.
SERVICE, YOU WILL BE CONNECTED WITH THE DISPATCHER AND A If You meet all of the eligibility requirements set forth herein,We will reimburse
SERVICE VEHICLE WILL BE SENT TO YOUR LOCATION. PLEASE You for vehicle rental charges You actually incur up to$30 per day(including
PROVIDE THE DISPATCHER WITH: tax) for Ford, Mercury and Competitive Make Vehicles and $45 per day
1)Your name,address and the VIN; (including tax) for Lincoln vehicles for up to 10 days or until the repair is
2)the exact location of the Vehicle;and, complete, whichever occurs first. Rental Car Reimbursement starts when the
3)the nature of Your emergency. Vehicle is delivered to the Selling Dealer or other Ford Motor Company
LIMIT OF LIABILITY: If You prefer to arrange Your own roadside assistance or franchised dealer for service and the vehicle is inoperable. Rental Car
towing,We will reimburse You up to$100 per disablement for the emergency Reimbursement ends when the repair is completed.
expenses You actually incur on Lincoln gas vehicles and up to$200 on Lincoln 6D. FIRST DAY RENTAL OPTION - If Your Vehicle is a Ford, Lincoln or
hybrid vehicles, provided that within twenty(20)days of the disablement You Mercury Vehicle, You received First Day Rental with Your NEW OR USED
send a written request for Roadside Assistance benefits that includes a CORE COVERAGES, LEASECARE COVERAGES, COMPONENT WRAP
statement of Your loss and the original receipts for Your expenses to AAA at (NON-CPO) COVERAGES, OR CPO UPGRADE COVERAGE, We will
the address shown herein. reimburse You for vehicle rental charges You actually incur up to$30 per day
2. EMERGENCY TRAVEL EXPENSE REIMBURSEMENT-If Your Vehicle is (including tax)for Ford, Mercury and Competitive Make Vehicles and $45 per
disabled 100 or more miles from Your residence (according to AAA records) day(including tax)for Lincoln vehicles for up to 10 days or until the repair is
as a result of a collision or a mechanical Failure covered by this Agreement or complete, whichever occurs first. Rental Car Reimbursement starts when the
the New Vehicle Limited Warranty, We will reimburse You up to $500 for the Vehicle is delivered to the Selling Dealer or other Ford Motor Company
actual Emergency Travel Expenses You incur within the first 72 hours franchised dealer for service. We will not reimburse You for any vehicle rental
following the disablement. charge(s) incurred before the Signature Date of this Agreement or upon
3. DESTINATION ASSISTANCE - If the Vehicle is disabled because of a completion of Your repair.
collision or Failure covered by this Agreement or a New Vehicle Limited 6E.ENHANCED RENTAL OPTION:This option is available on all NEW AND
Warranty and You require transportation to Your destination, We will USED CORE COVERAGES, LEASECARE COVERAGES, COMPONENT
reimburse Your transportation costs up to$75. WRAP (NON-CPO) COVERAGES, CPO UPGRADE COVERAGES,
To receive reimbursement expenses under "EMERGENCY TRAVEL RENTALCARE COVERAGES AND SUPER DUTY COVERAGES. If You
EXPENSE REIMBURSEMENT"and"DESTINATION ASSISTANCE",within elected to purchase Enhanced Rental Option with any of the Coverages
twenty (20) days of the disablement, You must send to AAA at the referenced above, We will reimburse You for vehicle rental charges You
address shown here in a written request for benefits that includes: (i)a actually incur up to$60 per day(including tax)for up to 10 days for all plans
statement of Your loss;(ii)the original receipts for Your expenses;(iii)a except RentaICARE and for up to 3 days on RentalCare or until the repair is
copy of the accident report filed with the state or local police (if the complete, whichever occurs first. Enhanced Rental Option starts when the
disablement is caused by a collision); (iv) a copy of the repair order Vehicle is delivered to the Selling Dealer or other Ford Motor Company
indicating the service or repairs performed under this Agreement or the franchised dealer for service.
Vehicle's New Vehicle Limited Warranty (if the disablement is due to a 6F. INTERIOR/EXTERIOR LIGHTING OPTION -This option is available on
Failure). New, Incomplete and CPO Upgrade PremiumCARE Coverages and
4. TOWING REIMBURSEMENT - If towing is necessary because a Failure
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 4 of 11
TERMS AND CONDITIONS
LeaseCARE Coverages. If you purchased any of the above coverages, You r)Shop supplies and disposal of environmental wastes from the Vehicle
received Interior/Exterior Lighting coverage for electrical failures on or fuel used during the repair of Your Vehicle or storage fees;
incandescent bulbs, halogen bulbs, High Intensity Discharge (HID) and LED s) A Vehicle is excluded from coverage if, (1) the New Vehicle Limited
lamp assemblies. Warranty for the Vehicle or specified component parts are voided, in
6G. LINCOLN PICK UP DELIVERY AND LOANER SERVICE OPTION:This whole or part, (2)the Vehicle is a Branded or Salvaged Vehicle, or(3) if
option is available on New PremiumCARE Coverage and LeaseCARE We cannot determine the VIN.
Coverages on eligible Lincoln vehicles. If You elected the Lincoln Pick Up, t)The following are not covered by this Agreement: Alfa Romeo,Aston
Delivery and Loaner Service Option You may contact any Lincoln dealership Martin, Bentley, Bugatti, Ferrari, Fisker, Hummer, Lamborghini, Land
within a 20 mile radius of Your vehicle location for pick up and delivery of Your Rover, Lotus, Maserati, Maybach, McLaren, Porsche, Rolls Royce,Saab,
Lincoln vehicle to the dealership location for unlimited repairs and other Suzuki,Tesla and Wheego.Acura NSX,Audi: R8,R9,R20 and any model
services related to Your vehicle. You will receive the First Day Rental Option with 8 or more cylinders, BMW: 6 series, 7 series, M series, Z8 and 18,
and a loaner vehicle at the time of pick up and delivery of Your vehicle for Cadillac: V series, and XLR, Chevrolet: Camaro ZL1, Corvette 427,
repairs or services. The loaner vehicle will be provided for up to two days Corvette Z06,and Corvette ZR1,Chrysler:SRT,Dodge:SRT,Stealth,and
and up to$45 per day per service. Viper, Ford: Foose F-150,GT, Mustang Cobra R,All Roush Performance
7. WHAT IS NOT COVERED BY THIS AGREEMENT: Unless stated Modified Vehicles (except Stage land Stage 2,) Shelby GT 500KR, GTS,
otherwise(See STATE SPECIFIC provisions for additional exclusions or Supersnake, all Saleen modified vehicles, and all Transit Connect
changes),this Agreement does NOT cover: Electric, Honda: Civic Natural Gas and FCX Clarity, Jaguar: F-Type, XJ
a) Repairs covered by manufacturer recalls, insurance or in-force series and XK series,Jeep:SRT,Lexus: LF-A and RC F,Mercedes-Benz:
warranty or warranty provided by an insolvent manufacturer or insurer; AMG,CL Class,G Class,Kompressor,S Class,SL Class,and SLR Class,
b) Service adjustments, cleaning not made with a covered repair and Nissan: GT-R, and Volkswagen: Phaeton and any model with a W12
software upgrades; engine, taxis, vehicles used for competitive driving/racing/off-road use,
c) Repairs to any engine, transmission and final drive components for all performance modified vehicles (including Hennessey), 4X2-equipped
damages caused by an after-market(non-factory installed)part including vehicles modified with 4X4 AWD capabilities, fuel cell vehicles,
but not limited to:turbocharger,supercharger,Compressed Natural Gas incomplete vehicles (e.g., chassis cabs, cutaways, stripped chassis
(CNG), Liquid Propane Gas (LPG), Nitrous Oxide fuel system (except Ford Chevrolet, Dodge and GMC).Additional exclusions for New
modification or any other performance enhancing powertrain and Used Core,LeaseCARE and Component Wrap(Non-CPO)Coverages
components including but not limited to Ford racing parts or includes all trucks with the box removed or deleted. Additional
accessories; Exclusions for Used Core Plans and Component Wrap(Non-CPO) Plans
d)Repairs caused by loss of lubricants or fluids or contamination of oil, includes all emergency vehicles (fire/ambulance), police vehicles,
fluids or fuel and repairs caused by continued operation of the vehicle limousines, livery, shuttles, and tow trucks. LeaseCARE (Ford and
after loss of lubricant or fluids or contamination of oil,fluids or fuel; Competitive Make vehicles) excludes all Lincoln vehicles. LeaseCARE
e) Repairs caused by improper or unauthorized service procedures, (Lincoln vehicles) excludes all Ford and Competitive Make vehicles.
collisions or other physical damage to the Vehicle, damage caused by a RentaICARE coverage (Ford and Competitive Make) excludes
foreign object, unreasonable use or continued use with an obvious Competitive Make Incomplete, Cab and Chassis vehicles and all Lincoln
failure(including driving over curbs,overloading,or using the Vehicle as vehicles. RentaICARE (Lincoln vehicles) excludes all Ford Vehicles.
a stationary power source), damage from fire or explosions, road Additional exclusions for Certified Pre-Owned Upgrade Coverages
hazards, other casualty losses, or losses due to negligence, racing or includes vehicles equipped with snow plows. Additional exclusions for
Failures caused by: (1) alterations or modifications of the Vehicle, Incomplete Vehicle coverages includes all Competitive Make(non-Ford)
including the body,chassis,or components,after the Vehicle leaves the vehicles except Chevrolet, Dodge and GMC, Ford E Series vehicles with
control of the manufacturer (any part or accessory that is not body codes EIB, El E, E2E, E3B, E3E, SIE, S2E, S3B, and S3E, and all
permanently affixed to the Vehicle at point of sale); (2) tampering with Ford F-650 and higher vehicle series and any equivalent competitive
the Vehicle or the emissions systems and components; (3) the make vehicle.The Pick Up,Delivery and Loaner Service Option excludes
installation or use of any mechanical or electrical part not approved, car washes, detailing, lease or vehicle returns, Lincoln Commercial Use
certified or authorized by the Vehicle's manufacturer or any repair vehicles, Lincoln fleet vehicles purchased or leased with codes 7 and D,
caused by after-market (nonfactory approved) PCM reprogramming; or Lincoln vehicles purchased outside of the United States, and Roadside
(4) any part designated for "offroad only" that is not installed by the Assistance Services.
manufacturer, including, but not limited to, lift kits, oversized tires, u) Batteries of all types and cables, belts, hoses, hose clamps, brakes
aftermarket wheels that do not provide equivalent fit and function as the (front hub, drums, shoes, linings, disc rotors, pads), manual
original equipment installed by the manufacturer, roll bars, cellular transmission clutch disc, exhaust system (includes catalytic converter),
phones, alarm systems, automatic starting systems and performance- spark plugs, squeaks, rattles, tires, tune-ups, wheel balancing, wheel
enhancing powertrain components; alignment, all lamps and lights(LED and HID lights, bulbs, sealed beam
f) Damage caused by the environment and pollution, including airborne and lenses) except when purchased with New or Incomplete
fallout, corrosion chemicals, debris, tree sap, salt, hail, windstorm, PremiumCARE Interior/Exterior Lighting, fogging of lamp assemblies
lightning,freezing,flooding,earthquake,snow or ice; and shock absorbers. NOTE: When LeaseCARE is purchased, Wear
g)Damage caused by theft,vandalism,terrorism,riot or acts of war; Items are not excluded.
h) Any vehicle plan that exceeds the hour parameter for coverage v) Service adjustments and cleaning, fixed (non-moving) body parts,
expiration. bumpers, glass, moldings, ornamentation, paint, rust, sheet metal,
i)Repairs or services caused by lack of required or recommended main- structural underbody framework, side and rear view mirrors (glass and
tenance; housing), water leaks, wind noise, weather strips, wheels, wheel studs,
j)Scheduled Maintenance Services; wheel covers,convertible top and bow,fabric, liners,fasteners, carpets,
k) Repairs needed to a covered part caused by the Failure of a non- dash pad, wiper blades, knobs, trim, upholstery, physical damage or
covered part; cosmetic issues. NOTE: When LeaseCARE is purchased, Wear Items
I)Repairs to the Vehicle if the odometer or hour meter is altered,broken, are not excluded.
repaired or replaced so that We cannot determine the actual mileage or w) Costs or expenses for the teardown, rental expense, inspection or
hours on the Vehicle; diagnosis of Failures not covered by this Agreement.
m) Loss of use of the Vehicle, loss of income, special or consequential 8.REPAIR INFORMATION
damages,and personal expenses,such as motels,food,gas and mileage 8A. WHERE TO GO FOR REPAIRS: (1)To obtain repairs or services under
(except as provided by Roadside Assistance); this Agreement on Ford, Lincoln and Mercury products, We require that You
n)Rental vehicle charges or fees such as mileage charges,drop-off fees, return to Your Selling Dealer or any other Ford or Lincoln franchised
insurance,or gasoline; dealership in the United States or Canada. On Competitive Make products,
o)Vehicles manufactured for sale outside the United States, District of We recommend that You return to Your Selling Dealer or other repair facility to
Columbia or Canada; obtain repairs or services to Your vehicle. If Your Vehicle is a Ford or Mercury,
p) Repairs to the Vehicle necessary due to operation outside of the call 800-392-FORD to find the nearest Ford dealership. If the Vehicle is a
United States, District of Columbia, Guam, Mexico, Puerto Rico, Virgin Lincoln, call 800-521-4140 to find the nearest Lincoln dealership. Call
Islands,American Samoa,or Canada; 800-521-4144 to determine if repairs or services to Your Competitive Make
q) Repairs made to the Vehicle that are required due to a condition that Vehicle are covered by this Agreement. (2) If the Vehicle should need
existed prior to the purchase or transfer of this Agreement; Emergency Service or Repair in the United States or Canada,and the vehicle
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 5 of 11
TERMS AND CONDITIONS
is inoperable,You may use other repair or service facilities if all local Ford or 12.CANCELLATION AND REFUND
Lincoln dealerships within a 25 mile radius are closed. If the Vehicle should (A) YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
- need Emergency Service or Repair in Mexico,We require that You return to a REFUND:
Ford or Lincoln Dealership for repairs or services. If the vehicle is inoperable, (1) If the Selling Dealer receives a written cancellation request, including a
You may use other repair or service facilities if all Ford and Lincoln dealerships copy of Your Application, proof of payment and statement of the odometer
within a 25 mile radius are closed. (3) To request reimbursement, You must reading,on or before the 30th day from the Signature Date and no claims have
provide a copy of the repair order and proof of payment to Your Selling Dealer been filed under this Agreement,the Selling Dealer will cancel this Agreement
or contact 1-800-321-7790.You have one year from the repair order open date and refund the purchase price You paid for this Agreement, minus a $75
or payment receipt date to request Your refund. processing fee for each plan cancelled.
8B. REPAIRS & MAINTENANCE SERVICES ARE MADE WITH (2) If the Selling Dealer receives a written cancellation request, including a
AUTHORIZED NEW OR REMANUFACTURED PARTS: All repairs will be copy of Your Application, proof of payment and statement of the odometer
made with Ford authorized new or remanufactured parts or other products We reading, after the 30th day or a claim has been filed at any time during the
authorize. term of this Agreement from the Signature Date the Selling Dealer will divide
8C. LOSS LIMITS: We will pay up to the current NADA Retail Value of the the purchase price You paid for the Agreement by the number of miles or
Vehicle for all service contract repairs for CORE Coverages, LeaseCARE months of coverage provided by this Agreement, whichever is greater. The
Coverages, Component Wrap (Non-CPO)Coverages, Limousine/Livery Wrap Selling Dealer will multiply this dollar amount by the remaining unused miles or
Coverages and Super Duty Coverages for each Eligible Repair Visit. On a months,whichever is less,and refund this amount("Pro Rata basis")to You or
Ford or Lincoln vehicle, We will reimburse You fair and reasonable costs for Your lender,minus a$75 processing fee for each plan cancelled.
parts and labor. On a Competitive Make vehicle, We will reimburse You up to (3) If the Selling Dealer is no longer in business, then You may submit a
the Manufacturer's Suggested Retail Price for parts and up to the retail time in written request to Us at the address referenced in 11A.
a National Industry Labor Time manual for labor. (4)You may not cancel the options You purchased without canceling the entire
9. YOUR RESPONSIBILITIES FOR CARE OF THE VEHICLE: To obtain Agreement. If this Agreement expires under the time or mileage limitations,
coverage or reimbursement under this Agreement,You must:(i)properly You are not entitled to a refund. If we provided this Agreement to You at no
operate the Vehicle and (ii) provide proof of Scheduled Maintenance cost,You are not entitled to a refund.
Services. Proof of Scheduled Maintenance Services includes (5) If You have financed this Agreement, (a) any refund due under this
maintenance records that show mileage, date of maintenance service, Agreement will be made payable to the lienholder,up to the amount of the lien;
VIN and the maintenance that was performed. Scheduled Maintenance and(b)only that portion of a refund due under this Agreement in excess of the
Service requires periodic service checks based on mileage intervals and amount of the lien will be paid to You. If this Agreement was not financed,any
the make and model of Your vehicle.Please review the Owner's Guide for refund due under this Agreement will be paid by check issued in Your name.
Your Scheduled Maintenance Service requirements that are provided to (B) OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A
You at the time of vehicle purchase.If You perform Your own Scheduled REFUND: We may cancel this Agreement if You fail to comply with this
Maintenance Services,You must maintain a log including date, mileage Agreement. If We cancel this Agreement,We will refund the purchase price on
and description of each maintenance service and provide corresponding a Pro Rata basis. If We provided this Agreement at no cost, You are not
receipts for purchases of parts and fluids. entitled to a refund.
10.INELIGIBLE OR EXCESS COVERAGE: If You were charged for coverage 13. DISPUTE RESOLUTION & ARBITRATION: Either You or We may
for which Your Vehicle is ineligible or coverage in excess of the maximum choose to have any dispute related to this Agreement or the Application
allowed under this Agreement, We will refund the excess charge. If You decided by non-binding arbitration administered by the Better Business Bureau
financed Your Agreement We will send the refund to Your lender with (BBB). You agree not to consolidate or group Your dispute with other
instructions to credit Your loan. You will be notified of the refund and the arbitration or disputes concerning this Agreement or Application.
termination of any ineligible or excess coverage. You agree that You will not participate in any class arbitration concerning this
11.CONTRACT MODIFICATIONS&CHANGES: If Your coverage under this Agreement or Application.We do not agree to class arbitration.To learn about
Agreement has not expired or been otherwise limited, it may be modified or or begin arbitration, or get a copy of the Arbitration Rules, You may contact
changed by You,as shown below: BBB at 800-955-5100 or www.auto.bbb.org/extendedserviceplan. If there is a
NEW CORE COVERAGE AND SUPER DUTY PLANS: For all Ford, Lincoln conflict between the Rules and this Agreement,this Agreement shall govern. If
or Mercury Vehicles and Super Duty Vehicles, You may change Your You initiate the arbitration process,BBB will charge You an arbitration filing fee
coverage under this Agreement: of$50.
(i)before the expiration of the New Vehicle Limited Warranty;or You may employ an attorney to represent You in the arbitration, but an
(ii)within the first 90 days after the Signature Date,whichever date(i)or(ii)is attorney is not required. We will not pay Your attorney fees if You use an
later. For all Competitive Make Vehicles, You may change Your coverage attorney. This Agreement is subject to the Federal Arbitration Act, 9 U.S.C.
under this §§1 et seq. The arbitration decision shall be in writing with a supporting
Agreement: opinion.
(iii) before the expiration of the first 3 years from the Warranty Start Date or 14. STATE SPECIFIC PROVISIONS: The following provisions are
within the first 36,000 miles from Zero Miles;whichever occurs first.or applicable in the states set forth below and modify only those specific
(iv)within the first 90 days after the Signature Date, whichever date in (iii)or terms referenced.All other terms and conditions are unchanged.
(iv)is later. 14.01 For Agreements in ALABAMA, ALASKA, HAWAII, MAINE,
On New Core Coverages and Super Duty Coverages purchased beyond 12 MINNESOTA, MISSOURI, NEW JERSEY, NEW MEXICO, SOUTH
months or 12,000 miles,whichever comes first,within the New Vehicle Limited CAROLINA,TEXAS,AND WISCONSIN:
Warranty coverage, We will charge a $100 fee for changes to coverage 12A. (6)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
("12/12 Surcharge"). On New Core Coverages and Super Duty Coverages REFUND: In New Mexico,if You have not received your refund amount within
purchased beyond the 5 months or 5,000 miles of the 3 year or 36,000 miles sixty (60)days of your cancellation request, and within forty five(45)days of
New Vehicle Limited Warranty coverage expiration on Ford and Competitive Your cancellation request in AL, AK, HI, ME, MN, MO, NJ, SC, TX, and WI
Make Vehicles or beyond the 5 months or 5,000 miles of the 4 years or 50,000 You are entitled to receive ten percent(10%)of the refund amount outstanding
miles New Vehicle Limited Warranty coverage expiration on Lincoln vehicles, for every month that the refund is delayed.
We will charge a $200 fee (includes the 12/12 Surcharge) for changes to 14.02 For Agreements in ALABAMA, ALASKA, HAWAII, MAINE,
coverage. MINNESOTA, MISSOURI, NEW JERSEY, NEW MEXICO, SOUTH
USED CORE COVERAGE PLANS: You may change Your coverage under CAROLINA,TEXAS AND VERMONT:
this Agreement within the first 90 days after the Signature Date. 12A. (1)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
11A. TRANSFERABILITY: You may transfer the remaining coverage of the REFUND: If the Selling Dealer receives a written cancellation request,
Vehicle under this Agreement, if You pay Us a$75 transfer fee and if You or including a copy of Your Application, proof of payment and statement of the
the transferee of this Agreement initiates the transfer process and provides the odometer reading, on or before the 30th day from the Signature Date and no
following items to any Ford or Lincoln dealership or Us at P.O. Box 6045, claims have been filed under this Agreement,the Selling Dealer will cancel this
Dearborn,Michigan 48121 within 180 days of the vehicle sale: Agreement and refund the purchase price You paid for this Agreement.
(i)a letter,signed by You,transferring this Agreement to the transferee; 14.03 For Agreements in HAWAII, MINNESOTA, MISSOURI, MONTANA,
(ii)a statement of the mileage on the Vehicle at the time of transfer;and NEW JERSEY,NORTH CAROLINA,SOUTH CAROLINA AND TEXAS:
(iii)the name and address of the transferee; 12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A
You may not transfer coverage if the Vehicle becomes a Branded Vehicle REFUND: In HI, MN, MT, NC, NJ and TX, We may cancel this Agreement
or is repossessed.Transferred Agreements may not be cancelled. within 5 days prior written notice and 15 days prior written notice in MO, NJ
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 6 of 11
TERMS AND CONDITIONS
and SC when sent to You at Your last known address. Prior written notice is Services, You must maintain a log including date, mileage and
not required if cancellation is for any of the following reasons: description of each maintenance service and provide corresponding _
(a)You failed to pay the purchase price of this Agreement; receipts for purchases of parts and fluids.
(b)You materially misrepresented any fact or circumstance to Us;or 12A.(1)(A)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE
(c)You substantially breached Your duties under this Agreement regarding the A REFUND: If the Selling Dealer receives a written cancellation request,
Ve-hicle or its use. including a copy of Your Application, proof of payment and statement of
14.04.ALABAMA: odometer reading, on or before the 60th day from the Signature Date and no
12A. (1)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A claims have been filed under this Agreement,the Selling Dealer will cancel this
REFUND: If You have not made a claim, and the Selling Dealer did not Agreement and refund the purchase price You paid for this Agreement.
receive notice of cancellation within 30 days from the date the Selling Dealer (1)(B)If the Selling Dealer receives a written cancellation request,including a
mailed or delivered this Agreement to You,We will charge You a cancellation copy of Your application, proof of payment and statement of the odometer
processing fee not to exceed$25. reading, on or before the 60th day from the Signature date and a claim has
12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A been filed under this Agreement, the Selling Dealer will divide the purchase
REFUND:We may cancel this Agreement with five(5)days prior written notice price You paid for this Agreement by the number of miles or months of
sent to You at Your last known address. Prior written notice is not required if coverage provided by this Agreement,whichever is greater.The Selling Dealer
cancellation is for any of the following reasons: a) You failed to pay the will multiply this dollar amount by the remaining unused months or miles,
purchase price for this Agreement; or b) You materially misrepresented any whichever is greater,and refund this amount("Pro Rata"basis)to You or Your
fact or circumstance to Us. lender.
14.05 ALASKA: (2) If the Selling Dealer receives a written cancellation request, including a
12. CANCELLATION AND REFUND (A) YOUR RIGHT TO CANCEL THIS copy of Your Application, proof of payment and statement of the odometer
AGREEMENT AND RECEIVE A REFUND:(2)If the Selling Dealer receives a reading, after the 60th day from the Signature Date the Selling Dealer will
written cancellation request, including a copy of Your Application, proof of divide the purchase price You paid for the Agreement by the number of miles
payment and statement of the odometer reading,after the 30th day or a claim or months of coverage provided by this Agreement,whichever is greater.The
has been filed at any time during the term of this Agreement from the Selling Dealer will issue a Pro Rata refund to You or Your lender, minus a
Signature Date the Selling Dealer will divide the purchase price You paid for cancellation processing fee equal to the lesser of$25 or 10%of the purchase
the Agreement by the number of miles or months of coverage provided by this price.
Agreement, whichever is greater. The Selling Dealer will multiply this dollar 12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A
amount by the remaining unused miles or months, whichever is less, and REFUND: We may cancel this Agreement at any time during the term of this
refund this amount ("Pro Rata basis") to You or Your lender, minus a Agreement if You fail to pay the purchase price of this Agreement or for any
cancellation processing fee equal to the lesser of 7.0%or$75.00. material misrepresentation or fraud. We will provide written notice, stating the
12 (B). OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A specific grounds for cancellation, to You at Your last known address. This
REFUND: We may cancel this Agreement within five days of written notice Agreement will no longer be valid five days after the postmark date of the
sent to You at Your last known address. Prior written notice is not required if notice. If any refund is owed,a Pro Rata Refund will be issued to You or Your
cancellation is for any of the following reasons: (a) You failed to pay the lender within thirty days of the cancellation date. If We cancel this Agreement
purchase price of this Agreement; or (b) You materially misrepresented any for any of the reasons stated above, We will honor any claims for repair or
fact or circumstance to Us. If We cancel this Agreement, We will refund the reimbursement if submitted to Us prior to the effective date of cancellation, if
purchase price on a Pro Rata basis. If We provided this Agreement at no cost, eligibility requirements are met.
You are not entitled to a refund. 13. DISPUTE RESOLUTION & ARBITRATION - Either You or We may
14.06.CALIFORNIA: choose to have any dispute related to this Agreement, or the Application
1A. CALIFORNIA LICENSE NUMBER DISCLOSURE: THE CALIFORNIA decided by non-binding arbitration administered by the Better Business Bureau
LICENSE NUMBER OF FORD MOTOR SERVICE COMPANY IS OC41369.
(BBB). To learn about or begin arbitration, or get a copy of the Arbitration
1E. CALIFORNIA DEPARTMENT OF INSURANCE CONTACT Rules, You may contact BBB at 800-955-5100 or www.auto.bbb.org/
INFORMATION: If any promise made in this contract has been denied or has We will extendedserviceplan.
not been honored within 60 days after Your request, You may contact the p pay Your reasonable arbitration fees and
California Department of Insurance at 1-800-927-4357 or access the expenses that are in excess of$125.
department's Internet website surae nsuranceca.gov). You may employ an attorney to represent You in the Arbitration, but an
2C.SALES TAX:Sales tax is not applicable in California. attorney is not required. We will not pay Your attorney fees if You use an
6A(2)and 6B(2) EMERGENCY TRAVEL EXPENSE REIMBURSEMENT: If attorney. If We request arbitration,We will pay the arbitration filing fee.
Your Vehicle is disabled 100 or more miles from Your residence as a result of This Agreement is subject to California law applicable to consumer contracts
a mechanical Failure covered by this Agreement or the New Vehicle Limited and the California Arbitration Act(CCP section 1280 et. seq.).Any arbitration
Warranty, We will reimburse You up to$500 for the actual Emergency Travel d144.. shall be in writing with a supporting opinion.
1077..CONNECTICUT:
Expenses You incur within the first 72 hours following the disablement. 5. WHAT THIS AGREEMENT COVERS: If Your Vehicle is in Our custody
6A(3)and 6B(3)DESTINATION ASSISTANCE: If Your Vehicle is inoperable being repaired, the coverage under this Agreement will be extended until the
because of a Failure covered by this Agreement or the New Vehicle Limited repair to Your Vehicle is complete if this Agreement expires within one year of
Warranty and You require transportation to Your destination, We will purchase pursuant to the Application section titled "COVERAGE TERM AND
reimburse Your transportation costs up to$75. COST".
7. WHAT IS NOT COVERED BY THIS AGREEMENT 8A. WHERE TO GO FOR REPAIRS: (3) In house service is not provided
q. Repairs made to the Vehicle that are required due under this Agreement. You are responsible for any costs to transport the
to a condition that existedprior to thepurchase of this covered Vehicle for service that exceed the towing allowances referenced in
Section 6A.of this Agreement.
Agreement. 12A (6). YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
8D. CLAIMS APPROVAL:A valid claim will not be denied based solely on a REFUND: This Agreement is cancelable if the covered Vehicle is returned,
failure to obtain claim approval before commencing the repair if the repair sold,lost,stolen,or destroyed.
facility reasonably attempted to obtain approval. 3. DISPUTE RESOLUTION & ARBITRATION: If You purchased this
9. YOUR RESPONSIBILITIES FOR CARE OF THE VEHICLE: To obtain Agreement in Connecticut, You may pursue arbitration to settle disputes
coverage or reimbursement under this Agreement,You must:(i)properly between You and Us. You may mail your complaint to: State of Connecticut,
operate and maintain the Vehicle, and (ii) provide proof of Scheduled Insurance Department, P.O. Box 816, Hartford, CT 06142-0816, Attention:
Maintenance Services when the Failure appears to be directly related to Consumer Affairs.The written complaint must describe the dispute,identify the
the lack of required or recommended maintenance for Your Vehicle as price of the product and cost of repair,and include a copy of this Agreement.
outlined in the Owner's or Scheduled Maintenance Guide. Proof of 14.08.FLORIDA:
Scheduled Maintenance Services includes maintenance records that 2C. FRAUDULENT CLAIM NOTICE: Under the Code, any people who, with
show mileage, date of maintenance service, VIN and the maintenance the intent to injure, defraud or deceive any insurer, knowingly files an
that was performed. Scheduled Maintenance Services require periodic application for coverage or a statement of claim that contains false,incomplete
service checks based on mileage intervals and the make and model of or misleading information is guilty of a felony of the third degree.
Your Vehicle. Please review the Owner's Guide for Your Scheduled 2D. FLORIDA OFFICE OF INSURANCE REGULATION: The Florida Office
Maintenance Service requirements that are provided to You at the time of of Insurance Regulation does not regulate the rates charged for any
vehicle purchase. If You perform Your own Scheduled Maintenance plans sold pursuant to this Agreement. The Florida Office of Insurance
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 7 of 11
TERMS AND CONDITIONS
Regulation does not regulate Maintenance plans. Maintenance plan request, including a copy of Your application, proof of payment and statement
coverage is optional and may only be purchased in conjunction with the of the odometer reading, on or before the 30th day from the Signature Date
purchase of a motor vehicle service agreement plan.The purchase price and no claims have been filed under this Agreement, the Selling Dealer will
of a Maintenance plan must be disclosed separate and apart from the cancel this Agreement and refund the purchase price less a cancellation
premium of a motor vehicle service agreement plan. processing fee, not to exceed 10% of the Agreement purchase price or$50,
4. DEDUCTIBLES, STANDARD AND OPTIONAL: In the event You have whichever is less. If the Selling Dealer receives a written cancellation request,
purchased the Disappearing Deductible option and Your Selling Dealer is no including a copy of Your application, proof of payment and statement of the
longer in business, You may take Your vehicle to any Ford or Lincoln odometer reading, after the 30th day or a claim has been filed at any time
dealership for repair or service and Your Disappearing Deductible will be during the term of this Agreement from the Signature Date,the Selling Dealer
honored. will divide the purchase price You paid for the Agreement by the number of
11A. TRANSFERABILITY: You may transfer the remaining coverage of the miles or months of coverage provided by this Agreement,whichever is greater.
Vehicle under this Agreement,if You pay Us a$40 transfer fee and if You or if The Selling Dealer will multiply this dollar amount by the remaining unused
the transferee of this Agreement initiates the transfer process and provides the miles or months,whichever is less, and refund this amount("Pro-Rata basis")
following items to any Ford or Lincoln Dealership or Us at P.O. Box 6045, to You or Your lender, and a cancellation processing fee that is the lesser of
Dearborn,Michigan 48121 within 180 days of the vehicle sale: 10%of the Agreement purchase price or$50 for each plan cancelled.
(i)a letter,signed by You,transferring this Agreement to the transferee; 14.10.INDIANA:
(ii)a statement of the mileage on the Vehicle at the time of transfer;and 2C. PROOF OF PAYMENT - Your proof of payment to the Selling Dealer,
(iii)the name and address of the transferee; Administrator or Service Contract Provider constitutes proof of payment to the
You may not transfer coverage if the Vehicle becomes a Branded Vehicle Insurer listed in provision 1.D.of this Agreement.
or is repossessed.Transferred Agreements may not be cancelled. 2D.This service contract is not insurance and not subject to Indiana Insurance
12.CANCELLATION AND REFUND
Law.
(A) YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A 14.11.LOUISIANA:
REFUND: If We or the Selling Dealer receive a written cancellation request, 12A. (1)YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
REFUND: If the Selling Dealer receives a written notice of cancellation within
including a copy of Your Application, proof of payment and statement of the
thirty(30)days from the date this Agreement was delivered or mailed to You,
odometer reading,on or before the 60th day from the Signature Date, We will
Selling Dealer will provide You with a full refund less a$50 processing fee.
cancel this Agreement and refund the purchase price You paid under this
Agreement. If We or the Selling Dealer receive a written cancellation request, (2) If You cancel this Agreement after 30 days from the date the Agreement
including a copy of Your Application, proof of payment and statement of the was delivered or mailed to You, You shall receive a refund on a "Pro-Rata"
odometer reading,after the 60th day from the Signature Date,You will receive basis less a $50 processing fee. For purposes of this section 12.A. (2), "Pro
a refund of not less than 90% of the unearned pro rata premium paid under Rata basis"will be determined by dividing the purchase price You paid for the
this Agreement. If You have financed this Agreement, (a) any refund due Agreement by the number of miles or months of coverage provided by this
under this Agreement will be made payable to the lienholder, up to the amount Agreement, whichever is greater, multiply this dollar amount by the remaining
of the lien; and (b)only that portion of a refund due under this Agreement in unused miles or months,whichever is less.
excess of the amount of the lien will be paid to You. If this Agreement was not 14.12.MAINE:
financed,any refund due under this Agreement will be paid by check issued in 1. E.ADMINISTRATION:All service contract obligations in the state of Maine
Your name.You may not cancel the options You purchased without canceling are administered by:
the entire Agreement and We will not charge You a cancellation processing Percepts Philippines, LLC
fee. If this Agreement expires under the time or mileage limitations, You are P.O. Box 6045
not entitled to a refund. Dearborn,Michigan 48121
(B) OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A Toll Free Number:800-521-4144
REFUND: We may cancel this Agreement within 60 days from this 12.CANCELLATION AND REFUND
Agreement's Signature Date for any reason. After 60 days from this (A) YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
Agreement's Signature Date, We may cancel this Agreement only for the REFUND:
following reasons:a)If You failed to pay the purchase price for this Agreement (2) If the Selling Dealer receives a written cancellation request, including a
(in which case We must provide you notice of cancellation by certified mail);b) copy of Your Application, proof of payment and statement of the odometer
If You materially misrepresented any fact or circumstance to Us at the time of reading, after the 30th day or a claim has been filed at any time during the
sale of this Agreement;c)If You substantially breached Your duties under this term of this Agreement from the Signature Date the Selling Dealer will divide
Agreement to maintain or use the Vehicle as prescribed by the Manufacturer; the purchase price You paid for the Agreement by the number of miles or
d)You failed to repair a tampered or disabled odometer on the Vehicle. If We months of coverage provided by this Agreement, whichever is greater. The
Selling Dealer will multiply this dollar amount by the remaining unused miles or
cancel this Agreement, We will make a refund of not less than one hundred
months,whichever is less,and refund this amount("Pro Rata basis")to You or
percent (100%) of the unearned gross amount that You paid for this
Agreement(equally prorated basis)and We will not charge You a cancellation Your lender.
processing fee. 12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A
13. DISPUTE RESOLUTION&ARBITRATION-If the parties fail to agree on REFUND: We may cancel this Agreement at any time during the term of this
any matter concerning this Agreement or the Application or You allege Agreement within 15 days prior written notice when sent to You at Your last
known address. We will state the effective date of the cancellation and the
damages under this Agreement or Chapter 634 of the Florida Statutes, then
the matter shall be submitted to arbitration upon the written demand of either specific grounds for cancellation. If any refund is owed,a Pro Rata Refund will
be issued to You or Your lender within thirty days of the cancellation date.
party. The parties may contact the Better Business Bureau (BBB) at
1-800-955-5100 or www.auto.bbb.org/extendedserviceplan to learn about or 3.1MI MINNESSNTSOTA:
begin arbitration. The arbitrator's decisions shall be nonbinding on You and If3.MOTA USED VEHICLE NOTICE:
Us, unless both parties mutually agree to accept the arbitrator's decision as Dealer,, othe date You purchased a used 36,0000from froma Minnesota Miles,Selling
final. No suit shall be commenced in a federal, state or local court until such Selling A)the Vehicle hadefewer than warrantthe Vehicleeh Zero the
time as both You and We first address our disagreement in an arbitration layDealer may be ouu required to the for(2,500at leastm60
proceeding pursuant to this Section 13. Each claim must be arbitrated days after the date You purchased the Vehicle or (ii) miles,
individually. If there is a conflict between the Rules and this Agreement, this whichever occurs first.
Agreement shall govern. B)If,on the date You purchased a used Vehicle from a Minnesota Selling
We will pay Your reasonable arbitration fees and expenses that are in excess Dealer, the Vehicle had more than 36,000 miles but fewer than 75,000
of$125. You may employ an attorney to represent You in the Arbitration, but miles from Zero Miles,the Selling after the amayYou requiredpurhato warrant the
an attorney is not required. We will not pay Your attorney fees if You use an oVehicle for1,00o miles,(i)at least 30 days the date purchased the Vehicle
attorney. If We request arbitration, We will pay the arbitration filing fee. This whichever(ii) occurs
Agreement is subject to the Federal Arbitration Act (9 U.S.C. section 1 et. first.
seq.)and the arbitration decision shall be in writing with a supporting opinion. C) l r,othe date You purchased thana used Vehicle0 i from a Minnesota Selling
14.09.ILLINOIS: Dealer, the Vehicle had more 75,000 miles from Zero Miles, the
5. WHAT THIS AGREEMENT COVERS: Unless specifically provided in Selling Dealer is not required to warrant the Vehicle.
7.WHAT IS NOT COVERED BY THIS AGREEMENT: (Additional Exclusions
this Agreement,this Agreement does not cover "wear and tear".
12(A)(1)&(2): YOUR RIGHT TO CANCEL THIS AGREEMENT AND or changes)
f)Damage caused by the environment and pollution, including airborne fallout,
RECEIVE A REFUND: If the Selling Dealer receives a written cancellation
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used)
Page 8 of 11
TERMS AND CONDITIONS
chemicals, debris, tree sap, salt, hail, windstorm, lightning, freezing, flooding, SERVICE CONTRACT AGREEMENT, YOU DO
earthquake,snow or ice; NOT HAVE THE SERVICE CONTRACT -
j)Scheduled Maintenance Services, COVERAGE IT PROVIDES AND YOU ARE
1. For New Vehicles - repairs resulting from the lack of required or ENTITLED TO A FULL REFUND OF THE
recommended maintenance as contained in the Scheduled Maintenance AMOUNT YOU PAID. IF YOU DO NOT REJECT
Guide for your vehicle;
2. For Used Vehicles - repairs resulting from the lack of required or THE SERVICE CONTRACT AGREEMENT WITHI
N
recommended maintenance, provided that,at the time the used Vehicle came 5 DAYS, YOU YOUR HAVE
TOTALREASONABLEIT. WE WALL
LL
into Your possession or control: 1)the Vehicle still retained its owner's manual;
PAY or, 2) You were offered a copy of the owner's manual for an incremental ARBITRATION FEES AND EXPENSES.
charge of ten dollars($10)or less;or ARBITRATION PROCEEDINGS MUST
3) the maintenance requirements contained in the Scheduled Maintenance COMMENCE NO LATER THAN 120 DAYS AFTER
Guide were replaced with a new specific maintenance schedule. THE FIRST NOTIFICATION BY YOU OR US OF
I)Repairs to the Vehicle if the odometer
1. has been tampered with, but only if the tampering occurs while the Vehicle AN ELECTION TO ARBITRATE A DISPUTE.
is in Your possession or control;or UNLESS YOU AND WE AGREE OTHERWISE,
2. If You have failed to have a broken odometer repaired, if the odometer ALL ARBITRATION PROCEEDINGS WILL BE
failed while the Vehicle is in Your possession or control. CONDUCTED AT A LOCATION IN THE COUNTY
12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A OF YOUR RESIDENCE.
REFUND: We may cancel this Agreement with (5) days prior written notice 14.15.MISSOURI
sent to You at Your last known address. Prior written notice is not required if 12.(A)(2).YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
cancellation is for any of the following reasons: REFUND: If the Selling Dealer receives a written cancellation request,
a)You failed to pay the purchase price for this Agreement; including a copy of Your Application, proof of payment and statement of the
b)You materially misrepresented any fact or circumstance to Us;or odometer reading, after the 30th day or a claim has been filed at any time
c)You substantially breached Your duties under this Agreement regarding the during the term of this Agreement from the Signature Date the Selling Dealer
Vehicle or its use. will divide the purchase price You paid for the Agreement by the number of
d) if the VIN cannot be established because of actions for which You are miles or months of coverage provided by this Agreement,whichever is greater.
responsible. The Selling Dealer will multiply this dollar amount by the remaining unused
14.14.MISSISSIPPI miles or months,whichever is less, and refund this amount("Pro Rata basis")
1. ARBITRATION MAY ONLY PROCEED ON AN
INDI-VIDUAL BASIS, AND MAY NOT BE to14.16.NYou orEBRASYour lenderKA: ,minus a$50 processing fee for each plan cancelled.
nd
st
CONSOLIDATED WITH OTHER ARBITRATIONS 13. DISPUTE
IS have RE O UTIIOrN & tARBITRATION:
BII o RAAg ION: Yount atApeimusnducidey
OR ACCORDED ANY CLASS ACTION STATUS.
A. THIS SERVICE CONTRACT AGREEMENT, by nonbinding arbitration administered by the Better Business Bureau (BBB).
INCLUDING THE APPLICATION, INVOKES You agree not to consolidate or group Your dispute with other arbitration or
ARBITRATION UNDER THE FEDERAL disputes concerning this Agreement or Application.You agree that You will not
participate in any class arbitration concerning this Agreement or Application.
ARBITRATION ACT. EITHER YOU OR WE MAY To learn about or begin arbitration,or get a copy of the Arbitration Rules,You
ELECT BINDING ARBITRATION TO RESOLVE may contact BBB at 800-955-5100 or www.auto.bbb.org/extendedserviceplan.
DISPUTES UNDER THIS SERVICE CONTRACT If there is a conflict between the Rules and this Agreement, this Agreement
AGREEMENT. shall govern.
B. IF EITHER YOU OR WE DECIDE TO ARBITRATE If You initiate the arbitration process, BBB will charge You an arbitration filing
A DI-SPUTE REGARDING ANY ASPECT OF THIS fee of$50.You may employ an attorney to represent You in the arbitration,but
SERVICE CONTRACT AGREEMENT OR THE 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.SS
APPLICATION AND THE SALE OF THE SERVICE 1 et seq.The arbitration decision shall be in writing with a supporting opinion.
CONTRACT, AN ARBITRATOR WILL RESOLVE 14.17.NEVADA
THE DISPUTE. IF ARBITRATION IS SELECTED 2C.SPECIAL NOTICE-RENEWABILITY:This Agreement is non-renewable.
TO RESOLVE THE DISPUTE, BOTH PARTIES 7(t):Taxis,vehicles used for competitive driving/racing/offroad use,fuel
WAIVE THEIR RIGHTS TO RESOLVE THE cell vehicles, performance modified vehicles at point of sale (vehicles
DISPUTE IN A COURT PROCEEDING. that qualify for coverage that are later modified or altered with
performance modified parts are covered except for the performance
C. IN AN ARBITRATION, ONE OR MORE OF THE modified parts and failures or repairs resulting from the performance
AR-BITRATORS (WHO ARE NEUTRAL modified parts that were not permanently affixed at point of sale), 4X2-
DECISION MAKERS) RENDER A DECISION equipped vehicles modified with 4X4 AWD capabilities and incomplete
AFTER HEARING THE ARGUMENTS FROM ALL vehicles (e.g. Chasis, cabs, cutaways, stripped chassis) except Ford,
PARTIES. ARBITRATION TAKES THE PLACE OF Chevrolet,Dodge and GMC.
A TRIAL AND DISPUTES ARE DECIDED BY 7(x):WHAT IS NOT COVERED BY THIS AGREEMENT:This Agreement will
not be issued for any Vehicle where the New Vehicle Limited Warranty is void
ARBITRATION, NOT A JUDGE OR JURY.
at the time of Application. If this Agreement is already in effect and the New
D. YOU AND WE ARE BOUND BY THE DECISION Vehicle Limited Warranty on the vehicle becomes void,this Agreement will not
OF THE ARBITRATOR AND THE RESULTS OF automatically reement will exclude
all
coverage
eryr the
s thVe Vehicle.
In
otherwise such
s iituhaioes, the
he
THE ARBITRATION ARE BINDING AND FINAL Agreement
the New Veahy icle Limited thatwould
butoee sereementwin
AND MAY NOT BE APPEALED TO A COURT. coverroviany under service listed in the LiAgmited
Warranty,ent, usuch gementcoveragis
ll
E. IF YOU NEED ADDITIONAL INFORMATION subject to other exclusions.
REGA-RDING THE DISPUTE RESOLUTION AND 8A. (4). Prior approval may be necessary for services depending on the total
ARBIT-RATION SECTION IN THE SERVICE cost of the repair. If prior approval is required, Your servicing dealer will
CONTRACT AGREEMENT, PLEASE CALL THE contact Ford ESP Prior Approval Headquarters for authorization.
TOLL FREE ASSISTANCE LINE AT 800-392-3673. 12 A.(1).YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
F. YOU HAVE 5 DAYS FROM DELIVERY OF THIS REFUND: If the Selling Dealer receives a written cancellation request,
SE-RVICE CONTRACT AGREEMENT TO REJECT including a copy of Your Application, proof of payment and statement of the
THE SERVICE CONTRACT AGREEMENT IF YOU odometer reading, on or before the 30th day from the Signature Date and no
DO NOT WANT TO ACCEPT THIS BINDING claims have been filed under this Agreement,the Selling Dealer will cancel this
Agreement and refund the purchase price You paid for this Agreement.We will
ARBITRATION PROVISION. IF YOU REJECT THE refund the purchase price of the Agreement within 45 days of written notice. If
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 9 of 11
TERMS AND CONDITIONS
a full refund is not received within 45 days of Your written cancellation request, 13. DISPUTE RESOLUTION AND ARBITRATION: If You and We cannot
4 You are entitled to receive an additional 10% on the refund amount owed to agree to a claim settlement and You have exhausted all internal appeals,You
You for each thirty day period. and We may agree to have any dispute related to or arising from this
12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A Agreement or the Application decided by non-binding arbitration administered
REFUND: If this Agreement has been in effect for at least seventy(70)days, by the Better Business Bureau (BBB). To learn about or begin arbitration, or
We cannot cancel it prior to either: (i) its stated term, or(ii)the one (1) year get a copy of the Arbitration Rules,You may contact BBB at 800-955-5100 or
anniversary of its original effective date, whichever occurs first. We may, www.auto.bbb.org/extendedserviceplan. We will pay Your reasonable
however, cancel this Agreement, at any time, within 15 days prior written arbitration fees and expenses that are in excess of$100. You may employ an
notice when sent to You at Your last known address, if the cancellation is for attorney to represent You in Arbitration,but an Attorney is not required.We will
any of the following reasons: not pay Your attorney fees if You use an attorney. If We request arbitration,
a)You failed to pay the purchase price for this Agreement; We will pay the arbitration filing fee. This Agreement is subject to ORS
b)You materially misrepresented any fact or circumstance to Us; 36.600-36.740.Arbitration will take place in the state of Oregon in accordance
c) You were convicted of a crime that results in an increase in the service with Oregon laws unless You and We mutually agree to another location. All
required under this Agreement; arbitration decisions shall be in writing with a supporting opinion.
d)There is a material change in the nature or extent of the required service or 14.22.SOUTH CAROLINA:
repair to be substantially and materially increased beyond that contemplated at 2C. SPECIAL NOTICE - WHO YOU SHOULD CONTACT (SOUTH
the time this Agreement was issued(such as the Vehicle is a Branded,Totaled CAROLINA RESI-DENTS ONLY): Please direct all questions or complaints
or Salvaged Vehicle,or the VIN cannot be established);or concerning this Agreement to Us at P.O. Box 6045, Dearborn, Michigan
e)We discover(1)an act or omission by You,or(2)a violation by You of any 48121. In the event that We do not timely resolve such matters, You may
condition of the Agreement that occurs during the term of the Agreement and contact the South Carolina of Insurance at either: Post Office Box 100105,
that substantially and materially increases the service required under this Columbia,South Carolina,29202-3105,or(800)768-3467.
Agreement. 14.23.TEXAS:
13. DISPUTE RESOLUTION&ARBITRATION: You and We must mutually 2C. SPECIAL NOTICE - FOR GENERAL INFORMATION, WE MAY BE
agree have any dispute related to this Agreement or the Application decided CONTACTED AT 800-392-FORD.
by nonbinding arbitration administered by the Better Business Bureau (BBB). 2D.COMPLAINTS:Unresolved complaints concerning a provider or questions
You agree not to consolidate or group Your dispute with other arbitration or concerning the registration of a service contract provider may be addressed to
disputes concerning this Agreement or Application.You agree that You will not the Texas Department of Licensing and Regulation, P.O. Box 12157, Austin,
participate in any class arbitration concerning this Agreement or Application. Texas 78711,telephone number 512-463-6599 or 800-803-9202.
To learn about or begin arbitration,or get a copy of the Arbitration Rules, You 12. (A). YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
REFUND: (2). If the Selling Dealer receives a written cancellation request,
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 including a copy of Your Application, proof of payment and statement of the
shall govern. odometer reading, after the 30th day or a claim has been filed at any time
If You initiate the arbitration process, BBB will charge You an arbitration filing during the term of this Agreement from the Signature Date the Selling Dealer
fee of$50.You may employ an attorney to represent You in the arbitration,but will divide the purchase price You paid for the Agreement by the number of
an attorney is not required. We will not pay Your attorney fees if You use an miles or months of coverage provided by this Agreement,whichever is greater.
attorney.This Agreement is subject to the Federal Arbitration Act,9 U.S.C. SS The Selling Dealer will multiply this dollar amount by the remaining unused
1 et seq.The arbitration decision shall be in writing with a supporting opinion. miles or months,whichever is less, and refund this amount("Pro Rata basis")
14.18.NEW HAMPSHIRE: to You or Your lender,minus a$50 processing fee for each plan cancelled.
2C. SPECIAL NOTICE TO NEW HAMPSHIRE RESIDENTS ONLY: Please (6) The right to cancel this Agreement is not transferable to subsequent
direct all questions or complaints concerning this Agreement to Us at P.O. Box Service Contract Holders.
6045, Dearborn, Michigan 48121. In the event You do not receive satisfaction 14.24.WASHINGTON:
2B.INSURER CUT-THROUGH BENEFITS:You are not required to wait sixty
under this contract, You may contact the New Hampshire Insurance
(60) days to file a claim for service or other benefit owed pursuant to this
Department at either: 21 South Fruit Street, Suite 14, Concord, New
Hampshire 03301,or(800)852-3416. Agreement directly with the insurer of this Agreement.
14.19.NEW MEXICO: 7.WHAT IS NOT COVERED BY THIS AGREEMENT:
12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A i) Repairs to a covered part caused by the lack of required or recommended
REFUND: If this Agreement has been in effect for at least seventy(70)days, maintenance.
We cannot cancel it prior to either: i) its stated term, or, ii) the one (1) year 10.INELIGIBLE OR EXCESS COVERAGE:If You were charged for coverage
anniversary of its original effective date, whichever occurs first. We may, for which Your vehicle is ineligible or coverage in excess of the maximum
however,cancel this Agreement at any time,with fifteen(15)days prior written allowed under this Agreement, We will refund the excess charge. If You
notice sent to You at your last known address, if the cancellation is for any of financed Your Agreement We will send the refund to Your lender with
the following reasons: instructions to credit Your loan.We may cancel this Agreement within 60 days
a)You failed to pay the purchase price for this Agreement; of this Agreement being mailed or delivered to You for ineligible or excess
b)You materially misrepresented any fact or circumstance to Us; coverage. You will be notified of the refund and the termination of any
c) You were convicted of a crime that results in an increase in the service ineligible or excess coverage.
required under this Agreement; 12A. YOUR RIGHT TO CANCEL THIS AGREEMENT AND RECEIVE A
d)there is a material change in the nature or extent of the required service or REFUND:
repair that occurs after the Signature Date that causes the required service or (1)If You have not made a claim under this Agreement and the Selling Dealer
repair to be substantially and materially increased beyond that contemplated at receives written notice of cancellation within 30 days after this Agreement was
the time this Agreement was issued (such as the New Vehicle Limited delivered or mailed to You,the Selling Dealer will provide you with a full refund
Warranty of the Vehicle has been voided, in whole or in part, the Vehicle is a of the purchase price paid. (2) If You have not made a claim under this
Branded,Totaled or Salvaged Vehicle,or the VIN cannot be established)or, Agreement and You cancel this Agreement 30 days after the date this
e)We discover(1)an act or omission by You or(2)a violation by You of any Agreement was delivered or mailed to You,You shall receive a pro rata refund
condition of the Agreement that occurs during the term of the Agreement and of the unearned purchase price based upon the unused months or miles of
that substantially and materially increases the service required under this coverage remaining, whichever is less, minus a $25 cancellation processing
Agreement. fee. (6)If the Selling Dealer does not pay You the full refund amount within 30
14.20.NORTH CAROLINA: days of Our receipt of Your cancellation request,You are entitled to receive an
12A. (1) & (2) YOUR RIGHT TO CANCEL THIS AGREEMENT AND additional 10%based on the refund amount owed to You.
RECEIVE A REFUND: If You cancel this Agreement, the Selling Dealer will 12B. OUR RIGHT TO CANCEL THIS AGREEMENT AND PROVIDE A
refund the unearned purchase price prorated based upon the lesser of the REFUND: We may cancel this Agreement only within 60 days of this
unused months or miles of coverages, minus a cancellation processing fee Agreement being mailed or delivered if You fail to comply with this Agreement.
equal to the lesser of 10%or$75.00. If We cancel this Agreement,We will refund the purchase price on a Pro Rata
14.21.OREGON: basis. If We provided this Agreement at no cost, You are not entitled to a
2C. COMPLAINTS: Unresolved complaints can be addressed to the refund.
Department of Consumer and Business Services, Oregon Insurance Division, 12C.WHO ISSUES REFUND PAYMENTS: Refund payments will be made by
Consumer Advocacy Unit,350 Winter Street NE, Room 300-2,Salem,Oregon the Selling Dealer,your lienholder,The American Road Insurance Company or
97301.The telephone number is 1-888-877-4894. Us.
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 10 of 11
TERMS AND CONDITIONS
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.
14.25.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.
(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 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
Vehicle 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. 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.
ESP 8240-Nat App/Provs W/Key(Oct 16)(Previous Editions May Not be Used) Page 11 of 11
t41,
III ,,,,♦ fp 411:41.,.40,00.10y _. �' +�.—.._�<���
T
a �. LATE OF ORIGI , " . /. :
N „ y �.
`� r ;; .p�. ' �, Y ,-� � --.... m, AOR A VEHICLE �\�°;;;°l�°� � �II���
1114 � r � P �Itiesa.�.,..�i- A/ iii l,�! �""'__.--�r.
\ f'n [I a 1 I e iXs?,Y3�' \4 iia• , :� C.� ! g r< ,! ,
e v1 -------,77_-.,:,,,,,:::;., � -- I v E
,1,01%... (----
� 4 ti.
DATE 1,-)
i • � �"
APRIL 19 !
�2 0 17 ,1\lrnCE NO. ..1
VEHICLE IDENTIFICATION N 1 12 1 1
t 1FM5K8AR6HGC, 0
BODY TYPEPe 1
�� 113 EXPLORER I )61,1 \/
t ( '` �C(. 7�} NEIGHT
H.R(S A.E) k c t BS.
33.93 G. VV l.a C ' L
� C (
NOMINAL TON �� '? V 1?(-1--
',0,..R.4::.
?(I.,r tifili:
,EL
I undersigned authoriz ,.
I,the that the new vehicle de /
transferred on the above r ��°
ned below,hereby cer-
NAME OF DISTRIBUTOR,DEALEF r corporation and is
ing distributor or dealer.
(. Nelson Auto C
P• 0. BOX 338 �s
Fergus Falls MN 56538 i!.
58B404Y4 It is further certified that this was !te�'
the first transfer of such new motor vehicle in ordinary trade and commerce: ~
��oil MEMO DATA �,
O DATA ___ __ 1
gitfti: FINANCE SOURCE 660055 FORD MOTOR COMPANY 4 s t
BANE OFBY ,�
AMERICA tiac� iaf2
$ 4161 Piedmont Pkwy• JONATHAN E.OSGOOD,SECRETARY S'
( tS Greensboro NC (AGENT)
27410 DEARBORN MICHIGAN ✓,
CITY-STATE \,q
_.. iiiiliiiiillillilliilmilikliNNIIIIIIIN ..��
. . . .�,.� �. ..��. .a..l.�,,,,,„.„,,,..„.„„,..,r,nrz4:„•::„:„.,:,:,::„..„.„„,,,..„,?,;,„,:„„,,..„.,zr:,z7,.„,..„,A,,J.
, � lllll .. ...lllllll .,.IIII .....i�� � �° o �..;�. .. ,� �r_ •......� !!1111 .....
., �
/ t/%,5.
est of his knowledge information and belief under penalty of law that the vehicle Is new and has not been registered in _J
�rEach undersigned seller oerhfies to the b security interests other than those disclosed herein and warrant title to the vehicle. )
this. of any state at the time of delivery and the vehicle is not subject to any
FOR VALUE RECEIVED I TRANSFER THE VEHICLE DESCRIBED ON THE FACE OF THIS CERTIFICATE TO:
I
NAME OF _- - --
m w NAAME O SER(S) —� No Tenths_t ��'
w 2 ADDRESS
o • t..Lt' r
Z Z I certify to the best of my knowledge that the odometer reding Is
..= A -.______ BY n oath says Yhat the statements set
O r Being duly sworn
w DEALER N A - DEALERS LICENSE NUMBER forth are true and coi rest SdaY ubscf bed and sworn to me
NAME. OF DEALERSHIP ___ before to s - Notary Publrc
- State of.-_--- --`_.'_"__-----
' NNOTARIZATION ONLY IF REQUIRED IN TITLING L____DIOTION .I
o y County o' 1
4 - -
w NAME: OF
w w PURCHASER(S) v No Tenths U
--- Z
w? ADDRESS7.c..13.1>r? knowledge that the odometer eading is-- - e
Z Z I:certify to the best of my O Being duly sworn upon oaCFt says that the statements set
DEALER S LYGENSE NUM6ER forth are true and correct dayscr bed and sworn to me
�., ria DEALER.NAME of before this Notaty Puolic T.6 0 State ofW N N '.County of USE NOTARIZATION ONLY IFREQUIRED_IN TITT_ LIRISDIGf ON
t- n a I-
W M NAME OF
I
2 PURCHASERS) —___— --– -- __—No Tenths W ____- — -
a En ADDRESS %.:3
O o knowledge that the odometer reading is_---- U
J is: I certfy to the best of my Being dais sworn upon oath says that the statements set 0
I,N DEALER DEALER'S DCENSE NUMBER forth are true and cor'ect.da scot bell and sworn to me m
m NAME OF pEALERSW" before tau_ Notary Public
r ""__- -- _ - ce
ce
CG State of '
NN O
z Q 4 County of;.__---- �— USE NOYARIZ�,?TION-ON)LY IF REQUIRED N ITLING.IUHISDIC__
Z w NAME OF W
h�4- w PURCHASER(6)------' __-_--'-- _ _ No Tenths 7(7)::::
L° ADDRESS U IA ethattheodometer:i.adingis � ,
F, O r I certfyao the best of my knowledge Belnq Y
._- CiulBVsworn upon oath says that the statements set
W F-.W DEALER DEALERS LICENSEtJUM6ER forth are true and correct Subscribed and Sworn ton J
W. P� NAM---DEALERSHIP, clay of (Q. '
P-3. before hrs ;., Notary Public _
S2'.. State of
- N ': County of USE NOTARIZATION ONLY .t REQUIRED IN T I'LING IUHISDICTION
J d'
aw requires youcowing statementser ng is not the actual mileage Odometer
ual mileage of the vehicle unless one of the following is checked.Odometer
Federal� to state the odometer mileage"�in connection with the transfer ofof owrershlp Failure to complete or providing a false statement may^resu
in fines and/or imprisonment. WARNING ODOMETER 41SCREPANCY
I certify to the best of my knowledge that the odometer reading is tst act
'_— NpI:rths VThe-mileage stated is in excess of its mechanical limn., ❑ fhe
Reading Date of Sale_
____ Date of Statement.-
y Wj - ,,ad.,sa s that the statements set
OBeing duly sward uponY
Signature(s)of Seller s -
wName(s)"of Seller(s)----------Dealer's No._-- o h are true and correct.Subscribed of and sworn to me
Yo?f- Printed rbefore ti_,
f. Notary Public
I
w Signature of of serchaser ..____
1-• 2 of Purchasers)
Printed Name(s) - State of ---- -
o Name Iif ApPhcablei-_ --^--
Company - County ol____-.---- --
Address of Pureilaser(s) -" oTARIZAT oN oNtIT-SEQUINED tN Tr ICTION
- -- fV !.
UI 1st lien in favor of
O _
J2
whose addresses�----- �_ �_--
O
S 2nd se address favor of- .�- _......_�._
W Whose Is__-_-
._._.. ---,-'''''-'4_..,, - � X uar p- '_ `.,�-3
N._ „
; i 1 :
s
,, ,%.,,, --,
,,_;„I::
0
Auto Center .,, 1 _.. i �p�,, z �..: a.._ l
Fleet Department 2228 College Way • PO Box 338 • Fergus Falls, MN 56538-0338
218-998-8866 • 800-477-3013 Ext. 8866 • Fax 218-998-8813 • www.nelsonfergusfalls.com
VEHICLE INVOICE NUMBER F H198
Sold To: Oak Park Heights, City of Date: 05/15/2017
Attn: Brian DeRosier Phone: 651-439-4723
Address: 14168 Oak Park Blvd No. PO Box 2007 FAX:
Oak Park Heights, MN 55082 Salesperson: Melissa Nelson
bwderos@cityofoakparkheights.com Key Code:Ignition/Door: 0151X
Stock No. Year Make Model New/Used Vehicle ID Number
H198 2017 Ford Police Interceptor 4dr Police Utility New 1 FM5K8AR6HGC86270
Color: White/Black cloth/vinyl
Price of Vehicle Contract 83065 2017 price $26,312.95
Includes rearview camera display in rearview mirror vs. std. dash location
Options& Extras $1,398.00
Add for Dept. options per specs $808.00
Dealer installed options (no Ford warranty; contact Nelson with questions before diagnosis/repair)
Dealer installed 2" receiver hitch w/4 wire flat plug-in $590.00
Delivery $0.00
Subtotal $27,710.95
Trade- In
Total Cash Price each: $27,710.95
T-rm • Net 0 • - • -d• .ail int-re t - 1. °°/min h if • r= ei ; . . =n l; :r
Your Purchase Order# 41510-02162017 Project# MN Contract 83065
Thanks for your business!
Ship To/ Lessee/End User: Oak Park Heights, City of Phone: 651-439-4723
Brian DeRosier FAX:
Police Department
14168 Oak Park Blvd No. PO Box 2007
Oak Park Heights, MN 55082
•Equal Employment Opportunity/Affirmative Ac 61691914)akParkHeights K8A 17F.123 05/15/2017
Customer: Oak Park Heights,City of Nelson Auto Center
Attn.:(Name,Title) Brian DeRosier Fleet Department
Dept: Police Department PO Box 338
Address: 14168 Oak Park Blvd No.PO Box 2007 Fergus Falls,MN 56538-0338
Oak Park Heights,MN 55082 Melissa Nelson Gerry Worner
Phone: 651-439-4723
Phone: 218-998-8836 218-998-8866
Fax: Fax: 218-998-8813 218-998-8813
email bwderos@cityofoakparkheights.com mnelson@nelsonfleet.com gwomer@neisonfleet.com
MN Contract 83065 Ford Police Interceptor(FPI)Utility All wheel Drive
1 Ford Police Interceptor Utility Vehicle All Wheel Drive 2017 1 K8A $26,312.95 $26,312.95
Please designate your color choice 153 $0.00 17A $579.00
License Plate bracket-front(Std.for MN)
-
- _
Auxiliary rear Air conditioning/Heat(NOT available with cargo storage vault#63V) 681 FW $79.00
F
Cloth rear seat,instead of standard vinyl rear seat 87P $$58.00
Power passenger seat
Rear view camera display in mirror,vs.in std.4"diagonal screen on dash 1 87R $0.00 $0.00_
cannot be modified once vehicle is built;must specify at time of order 53M $280.00
SYNC Voice Activated Communication System,includes aux.input jack for phone/IPOD
LH spotlamp w/LED bulb Unity 2 degree pencil beam 51R $375.00
00 $399.00_$399.
LH spotlamp w/Whelen LED bulb,Whelen 8 degree beam recommended 1 51T _-
Dual spotlamps w/halogen bulbs 51Z $334.00
$334.00
Dual spotlamps w/LED bulbs,Unity 2 degree pencil beam
Dual spotlamps w/Whelen LED bulbs,Whelen 8 degree beam 51V $635.00
Suppression bondingstraps; vehicle forms largerground plane for 2 wayradio 1 60R $95.00 $95 00
Radio Noise P . g
keyed alike(like Crown Vic)1284X 59B $49.00
keyed alike(like Crown Vic)1294X 59C $49.00
keyed alike(like Crown Vic)0135X 59D $49.00
keyed alike(like Crown Vic)1435X 59E $49.00
keyed alike(like Crown Vic)0576X 59F $49.00
keyed alike(like Crown Vic)0151X 1 59G $49.00 $49.00
keyed alike(new code 2013 on)1111X 59J $49.00
Remote keyless entry keyfob(w/o keypad;N/A w/keyed alike;req'd w/Perimeter alarm) 595 $248.00
Global Unlock;unlock liftgate w/door panel switch vs.overhead strongly recommended 1 18D $0.00 $0.00
Lock plunger for rear doors,hidden,with rear door handles operable52H $132.00
Lock plunger for rear doors,hidden,with rear door handles inoperable strongly recommended 1.. 52P $153.00 $153.00
Perimeter anti theft alarm(activated by hood,door,decklid)[req.#595 keyless entry] 593 $114.00
76R $261.00
Reverse sensing
Row 2 glass Light Solar tint,instead of std.deep tint 92R $81.00
Row 2&cargo glass Light Solar tint,instead of std.deep tint 92G $114.00
Pre wiring for grille lamp,siren&speaker(required w/#18X siren or#21 L front aux lights) 60A $49.00
100 Watt siren/speaker includes bracket&pigtail(requires#60A pre-wire) 18X $285.00
Dome light,rear,in cargo area Red/White recommended 1 17T $49.00 $49.00
Daytime running lamps(N/A w#430 courtesy lamps disabled;use#43L instead) 942 $42.00
Automatic Headlamps(use w/#43L Stealth mode to allow driver to shut off auto headlamps) 86L $109.00
Stealth mode switch,to temp.cancel automatic headlamps or daytime running lamps req.#942 43L $19.00
Auxiliary Red/Blue LEDs"C"shaped in front bumper fascia(requires#60A) 21 L $524.00
Forward pocket warning Red/Blue LEDs-Warn/Park/Turn(requires#60A) 21W $607.00
Windshield interior Red/Blue/White LED"Visor"Lights Sound Off Signal(req.#85R,N/A w/#65U) 96W $1,059.00
Rear Spoiler Red/Blue AmberTraffic Warning Lights NEW for 2017(requires#85R,N/A w/#65U) 96T $1,330.00
Wheel covers 18"full face 65L $58.00
Aluminum Wheels,18"painted 64E $451.00
Police Interior Upgrade(cloth rear seat,carpet front/rear w/4 mats,civilian console) 85U $371.00 _
Delete Police Interceptor Badge(unmarked/non-police);deletes Interceptor letters on hood 1 16D $0.00 $0.00
Roof Rack side rails,black 68Z $148.00
Lockable gas cap for Easy Fuel capless fuel filler __ 19L $19.00
BLIS Blind spot monitoring,cross traffic alert;Heated Mirrors(req.#53M SYNC) 55B $517.00
LED Marker lightrs in left&right sideview mirrors(requires#60A) 63B $276.00
Side marker lights in rear quarter glass 63L $546.00
Four switches on steering wheel(w/o SYNC,#53M) 61 R $148.00
Four switches on steering wheel(w/SYNC,#53M) 61S $148.00
My Speed Fleet Managemnet 43S $58.00
Speed Limited Calibration w/EcoBoost V6 131 mph top speed-standard with EcoBoost 99T $3,130.00
EcoBoost 3.5 L V6 engine 131 mph top speed(NON E85)
Police engine secure idle feature;can remove key and leave engine running NEW for 2017 1 47A $248.00 $248.00
Garnet Red Clearcoat for MN State Patrol 58M00 $964.00
Bright Red for Fire Dept.vehicle W4650 $911.00 -_
Dark Forest Green OR Emerald Green OR Tan special paint colors $812.00
Two tone with white vinyl on 4 doors and roof behind crease91A $797.00
------------
00
Two tone with white vinyl on 2 doors and roof behind crease 91 C $665.
Two tone with white vinyl on roof only,behind crease 91 H $466.00 _--
Two tone with white vinyl on 2 front doors only 91J $290.00
White Vinyl Word"POLICE"wrap on both sides for 2 tone effect,non-reflective 91D $755.00
Black Vinyl Word"POLICE"wrap,reflective 91 E $755.00
White Vinyl Word'POLICE"wrap, reflective 91F $755.00
White'Vinyl Word"SHERIFF"wrap,non-reflective 91G $755.00
Scuff Guards clear film on front of rear door and top of rear bumper fascia 55D $86.00
Additional owners manual OMANUAL $90.00 _
Service/Driveability/Emissions/Electrical Manuals(late avail.) SMANUAL $498.00
Technical Service Bulletins(annual subscription) TSB $1,395.00 _
Extended Warranty,Ford Extended Service Plan$1500 to$5500;will quote ESP
$27 305.95
Page 1 subtotal
14198 OakParkHeights K8A 17F.123 05/15/2017
Customer: Oak Park Heights,City of Nelson Auto Center
Attn.:(Name,Title) Brian DeRosier Fleet Department
Dept: Police Department PO Box 338
Address: 14168 Oak Park Blvd No.PO Box 2.007 Fergus Falls,MN 56538-0338
Oak Park Heights,MN 55082 Melissa Nelson Gerry Worner
Phone: 651-439-4723 Phone: 218-998-8836 218-998-8866
Fax: _ Fax: 218-998-8813 218-998-8813
-
email bwderos@cityofoakparkhelghts.corn mnelson@nelsonfleet.com gworner@nelsonfleet.com
MN Contract 83065 Ford Police Interceptor(FPI)Utility All wheel Drive
$2.7,305.9.5
Page 1 subtotal -
Additonal Factory options: 1 85R $33.00 $33 00
rear console plate,"U"shaped channel on rear floor hump for wiring recommended 63V $232.00
Cargo storage vault,lockable,on left side of rear cargo area(NOT available with rear AC#17A)
Underbody Deflector plate("Beaver Guard") recommended 76D $318.00
Rear locks operable,but rear door handles inoperable(no change in base price) -68G,+68L $0.00
Courtesy lamps disabled when door open(Dark car)N/A w DRLs#942 recommended 1 430 $19.00 $19.00
Ultimate wiring package w/o LEDs or connectors;main lighting harness 67U $524.00
Police Wire Connector Kit Front;pigtails used w/Ultimate wiring harness 47C $100.00
Police Wire Connector Kit Rear;pigtails used w/Ultimate wiring harness 21 P $123.00
Pre-Drilled holes only for LEDs in headlamp housings recommended 1 86P $119.00 $119.00
Pre-Drilled holes only for LEDs in taillamp housings 86T $58.00
Two front integrated LED lights in headlamps 66A $809.00
Two rear integrated white LED lights in tail lamps(see options for red/blue) 66B $404.00
Four flashing LEDs:2 in back window&2 litigate bottom recommended 66C $433.00
Pkg.#24 Whelen PCC8R controller,relay center,wiring,rear plate 67G $1,272.00
Ready for the Road;Whelen Cencom controller,relay center,wiring 67H $3,244.00
Ballistic door panels Level III,driver door only 90D $1,506.00
Ballistic door panels Level Ill,both front doors 90E $3,012.00
Ballistic door panels Level IV+,driver door only 90F $2,294.00
Ballistic door panels Level IV+,both front doors 90G $4,588.00
Credit to omit the following items included in MN specs: 1 51Y ($204 00) _ ($204 00)
Delete driver side halogen spotlamp#51Y
Delete engine block heater#41 H -41 H ($86.00)
Delete carpet floor covering#16C;std.full rubber floor instead 1 -16C ($119.00) ($119.00)
Dolete Heated outisde mirrors#648 _- -549 ($58.00)
Delete Rear window switches inoperative#18W(allows them to work like a normal vehicle) -18W ($24.00)
Delete rear door locks&handles inoperable#68G(allows them to work like a normal vehicle) 1 -68G ($33.00) ($33.00)
Dealer Installed items (no Ford warranty;contact Nelson with questions before diagnosis/repair)
Dealer reprogramming per item(daytime running lamps,dark car feature,etc.) RPRGRM $95.00
Dealer re-key 4 locks(ignition,2 doors,liftgate)to specific key code REKEY $385.00
Dealer Silence key in ignition chime(may drain battery if left 7 days) NOCHIME $160.00
Dealer installed keypad keyless entry(must have#595 remote entry) KPAD $205.00
Dealer installed keyless entry,remote start,1 fob w/o feedback KLES $525.00
Dealer installed remote start and keyless entry,1 fob w/feedback RSTRT $580.00
Dealer installed power lock button in rear,accessible with liftgate open RLOCK $192.00
Dealer installed 2"receiver hitch w/4 wire flat plug-in(add$100 for 7 blade RV plug) 1 HITCH4 $590.00 $590.00
Dealer installed running boards,black REDS $715.00
Roof Rack cross bars,dealer installed _ RACKCB $277.00
Ford molded mudflaps dealer installed FLAPS $198.00
Rubber slush mats,front pair SMATS $117.00
Dealer installed vinyl wrap on 4 doors for two tone WRAP4 $400.00
Dealer installed vinyl wrap on 4 upper door frames around windows WRAPF $190.00
Dealer installed vinyl wrap on 4 doors&roof for two tone WRAP4R $695.00
Dealer installed vinyl wrap on 2 doors&roof for two tone WRAP2R $550.00 _
Dealer installed vinyl wrap on hood and roof for two tone WRAPTOP $525.00
Dealer installed vinyl word wrap,White or Black,POLICE or SHERIFF WORD $695.00
Dealer installed Reflective vinyl word wrap,White or Black,POLICE or SHERIFF REFWORD $695.00
Dealer Installed reusable Ballistic door panel Level III,driver door only AADP1 $1,379.00
Dealer installed Ballistic door panels Level III,both front doors AADP2 $2,698.00
Dealer installed Surveillance Mode Module(requires 76R reverse sensing) SURVEIL $696.00
Push Bumper,Setina PB 400VS,installed PB400 $679.00
Push Bumper,Setina PB 450L2VS w/2 red/blue lights,installed PB452 $1,037.00
Push Bumper,Setina PB 450L4VS w/4 red/blue lights,installed PB454 $1,198.00
Fender Protector,Setina PB8-VS PB8 $545.00
Fender Protector,Setina PB5 PB5 $600.00
Fender Protector w/single headlight wrap PB6-VS PB6 $760.00
Rear Window barriers Setina steelWBVSS $387.00
-_...----- __..___..---------
Rear Window barriers Seting Polycarbonate WBVSP $398.00
Setina 6-VSSPT single prisoner transport partition w/polycargonate window CAGESP $1,284.00
Seting 10-VS sliding partition w/o recesssed gun panel w/lower extensions CAGE $995.00
Setina 10-VSRP sliding partition w/recesssed gun panel w/lower extensions CAGER $1,099.00
Setina 10XL partition uncoated,w/recessed panel and seat extensions CAGEXL $1,076.00
Setina 12-PotyC rear cargo partition,polycarbonate scratch resistant RCAGE $808.00
Setina 12 EXP rear vinyl coated expanded metal partition RCGEM
Setina single vertical gun mount Universal lock,handcuff key,unwired 1GUN $436.00
Setina dual vertical gun mount/lock shotgun/AR-15,handcuff keys,unwired 2GUN $536.00
Toggle switch to disable brake lights and backup lights CANCEL $397.00
Whelen visor lights,interior lightbar Red/Blue/White LEDs VISOR $978.00
Red/Blue LEDs in taillamps only TAILRB $397.00
Red/Blue LEDs in taillamps&grille(not available with EcoBoost V6) GRILTAIL $883.00 _
Red/Blue LEDs in taillamps&Headlights(requires 86P pre-drilled holes$110.00) 4CRNRRB $883.00
Headlamp flasher system,flashes 2016 halogen High Beams HFLASH $397.00
Alarm system: Horn/lights upon door/hatch violation,w/2 remotes ALARM $310.00
Extra key(w/o microchip,simple "dumb"key) each KEY $12.00
Extra remote entry keytob (limit of 4 total per vehicle on dealer installed) each REMOTE $147.00
Transit Improvement Vehicle Excise Tax on any delivery within any Transit Tax county, TIVET $20.00
including at our dealership;only marked emergency vehicles are exempt
Option to pick up car in Fergus Falls,MN ($45.00)
$27,710.95
Total pages 1 and 2
H198 OakParkHeights K8A 17F.123 05/15/2017
4 .,:F _ c5. li 2228c01 .2., ay
P.U. Box
Ftp 4 { E .,.i t, r''
' • fb c a Fergus Fails, t,lf 16533
218-998-8878
www.neisonfergusfaiis.com 800-477-3013
Stock#: FH198 Date: 05'1//1 MELISSA NELSON
Salesperson:
Buyer Name:(Last) OAK PARK HEIGHTS, CITY OF (First) N/A (Middle)
Co-Buyer Name:(Last) N/A (First) N/A (Middle)
111168 OAK PARK BLVD NO. OAK PARK HEIGHTS MN WASHINGTON 55082
Address: City: State: County: Zip:
Home Phone: N/A Bus Phone: (.651)1139-11/L 4uyer DOB: N/A Co-Buyer DOB: N/A
Buyer D.L.#: N/A Co-Buyer D.L.#: NIA
Buyers Insurance Co.: N/A
PLEASE ENTER MY ORDER FOR: New 0 Used 0 Demo❑ Lienholder N/A Address N/A
YEAR 2011 MAKE FORD MODELPOLICE IN T ERLBODr' AL-JO IDR TRANSMISSION COLOR OXFORD aTriQFt
VIN# LIC.# TAB EXP.DATE STATE MILEAGE DELIVERED
1FM5K8ARGHGC862/@ N/A 20/ON OR ABOUT
Buyer Email: CASH PRICE OF VEHICLE 21, 710.95
Co-Buyer Email: FREIGHT
DEALER INSTALLED OPTIONS
N/A
REBATE N/A
TOTAL 27, /10.95
LESS TRADE-IN
REGISTRATION TAX N/A ALLOWANCE(-) N/A
PLATE FEE N/A TRADE DIFFERENCE 21, /10.95
TRADE-IN DATA PUBLIC SAFETY N/A N/A
VEHICLE FEE
YEAR MAKE MODEL BODY MOTOR VEHICLE N/A
N A N A N/A STYLE N/A TRANSFER TAX N/A SALES TAX
VIN# N/A
N/A TITLE/TRANSFER FEE N/A N/A
LIEN HOLDERS STATE/DEPUTY N/A SERVICE CONTRACT N/A
NAME FILING FEE
ADDRESS MAINTENANCE
N/A LIEN RECORDING FEE CONTRACT N/A
PLATES# N/A STATESE N/A DATE N/R WHEELAGETAX N/A &LOCALOTHER STATE
SALES TAXES N/A
MILEAGE N/A TRANSMISSION
NOW TRANSIT TAX N/A N/A
DOES YOUR TRADE-IN HAVE A BRANDED /A DOCUMENT
TITLE OR INSURANCE SALVAGE HISTORY? YES 01NO❑ ADMINISTRATION FEE 75 -x
IS THE POLLUTION CONTROL EQUIPMENT ON YOUROPTIONAL ELECTRONIC N/A
TRADE-IN INTACT AND IN OPERATING CONDITION? YES❑ NO❑ TRANSFER FEE
N/A
Dealer's Disclaimer of Warranty TOTAL LICENSE&FEES lb
Unless the vehicle is sold with a separate written dealer warranty or the SUBTOTAL 21, 110.95
dealer enters into a service contract with the buyer,the vehicle is sold
"AS IS".Dealer expressly disclaims all warranties,either express or LESS AMOUNT SUBMITTED WITH ORDER(—) N/A
implied,including the implied warranties of merchantability and fitness
for a particular purpose.The entire risk of the quality and performance PLUS BALANCE OWING TO LEINHOLDER ON TRADE IN(+) N/A
of the vehicle is with the buyer. ? ,71C�.95
Important:A manufacturer warranty may apply. TOTAL AMOUNT DUE ON DELIVERY
The front and back of this CONTRACT comprise the entire CONTRACT affecting this purchase.The DEALER will not recognize any verbal agreement,or any other agreement or
understanding of any nature.You certify that you are 18 years of age or older and acknowledge receiving a copy of this contract.
The terms of this CONTRACT were agreed upon and the CONTRACT signed in the IMPORTANT: THIS MAY BE A BINDING CONTRACT
dealership on the date noted at top of this form. AND YOU MAY LOSE ANY DEPOSITS IF YOU DO NOT
PERFORM ACCORDING TO ITS TERMS.
NOTICE OF SALESPERSON'S LIMITED AUTHORITY.This contract is not valid unless signed
and accepted by Sal s anager or Officer of Dealership.
�c o —
Accepted O Buyer's Signature Accepting Terms of Contract
This ODOMETER DISCLOSURE STATEMENT and ASSIGNMENT Refers to Vehicle Being Sold
Federal and State law require that you state the mileage upon transfer of ownership.Failure to complete or providing a false statement may result in fines and/or imprisonment.
I(we), ' LSOINI AUTO CENTER ,the owner(s)of the vehicle described below,certify the vehicle is free of all security
(Transferor's Name,Print) 'ern
interests,warrant title,assign the registration tax and the vehicle to the person(s)named below and state that the odometer now reads (no tenths)miles
and to the best of my knowledge the odometer mileage is:
0 ACTUAL MILEAGE
❑ EXCEEDS MECHANICAL LIMITS OF ODOMETER`
0 NOT ACTUAL MILEAGE-WARNING ODOMETER(DISCREPANCY ,
YEAR MODEL
2L^1 J MAKE F OR[7
POLICE INTERCEPTOR U 1 1131D TYPE AWL) IIDR
VIN NO. 1 F M 5 K 8 A R SH G C H G 2/0 LICENSE NO. LIC.EXP.DATE
TRANSFEREE'S NAMEY R) V TRANSFEROR'S(SELLER)STREET ADDRESS
+ 'K HEIGHTS, CITY OF 2223 COLLE-32 WAY P.O.BOX 635
STREET ADDRESSCITY STATE ZIP
1/1168 OAK PARK OLVfO NO. " P:oeLS FALLS MN 56538 .
CITY OAK PARK HEIGH1 E MN 5508 TTRRA�N/SFE O 'S.LSE R)SIGNATURE(PRINT SIGNER'S NAME ALSO)
05/1//1/TRANSFEREE'S(BUYER)SIGNATURE(,P�MIVT�$10f�ER'S NAME ALSO) 5/1 J/1
Receipt of copy acknowledged QX �--
STATEMENT DATE
L
ADDITIONAL TERMS AND CONDITIONS OF THIS VEHICLE PURCHASE CONTRACT
i. Definitions: As used in this CONTRACT, YOU or"YOUR"means the buyer andbosbuyer,"I" "ME" or"MY"means the seller or dealer.
"VEHICLE"means the car,truck,or other vehicle described on the front of this CONTRACT including all the options listed."Manufacturer"
means,ticompany which!bakes the VEHICLE.l'Tradern"means the thiihhiCie that YOU trade to ME in partial payment for the VEHICLE.
.2. Purpose: By signing file CONTRACT YOU agree to buy the VEHICI....E from ME. By accepting this CONTRACT, I agree to deliver the
VEHICILE to YOU if the VEHICt„E is in My inventory. If the.VEHCLE is not in my inventory, I agree to order it from the Manufacturer After
reeerviag the VEHCL.E frOrn the Manufacturer, I agree to deliver the,VelI/I0I0 to YOU.
3, Price Changes by the IManufacturer The VEHICLE price stathd on the front of this CONTRACT is based en the current price the
Manufacturer charges ME.At any Lime before I receive the VEHICLE,the Manufacturer has the right to raise the price it charges to ME.
if the Manufacturer does mkse•the once, i firiay raise the once to YOU tn/the SaMe arnotmt. if I do raise MY price, YOU.may cancel the
le(egshElif AC] end get; Posh ar,'Il dCIIIIVIIPOYment YOU have made. If I have not already said lba3 Tradetin (See Paragraph 4),YOU may
haVe the Itadmin back(by,'paying ME the 110/,-ISOflatIe cost of storage amid any repad work or r•econdiboning I may have done.
4. Trade-by H YOU aro using a traciegn to bertiafly pay for the"Arldb,.1....E YOU may deliver•the i facietin to ME either when YOU sign
this(1)0(fladitrOT or when the VEHOI f"is Mtvivered to YOU. lf YOU do ricft deliver the Trade-1n to ME vynen YOU sign this CONTRACT,
Y(1)1.) agree thsd at the time YOU dekver the Tradmln may reabscect C-riu Tradveln and Pkwer the allowance stated on the front of this
ocyfirriffersis It;du Hater inci uscrietherith YOU may cancel this(1112i2fifiliiii212 and ittit2 ithiiii2iit your hash 0 CANT1 payrac-mt. If YOU deliver the
.ft,wc,,m,kh-tr,pij egr lt,i()cc,g)..)...,(wegsett ., may seN the)1(a.acetri at may time tb,••••ta at any phce i,tfkras proper. -If this CONTRACir is cancelled and
I have ak-eady seitsi the Irafte In. wP pay YOU the price received for the Tragerbt minus •15())),comatission, •minus any money i spent
regarkm. Gomm, Haw ow( tv advertesum me fradebn, uniess othervase requireo by ow. .
VA-awn you&diver the T;'-d,.-101li to Mig YOU guarantee Mat YOU owri Gm Trade-th free and olitar and .:1grttie to furnish proper proof of
ownershib, Mb:lading the(terblicate of Tate. fl any eatsttindfnd security frac:Tests ale aft ached to the Tradetin vehicle YOU are ohli(T-ated
to habstry tile dem securer) and to obestu•-) a remase of ail kens. H• arSIIIMSIIIII payment at the debt, and trig total amount is greater di it the
amount shown on this CONTRACT as the balance ow•Mg to lienhotcler„ YOU agree to pay ihe difference to ME in hash inimediately upon
n.H o the ee,ficiency. if the debt IS IIeSS than me amount S00,01-1, I MII 0000d-Wm ,,,a0Itis to yott,
5, YOUR Refusal te Take Deliveryi Uritges YOU canceiled thfs CONTRACT under paragraphs 2 cir 4 i'NW retain the cash downpqment
yrdfr gave ME as an offset ba M's"dmwages if k())11 refi(se fp con-pieta•the purcttase..Mat are also rasponsible for any off)er damages which
may Meta as IIII II,I,SIIItfafIIME1 iCII 0eff000 IsfaduR obligakong m-Rwe the terms of leis CONTRACT d YOU have delivered the Trade-
th to •t.:(0))., yyhen YOU ragned this CONTRACT i may retain the Trade-M tithid Seii it to re(mbusse MYSELF'tor the expenses of repairing, -
stogag,dr reconditioning the Trackata and for other expenses or losses nutty Meta as a.result of YOU a to perform YOLJR.obligations
Lmder this CONTRACT,
6, Design Changes by the Manufacturer The Manufacturer ha.s the right to change the design of the'A-If-HOLE, its chassis, its parts
or rAccessories at arty brae without notice to YOU or to ME. tri the event of a change ill design, Inaye no duty to YOU except to deliver •
the VItthiCLE as filade I Me r,,cc
7. Delays in Delivery: i aim net resognsiNe for delays in delivery c.)eused by the Manufactuf•et„ or by accidents,fires,or other causes
beyond MY control, I do not control the Manufacturer and am c, piart of the mandfactuter and do not work for the.manufacturer
8.. Taxes: The once of the VEHICLE does not include federal or state taXeS or any(Aher tax or governmental fed,YOU must pay ME the
proper amount of any to or governmental fee which a.ppliesito this sale.
9, Pollution Control Certification: I certify to the best of MY knowlsidge that the pollution control system on the VEHICLE including the
restricted gasoline pipe has not been removed,althreP Or rendered inoperative.
10, New VEHICLE Disclaimer of Warranties: If YOU are buying a new VEHICLE,the VEI-IICLE will come with a Manufacturer's warranty
whIch is a promise from the 1i1anuliiithturer directly to YOU. Unless it 'it agreed in a separate document(see Paraaraph 12 below), i
expressH disclaim ail wadanfies,express or iirtplirttd Including any implied warranty of merchantability or fitness for a par•ticular purpose. I
sell the VEHICLE"AS IS and ma.ke no guarantees of any Hind about the VEHICLES qualify or oerformaT)Ce. IF have complete responsibility
adS all the risk Mr any problems with H VEHICLE. •
11, Used VEHICLE Disclaimer of Warranties: Except as may he pr•ovided in the Buyer's Guide Wirdow Form and a separate warranty
document (see Paragraph 12 bei0.0;), if YOU are purchasing mused VEHICLE, I expressly disclaiM ali warranties, express or implied,
including any implied warranty.of marchardability or fitness for a particular purpose. I SION the VEHICLE"AS IS"and make no guarantees
of any king about the VD-HCLEs quality or performance. 'YOU Ii a.ve compiete r•esponsibiIity and all the risk for any problems with the
VEHICLE. 1 dp not guarantee that the VEHICLE will pass an exhaust(gnissions inspection.
12. Dealer Warranty or Service Contract: If I give a warranty on a used VEHICLE or YOU and f enter inM an extended service contract
on a ntiv Or used VEHICLE, I may not disclaim implied warranties of merchantabiity•or fitness for a road-Mahar purpose.
13. Used VEHICLE Window Sticker Form: If YOU are purchasing a it .t.ifil VEHICLE or a defliOnstrator,the information YOU see on the
ethic:low form far f his VEHK:1;t....E is part of this CONTRACT InformatiOn on the standow forifn overridOS any contrary pravisions in the CONTRACT
of stif1e..ilia information pith apareCO en la ventanilla de este vernictilo forma taute de erttte confrato„La informadon confenclida en el formulario
oie III7I Verlfafldit).anula cualguier prevision pue fithiablezca Cr'contrago y gue aparezca 00 0I Contrail)de yenta]