Fillable ENDVSAF Service Agreement Registration

Fill Online, Printable, Fillable, Blank ENDVSAF Service Agreement Registration Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

ENDVSAF Service Agreement Registration

On average this form takes 7 minutes to complete

The ENDVSAF Service Agreement Registration form is 1 page long and contains:

  • 0 signatures
  • 1 check-box
  • 26 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
ADDRESS
CITY
NAME
EMAIL
CELL PHONE
STATE
ZIP
(FIRST)
(LAST)
EFFECTIVE DATE
Service Agreement Registration
PRODUCER NAME
ENDVSAF
TERM MONTHS
NOTICE TO CUSTOMER: It is understood if purchasing a vehicle, this Vehicle Service Agreement is not required to obtain financing or to purchase
a Vehicle. This Service Agreement is not an insurance policy, a Warranty, or a guarantee. The Agreement Retail Price may be paid in full or financed
with an approved payment option allowed by Us. This Agreement represents the entire Agreement between You and Us. No person has the authority
to change this Agreement or to waive any of its provisions. No other written or oral statements apply to this Agreement.
MANDATORY WAITING PERIOD: It is understood that a 30 Mandatory Waiting Period applies to this Agreement from the Agreement Effective Date.
30 days will be added to end of the Term of Your Agreement. (EMERGENCY ROADSIDE SERVICE, PROMOTIONAL REWARDS AND TRIP INTERRUPTION
BENEFITS ARE AVAILABLE ON THE AGREEMENT EFFECTIVE DATE.)
PAYMENT PLAN PROVIDER (optional): If this Agreement was purchased on a payment plan, the Producer and or Payment Plan Provider listed on
this registration page shall be entitled to any refunds resulting from cancellation of this Agreement for any reason. Failure to make monthly payments
in a timely manner may result in cancellation of this Agreement; no refund will be due and no claims will be authorized.
By signing below You understand and agree to all of the terms and conditions described in this Agreement. You understand that purchase of this
Agreement is voluntary and is not insurance.
Emergency Roadside Services administered by: QUEST TOWING SERVICES, LLC
In Alabama and Utah by Quest Towing, Inc., all entities being individually and collectively
referred to as Quest Towing Services
Address: 106 W. Tolles Drive, Saint Johns, MI 48879
All other benefits are administered by: AXIOM PRODUCT ADMINISTRATION LLC:
Administrative Address: 8651 HWY N, SUITE 201, LAKE ST. LOUIS, MO 63367
For Emegency Roadside Service or Claims, call: 1-833-220-0680
To report an Identity Theft, call: 1-866-399-4389
12
RETAIL PRICE
PRODUCER REPRESENTATIVE NAME
END-VSA-F 5/19
VIN
YEAR
MAKE
MODEL
ODO
Page 1 of 8
PAID BY CUSTOMER
PAID BY PRODUCER*
*
If the Retail Price is paid by the Producer, You will not be entitled to a refund if cancelled.
CUSTOMER INFORMATION
AGREEMENT INFORMATION
PRODUCER INFORMATION
CUSTOMER SIGNATURE
DATE
SIGNATURE
VEHICLE INFORMATION
PAYMENT PLAN PROVIDER
PHONE NUMBER
ADDRESS
CITY
STATE
ZIP
NAME
FINANCED
PAID IN FULL
X
SAPE2212671-EC
JAMES
WINTERBOTTOM
702-580-5963
BIKERJ@GMAIL.COM
Las Vegas
NV
89129
09/18/2020
$0.00
1FTRW08LX3KD80137
2003
FORD
F150 SUPERCREW
115663
Endurance - Direct to Consumer
08/19/2020
END-VSA-F 5/19
Page 2 of 8
A. DEFINITIONS
ADMINISTRATOR, WE, US, AND OUR: For Roadside Service Benefits: Quest Towing Services. For Identitiy Theft: Car Dealer Benefits. For all other
benefits: Axiom Product Administration LLC,: Administrative address: 8651 Hwy. N, Suite 201, Lake St. Louis, MO 63367, 1-833-220-0680.
AGREEMENT: This Vehicle Service Agreement, which You have purchased for Your Vehicle.
COMMERCIAL USE: Any vehicle used for
police or law enforcement services, fire, ambulance or emergency services, taxi, rideshare (such as Uber,
Lyft, etc.), limousine or shuttle services, pick up and/or delivery operations, racing, newspaper or mail delivery, rental services, construction, security
services, snow removal or plowing, cable or line installation, or hauling for hire.
EFFECTIVE DATE: The date in which You purchased this Agreement and Your coverage becomes effective. It is listed on the Registration Page under
the Service Agreement Information section.
OBLIGOR: Axiom Product Administration, 1 PROGRESS POINT PARKWAY, SUITE 101, O’FALLON, MO 63368, (844) 252-0937.
PRODUCER: The seller of this Agreement as listed in the Producer Information section of the Registration Page
ROAD HAZARD: Road debris on the road’s surface such as rocks, trash, nails, glass, steel plates, etc., or road surface conditions such as, potholes,
sinkholes, cracks etc., that results in damage to Your Vehicle.
TERM: The Term of this Agreement is 12 months from the Effective Date listed on the Registration Page.
VEHICLE: The covered Vehicle listed under the Vehicle Information section on the Registration Page. All coverages apply to the Vehicle only, except
Emergency Roadside Service which covers the Vehicle and You when You are the passenger or driver of another vehicle.
YOU OR YOUR: The customer named as the Service Agreement Holder on the Registration Page.
B. WHAT YOUR AGREEMENT COVERS
A. TIRE REPAIR AND REPLACEMENT (This benefit is administered by Axiom Product Administration)
Your Tires are only eligible for repair or replacement benefits if the tire’s tread depth is greater than 2/32 of an inch at the time the covered
Road Hazard incident occurs. If the tread depth of the damaged tire is less than 2/32 of an inch at the time the Road Hazard incident occurs, it
is considered to be unsafe for normal operation according to TIA safety standards and is not eligible for repair or replacement under this benefit.
Oversized and off-road tires are specifically excluded from coverage. The benefits in this section are afforded to You only in the event Your Vehicle
incurs damage due to a covered Road Hazard incident. Our benefits are a “repair” benefit first, meaning We will use Tire Industry Association (TIA)
approved repair methods and services to repair Your tire. If Your tire is deemed unrepairable, We will pay the cost of the tire replacement subject
to the terms, conditions, and limits below.
TIRE REPAIR: If the covered tire can be safely repaired according to TIA repair standards, We will pay the cost of the tire repair subject to the
terms, conditions and limits, in this benefit section. It is not necessary to contact Us before having a tire repaired. The maximum amount payable
for tire repair is $50 per occurrence. You are responsible for any amounts exceeding this per occurrence limit.
TIRE REPLACEMENT: If the covered tire cannot be safely repaired per Tire Industry Association (TIA) standards, due to circumstances such as
side wall punctures, tears, punctures too large to be patched, tire manufacturer safety or performance requirements, We will pay the cost of the
tire replacement subject to the terms, conditions, and limits, in this benefit section. When tires are not repairable, tires will be replaced with new
tires of the same specifications of like, kind, and quality. Replacement tire costs will not exceed the lesser of the Manufacturer’s Suggested Resale
Price (MSRP) or the advertised price of the servicing facility for the covered tire being replaced. We reserve the right to ship replacement tires if the
cost of the local repair facility exceeds national MSRP averages or Our discounted national repair pricing is less. The maximum amount payable for
tire replacement is $125 per occurrence. You are responsible for any amounts exceeding this per occurrence limit.
This is a reimbursement only benefit. For reimbursement, mail Your paid invoice, Your repair order and a copy of Your Registration Page to Us at
8651 Hwy. N, Suite 201, Lake St. Louis, MO 63367, within 60 days of claim origination. The Tire Repair and Tire Replacement benefits combined
are limited to 2 occurrences for the Term of this Agreement.
B. KEY/FOB REPAIR OR REPLACE (This benefit is administered by Axiom Product Administration)
In the event You damage, destroy, or lose Your Key, and/or, Key FOB for Your Vehicle, We will reimburse You up to $500 per incident for the repair
or replacement of an OEM (or like, kind/quality replacement) Key/FOB/Remote. Your benefit amount can be used for the reasonable repair
or replacement costs of: key inserts, metal key charge, key housing, remote housing/transmitter, bluetooth replacement and any related Vehicle
reprogramming expenses.
This is a reimbursement only benefit. For reimbursement mail Your paid invoice, Your repair order, and a copy of Your Registration Page to Us at
8651 Hwy. N, Suite 201, Lake St. Louis, MO 63367, within 60 days of claim origination. This benefit is limited 1 use for the Term of this Agreement.
C. TRIP INTERRUPTION (This benefit is administered by Axiom Product Administration)
We will reimburse You up to a maximum of $150 per day for a maximum of 4 days, not to exceed a total of $600, for expenses incurred by You
for meals and/or lodging, provided: You cannot operate Your Vehicle due to a Vehicle disablement and You are more than 100 miles away from
Your permanent, and expenses are incurred between the time of the Vehicle disablement and the time repairs are completed. (The date of the
Vehicle disablement shall be considered the first day). 1 day’s trip interruption expense shall be allowed for each eight hours, or portion thereof,
of required manual flat-rate labor time.
This is a reimbursement only benefit. For reimbursement mail Your paid invoice, Your repair order, and a copy of Your Registration Page to Us at
8651 Hwy. N, Suite 201, Lake St. Louis, MO 63367, within 60 days of claim origination.
D. PROMOTIONAL REWARDS AND DISCOUNTS (This benefit is administered by Optimus Rewards)
You are entitled to receive promotional rewards with this purchase, in the form of $250 in Reward Dollars, which You can use to save on things like
shopping, dining, and travel. You access and use Your rewards and related benefits all via online or mobile device at www.mydigitalvehiclerewards.
com. Action on Your part is required to use Your rewards. Your rewards are free to You. You are under no obligation to use Your rewards. As long
as You have an active Agreement, and as long as You have a reward balance. Your rewards are not gift cards or gift certificates and have no cash
value. Your rewards are not for re-sale and are subject to change and availability.
E. ID THEFT PROTECTION (This benefit is administered by Car Dealer Benefits)
Upon reporting Your identity theft to Us, We will send you an emergency response kit. We will assist You with restoring Your credit and good repu-
tation. We will administer the costly steps required to properly dispute fraudulent debts as a result of identity theft, create a case file to document
actions taken during the resolution/recovery process, and prepare all necessary documents and letters. You will have unlimited access to Our
team of Fraud Resolution Specialist (FRS). Each FRS is an experienced fraud representative and has been trained under the Fair Credit Reporting
Act (FCRA). Each FRS is also educated and familiar with prohibited “collection” company activities under the Fair Debt Credit Protection Act (FDC-
PA). We will also provide Tax Fraud Assistance through our staffed CPA’s and Enrolled Agents, and via Power of Attorney, we are able to help You
by working directly on Your behalf with the IRS. We maintain a $25,000 expense reimbursement policy to cover reasonable and necessary costs
incurred by You in the United States for long distance phone calls and postage solely as a result of Your efforts to report a stolen identity event
and/or amend or rectify records as to Your true name and/or identity as a result of a stolen identity event. This also includes re-filing applications
for loans, grants, or other credit instruments. In addition, We will provide $500 per week for lost wage reimbursement for a maximum of 4 weeks.
ID Theft Protection is available for up to a family of 4 residing at Your address. To report an Identity Theft call 1-866-399-4389.
F. DIGNIFI
We provide you access to DigniFi who will provide you auto repair loans when you incur unforeseen auto repair expenses. DigniFi offers repair
loans with, no money down and competitive interest rates. Visit DigniFi.com for further details to obtain information regarding a repair loan for
Your Vehicle repairs.
G. EMERGENCY ROADSIDE SERVICE (This benefit is administered by Quest Towing Services)
All Emergency Roadside Service is administered by Quest Towing Services, 106 W. Tolles Drive, Saint Johns, MI 48879, 1-833-220-0680. In the
END-VSA-F 5/19
Page 3 of 8
event Your Vehicle or any vehicle to which You are a driver or passenger experiences a mechanical breakdown or disablement, and is in need of:
a. Towing or jumpstart,
b. Flat tire change (with inflated Spare),
c. Fluid delivery (oil, water, or fuel **Cost of uids not included), or
d. Lock out assistance (entry into passenger compartment only),
We will dispatch a service provider to Your location. Your benefit includes “sign & drive” services under this Agreement. *Sign & drive means You
incur no out of pocket expenses. If You arrange for service on Your own and do not utilize sign & drive services provided by Quest Towing Services
the maximum reimbursement for which You are eligible is limited to $50 per use/incident. The towing benefit included is limited to 25 miles per
occurrence, any expense incurred for towing Your Vehicle over 25 miles will be Your responsibility. Your benefit coverage allows for a maximum
of 1 use per any 72-hour period. All receipts must be submitted to Us within 60 days of incident. 24-hour Roadside Service is provided to You as
long as Your Agreement is active, and is available by calling 1-833-220-0680. Please provide the dispatcher with Your Agreement Number (which
is on the top right of Your Enrollment Page).
Emergency Roadside services are provided only for unmodied single rear-axle, four wheeled registered and licensed light duty
motor vehicles weighing less than 9,500 lbs./4,300 kg used for private, on-road transportation, including passenger vehicles and
light duty trucks.
Emergency Roadside services are provided to You in emergency situations only when Your Vehicle or any vehicle to which You are
a driver or passenger (due to an unforeseen disablement or unavoidable incident) is unable to be driven safely. Services are not
designed to be provided when the disablement is caused by poor or non-existent vehicle maintenance nor does this benet cover
services required for Your Vehicle due to an automobile accident or damage incurred by acts of nature such as: oods, hurricanes,
tornadoes, earthquakes, and hail.
Services provided by Quest Towing Services will not be available in areas not regularly traveled, such as vacant lots, beaches,
open elds, roads closed during the season of the request, or other places which would be hazardous for the Service Provider to
reach.
D. YOUR RESPONSABILITIES
All benefits are available to You up to the specified benefit limit. You are responsible for any amounts over the maximum benefit allowed per the terms
of this Agreement. Your are responsible for submitting all requested documentation for reimbursement within 60 day of covered claim origination.
E. EXCLUSIONS
This Agreement will not pay or reimburse You for any of the following:
1. Any damage caused by collisions/auto accidents, vandalism, acts of God including severe weather.
2. Any damage resulting from acts of fraud, theft, neglect, or Vehicle misuse.
3. Any vehicle driven for Commercial Use.
4. Any pre-existing conditions that existed prior to the Agreement Eective Date.
5. Damage resulting from o Road operation of Vehicle.
6. Any claim outside the United States or Canada.
7. Any damage that is covered by Your auto insurance coverage.
F. HOW TO MAKE A CLAIM
1. To file for claim reimbursement for all other covered benefits except ID Theft, call or submit reimbursement documentation to Axiom Product
Administration, 8651 Hwy. N, Suite 201, Lake St. Louis, MO 63367, 1-833-220-0680.
2. To Report an Identity Theft call 1-866-399-4389.
G. CANCELLATION AND TRANSFER
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. If You cancel
this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a $50 administrative fee, and
less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused Term Months. If the Retail
Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
2. CANCELLATION BY US: We may cancel Your Agreement for any reason in the first 30 days. After 30 days we may only cancel for (a) non-payment
of the Agreement Retail Price, or if the monthly payments under any payment plans used to finance the purchase of Your vehicle service Agreement
have not been made in a timely manner; (b) a material misrepresentation made by You; or (c) a substantial breach of duties by You relating to Your
Agreement. If We cancel this Agreement We will refund You 100% of the Agreement Purchase Price, less any paid or pending claims.
3. TRANSFER: This Agreement is non-transferable.
H. OBLIGATIONS
Obligations under this Agreement are insured under an insurance policy issued by Lyndon Southern Insurance Company, 10151 Deerwood Park Blvd.,
Bldg. 100, Ste. 500, Jacksonville, FL 32256, Tel: (800) 888-2738, except in California, Georgia, New York, Rhode Island and Wisconsin.
In Georgia, obligations under this Agreement are insured under an insurance policy issued by the Insurance Company of the South, 10151 Deerwood
Park Blvd., Bldg. 100, Ste. 500, Jacksonville, FL 32256, Tel: (800) 888-2738.
In New York, Rhode Island, and Wisconsin, obligations under this Agreement are insured under an insurance policy issued by Atlantic Specialty Insur-
ance Company, 605 North Highway 169, Suite 800, Plymouth, MN 55441, Tel: (800) 888-2738.
In the event the Obligor fails to pay an authorized claim within 60 days after proof of loss has been filed, You may file a direct claim with Lyndon
Southern Insurance Company, Insurance Company of the South, or Atlantic Specialty Insurance Company. To do so, please call the following toll–free
number for instructions: (800) 888-2738.
I. ARBITRATION
Any controversy or claim arising out of or relating to this Agreement, or breach thereof, will be settled by binding arbitration in accordance with
the Commercial Arbitration Rules of the American Arbitration Association at the time of the dispute. A judgment upon the award rendered by the
arbitrator(s) may be entered into any court having jurisdiction thereof. The parties specifically agree to the binding nature of the arbitration, unless
the law of resident State, at the time of purchase, dictates otherwise.
J. STATE AMENDMENTS
These special state disclosures apply if Your Agreement was delivered in one of the following states.
ALABAMA: Section G., Cancellation is amended by deleting items 1. and 2. and replacing it with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
void this Agreement only applies to You and only if no claim has been made. A 10% per month penalty shall be added to any refund that is not
paid or credited within 45 days after the return of this Agreement to Us. If You cancel this Agreement after the first 30 days of the Effective date,
We will refund the unearned Agreement Retail Price, less a $25 administrative fee. The unearned Agreement Retail Price will be calculated on a
pro-rata basis based on the unused Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will
not be entitled to a refund.
2. CANCELLATION BY US: We may cancel this Agreement based on one or more of the following reasons: (a) non-payment of the Purchase Price;
END-VSA-F 5/19
Page 4 of 8
(b) a material misrepresentation made by You; or (c) a substantial breach of duties by You relating to the Vehicle or its use. If We cancel this
Agreement, We will refund You 100% of the Agreement Purchase Price. If We cancel this Agreement for any reason other than non-payment or
material misrepresentation We shall mail a written notice to You written notice of cancellation at Your last known address at least 5 days prior to
the cancellation effective date.
ARIZONA: Section E., Exclusions, is amended by deleting item 4. and replacing it with the following:
4. ANY PRE-EXISTING MECHANICAL PROBLEMS KNOWN TO YOU THAT EXISTED PRIOR TO THE PURCHASE OF THIS AGREEMENT OR
CONSEQUENTIAL DAMAGES THAT RESULT FROM THE FAILURE OF A NON-COVERED COMPONENT.
Section G., Cancellation is amended by deleting item 1. and replacing it with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. If You cancel
this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a $50 administrative fee..
The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused Term Months. If the Retail Price was paid by the
Producer any refund will be issued to the Producer, You will not be entitled to a refund.
Section H. Obligations, is deleted and replaced with the following:
Obligations under this Contract are insured under an Insurance Policy issued by Lyndon Southern Insurance Company, 10151 Deerwood Park
Blvd., Bldg. 100, Ste. 500, Jacksonville, FL 32256, Tel: (800) 888-2738. In the event We cease to operate, are bankrupt or Your claim is not paid
within 30 days after proof of loss has been filed, You may file a direct claim with Lyndon Southern Insurance Company.
Section I., Arbitration, is amended by adding the following:
Arbitration does not prohibit You from following the process to resolve complaints under the provisions of A.R.S. §20-1095.09m, Unfair Trade
Practices, as outlined by the Arizona Department of Insurance. To learn more about this process, You may contact the Arizona Department of
Insurance at 2910 N. 44th Street, 2nd Fl., Phoenix, Arizona 85018-7256, Attn: Consumer Affairs. You may directly file any complaint with the
A.D.O.I. against a service company issuing an approved service Agreement under the provisions of A.R.S. §§20-1095.04 and/or 20-1095.09 by
contacting the Consumer Affairs Division of the A.D.O.I., toll free phone number 1-800-325-2548.
COLORADO: Section H., Obligations, is amended by adding the following:
Obligations under this Contract are guaranteed by reimbursement insurance policy issued by Lyndon Southern Insurance Company, 10151
Deerwood Park Blvd., Bldg. 100, Ste. 500, Jacksonville, FL 32256, Tel: (800) 888-2738
CONNECTICUT: The following disclosure is added to this Agreement:
If the Vehicle is in repair at the time this Contact expires, the expiration date will be automatically extended until the repair is complete.
Section G., Cancellation item ., is amended by adding the following:
You may cancel this Agreement at any time, including if You return the Vehicle or if the Vehicle is sold, lost, stolen, or destroyed.
Section H., Obligations, is amended by adding the following:
You may file a claim with Lyndon Southern Insurance Company, 10151 Deerwood Park Blvd., Bldg. 100, Ste. 500, Jacksonville, FL 32256, Tel:
(800) 888-2738, if We fail to perform according th the therms of this Contract.
Section I., Arbitration is amended by adding the following:
If We are unable to resolve any disputes with You regarding this Agreement, You may file a written complaint with the State of Connecticut
Insurance Department, P.O. Box 816, Hartford, Connecticut 06142-0816, Attention: Consumer Affairs. The written complaint must contain a
description of the dispute, the Purchase Price of the Vehicle, the cost of repair the Vehicle, and a copy of this Agreement.
GEORGIA: Section G., Cancellation items 1. and 2., are deleted and replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. If You cancel
this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price. The unearned Agreement Retail
Price will be calculated on a pro-rata basis based on the unused Term Months. If the Retail Price was paid by the Producer any refund will be issued
to the Producer, You will not be entitled to a refund.
2. CANCELLATION BY US: We may cancel this Agreement based on one or more of the following reasons: (a) non-payment of the purchase price;
(b) a material misrepresentation made by You; or (c) fraud by You relating to the Vehicle or its use. If We cancel this Agreement, We will refund
You 100% of the Agreement Purchase Price. If We cancel this Agreement for any other reason other than non-payment of the Purchase Price, We
will mail You written notice of cancellation at least 30 days prior to the effective date of cancellation. If We cancel this Agreement, We will provide
any refund due on or before the effective date of cancellation. All cancellations shall be in accordance with O.C.G.A. § 33-24-44.
Section E., Exclusion Item 4.is deleted and replaced with the following:
4. ANY PRE-EXISTING MECHANICAL PROBLEMS THAT EXISTED PRIOR TO THE EFFECTIVE DATE OF THIS Agreement AND WERE KNOWN
TO YOU OR CONSEQUENTIAL DAMAGES THAT RESULT FROM THE FAILURE OF A NON-COVERED COMPONENT.
Section I., Arbitration, is deleted in its entirety.
HAWA
II: Section G., Cancellation item 1., is deleted and replaced with the following:
1. CANCELLATION BY YOU:You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 30 days and receive a full refund only applies to the original purchaser and is non-transferable. If We do not
provide Your applicable refund within 45 days of the effective date of cancellation, a 10% penalty per month will be added to the amount of the
refund. If You cancel this Agreement after the first 30 days, or if a claim has been made within the first 30 days, We will refund the unearned
Purchase Price calculated on a pro-rata basis determined by the months remaining, less a $50 administrative fee and less any paid or pending
claims. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
IDAHO: The following disclosure is added to this Agreement:
Coverage afforded under this Agreement is not guaranteed by the Idaho insurance guaranty association.
ILLINOIS: Section G., Cancellation item 1., is deleted and replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. If You cancel
this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a $50 administrative fee, or
10% of the Agreement Purchase Price, whichever is less. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the
unused Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
INDIANA: The following disclosures are added to this Agreement:
This Agreement is not insurance and is not subject to Indiana Insurance law.
IOWA: The following disclosure is added to this Agreement:
You may contact the Iowa Commissioner of Insurance at 601 Locust St., 4th Floor, Des Moines, IA 50309.
END-VSA-F 5/19
Page 5 of 8
Section G., Cancellation item 1., is deleted and replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel and receive a full refund only applies to the original purchaser and is non-transferable. A 10% penalty per month shall be added to a refund
that is not paid within 30 days of the return of this Agreement. If You cancel this Agreement after the first 30 days of the Effective date, We will
refund the unearned Agreement Retail Price, less a $50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be
calculated on a pro-rata basis based on the unused Term Months. If You cancel we shall mail a written notice of cancellation to You within 15
days of the effective date of cancellation. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be
entitled to a refund.
MAINE: Section G., Cancellation items 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request
to the Producer or directly to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement
Retail Price. The right to cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the
original purchaser and is non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month
penalty will be added the refund. If You cancel this Agreement after the first 30 days o, We will refund the unearned Purchase Price calculated on
a pro-rata basis determined by the months remaining, less an administrative fee of $50 or 10% of the Purchase Price, whichever is less, and less
any paid or pending claims. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a
refund.
Section G., Cancellation, item 2., is amended by adding the following:
If We cancel this Agreement, We will mail written notice to you at least 15 day prior to the effective date of cancellation stating the date and reason
for cancellation.
MARYLAND: The following disclosures are added to this Agreement:
If the Vehicle is in repair at the time this Agreement expires, the expiration date will be automatically extended until the repair is complete. If
We fail to perform as outlined in this Agreement prior to the expiration of this Agreement, this Agreement will not terminate and the expiration
date shall be extended until Our obligations are complete pursuant to the terms and conditions of this Agreement.
Section G., Cancellation items 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
MASSACHUSETTS: The following disclosures are added to this Agreement:
NOTICE TO YOU: PURCHASE OF THIS AGREEMENT IS NOT REQUIRED IN ORDER TO REGISTER OR FINANCE YOUR VEHICLE. THE BENEFITS PROVIDED
UNDER THIS AGREEMENT MAY DUPLICATE EXPRESS MANUFACTURER’S OR SELLER’S WARRANTIES THAT COME AUTOMATICALLY WITH EVERY SALE.
THE SELLER OF THIS Agreement IS REQUIRED TO INFORM YOU OF ANY WARRANTIES AVAILABLE TO YOU WITHOUT THIS AGREEMENT.
Section G., Cancellation items 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request
to the Producer or directly to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement
Retail Price. The right to cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to
the original purchaser and is non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per
month penalty will be added to the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned
Agreement Retail Price, less a $50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-
rata basis based on the unused Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not
be entitled to a refund.
MINNESOTA: Section G., Cancellation items 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
Section G., Cancellation, item 2., is amended by adding the following:
If We cancel this Agreement for any reason listed, We will mail written notice to you at least 5 days prior to the effective date of cancellation stating
the date and reason for cancellation. If We cancel this Agreement for any other reason, We will mail written notice to you at least 15 days prior to
the effective date of cancellation stating the date and reason for cancellation.
MISSISSIPPI: Section G., Cancellation items 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
Section G., Cancellation, item 2., is amended by adding the following:
If We cancel this Agreement for non payment, We will mail written notice to you at least 10 days prior to the effective date of cancellation stating
the date and reason for cancellation. If We cancel this Agreement for any other reason, We will mail written notice to you at least 30 days prior to
the effective date of cancellation stating the date and reason for cancellation.
MISSOURI: Section I., Cancellation items 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
END-VSA-F 5/19
Page 6 of 8
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
NEVADA: The following disclosure is added to this Agreement:
If You are not satisfied with the manner We handle a claim, You my contact the Nevada Division of Insurance toll-free at (888)872-3234.
Section G., Cancellations items 1. and 2. are deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 70 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 70 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
2. CANCELLATION BY US: We may cancel this Agreement for any reason within the first 70 days of the effective date. After this Agreement has been
in effect for at least 70 days, We may only cancel this Agreement on one of the following grounds: (a) failure by You to pay the Purchase Price; (b)
Your conviction of a crime which results in an increase in the service required under this Agreement; (c) fraud or material misrepresentation by
You in presenting a Claim; (d) Your act or omission or violation of any condition of this Agreement which occurred after the effective date of this
Agreement and substantially and materially increases the service required under this Contact; or (e) a material change in the nature or extent of
the required service or repair which causes the required service or repair to be substantially and materially increased beyond that contemplated
at the time that this Agreement was sold. If We cancel this Agreement, We will mail You a written notice of cancellation at least 15 days prior to
the effective date of cancellation. If We cancel this Agreement We will refund You 100% of the Agreement Purchase Price.
NEW HAMPSHIRE: The following disclosures are added to this Agreement:
In the event that You do not receive satisfaction under this Agreement, You may contact the New Hampshire Insurance Department at 21 South
Fruit Street, Suite 14, Concord, NH 03301, 1-800-852-3416.
NEW JERSEY: Section G., Cancellations item 1. is deleted replaced with the following:
1
. CANCELLATION BY YOU: CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request
to the Producer or directly to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement
Retail Price. The right to cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to
the original purchaser and is non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per
month penalty will be added to the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned
Agreement Retail Price, less a $50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-
rata basis based on the unused Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not
be entitled to a refund.
Section G., Cancellations item 2. is deleted replaced with the following:
If We cancel this Agreement for any reason other than non-payment of the purchase price, a material misrepresentation made by You, or a sub-
stantial breach of duties by You relating to the Vehicle or its use, We will mail written notice of cancellation to You at least 5 days before the
cancellation date stating the cancellation date and reason for cancellation.
NEW MEXICO: Section G., Cancellations items 1. and 2. are deleted replaced with the following:
1
. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 70 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 70 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
2. CANCELLATION BY US: We may cancel this Agreement for any reason within the first 70 days of the effective date. After this Agreement has been
in effect for at least 70 days, We may only cancel this Agreement on one of the following grounds: (a) failure by You to pay the Purchase Price; (b)
Your conviction of a crime which results in an increase in the service required under this Agreement; (c) fraud or material misrepresentation by
You in presenting a Claim; (d) Your act or omission or violation of any condition of this Agreement which occurred after the effective date of this
Agreement and substantially and materially increases the service required under this Contact; or (e) a material change in the nature or extent of
the required service or repair which causes the required service or repair to be substantially and materially increased beyond that contemplated
at the time that this Agreement was sold. If We cancel this Agreement, We will mail You a written notice of cancellation at least 15 days prior to
the effective date of cancellation. If We cancel this Agreement We will refund You 100% of the Agreement Purchase Price.
NEW YORK: Section G., Cancellations item 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the original purchaser and is
non-transferable. If We do not provide Your refund within 30 days of the effective date of cancellation a 10% per month penalty will be added to
the refund. If You cancel this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a
$50 administrative fee, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis based on the unused
Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
Section G., Cancellations item 2. is amended by adding the following:
If We cancel this Agreement We will mail written notice to You at Your last known address stating the date and reason for cancellation at least
15 days prior to the effective date of cancellation. Written notice is not required if We cancel for non payment of the Purchase Price, a material
misrepresentation, or a substantial breach of duties by You relating to the use of Your Vehicle.
NORTH CAROLINA: Section G., Cancellations item 1. is deleted replaced with the following:
1.
CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. If You cancel
this Agreement after the first 30 days of the Effective date, We will refund the unearned Agreement Retail Price, less a $50 administrative fee, or
10% of the Purchase Price, whichever is less, and less any paid claims. The unearned Agreement Retail Price will be calculated on a pro-rata basis
based on the unused Term Months. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled
to a refund. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to a refund.
OKLAHOMA: The following disclosures are added to this Agreement:
This is not an insurance Agreement. Coverage afforded under this Agreement is not guaranteed by the Oklahoma Insurance Guaranty Association.
Our service warranty association license number is 44201497.
END-VSA-F 5/19
Page 7 of 8
Roadside Assistance is administered by Quest Towing Services, LLC, 106 West Tolles Dr., St. John, MI 48879. 833-220-0680.
Section G., Cancellations item 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. If You cancel
this Agreement after the first 30 days of the Effective date, We will refund 90% of the unearned Agreement Retail Price. The unearned Agreement
Retail Price will be calculated on a pro-rata basis based on the unused Term Months. If the Retail Price was paid by the Producer any refund will
be issued to the Producer, You will not be entitled to a refund.
OREGON: Section I., Arbitration, is amended by adding the following:
Arbitration is not mandatory and is not binding unless You and We agree to be so bound in a separate agreement. Any arbitration under
this Agreement will take place in the county and state where You reside or any other place agreed to in writing by You and Us, and will be in
accordance with Oregon Law.
SOUTH CAROLINA: The following disclosures are added to this Agreement:
In the event of a dispute between You and Us regarding this Agreement, You may contact the South Carolina Department of Insurance, Capitol
Center, 1201 Main Street, Suite 1000, Columbus, South Carolina 29201 or 1-800-768-3467.
Section G., Cancellations item 1. is deleted replaced with the following:
1
. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 60 days and receive a full refund, only applies to the original purchaser and is non-transferable. If We do not
provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to the refund. If You cancel this
Agreement after the first 30 days We will refund the unearned Purchase Price calculated on a pro-rata basis determined by the months remaining,
less an administrative fee of $50. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled
to a refund.
Section G., Cancellations item 2. is deleted replaced with the following:
If We cancel this Agreement for any reason other than non-payment of the purchase price, a material misrepresentation made by You, or a sub-
stantial breach of duties by You relating to the Vehicle or its use, We will mail written notice of cancellation to You at least 5 days before the
cancellation date stating the cancellation date and reason for cancellation.
TEXAS: Section G., Cancellations item 1. is deleted replaced with the following:
1. CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request to the Producer or directly
to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement Retail Price. The right to
cancel this Agreement in the first 30 days and receive a full refund, only applies to the original purchaser and is non-transferable. If We do not
provide Your refund within 45 days of the effective date of cancellation a 10% per month penalty will be added to the refund. If You cancel this
Agreement after the first 30 days We will refund the unearned Purchase Price calculated on a pro-rata basis determined by the months remaining,
less an administrative fee of $50. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled
to a refund.
Section G., Cancellations item 2. is deleted replaced with the following:
If We cancel this Agreement for any reason other than non-payment of the purchase price, a material misrepresentation made by You, or a sub-
stantial breach of duties by You relating to the Vehicle or its use, We will mail written notice of cancellation to You at least 5 days before the
cancellation date stating the cancellation date and reason for cancellation.
Section, I., Arbitration, is deleted and replaced with the following:
Obligations under this Benefit Program are insured under an Insurance Policy issued by Lyndon Southern Insurance Company, 10151 Deerwood
Park Blvd., Bldg. 100, Ste. 500, Jacksonville, FL 32256, Tel: (800) 888-2738. In the event We cease to operate, are bankrupt or Your claim is not
paid within 45 days after proof of loss has been filed, You may file a direct claim with Lyndon Souther Insurance Company. To do so, please call
the following toll-free number for instructions: 1-800-888-2738.
UTAH: The following disclosures are added to this Agreement:
This Agreement is subject to limited regulation by the Utah Insurance Department. To file a complaint, contact the Utah Insurance Department.
Coverage under this Agreement is not guaranteed by the Property and Casualty Guarantee Association.
The Registration Page is amended by adding the following:
If We do not provide, reimburse, or pay for a service on any claim under this Agreement within 60 days after You provide proof of loss, or if We
become insolvent or otherwise financially impaired, You may file a claim directly with Wesco Insurance Company for reimbursement, payment, or
provision of the service.
Section G., Cancellations Item. 2., is amended by adding the following:
If We cancel this Agreement, We will mail written notice of cancellation to You at least 30 before the cancellation date stating the cancellation
date and reason for cancellation. If We cancel this Agreement for non-payment of the Purchase Price, the cancellation is effective no sooner than
10 days after delivery or first class mailing of a written notice to You.
Section I., Arbitration, is deleted and replaced with the following:
Arbitration is only required if the claim in controversy exceeds the jurisdictional minimum of the small claims court of the state where the action
would be brought and resolution by a small claims court having jurisdiction is not precluded. ANY MATTER IN DISPUTE BETWEEN YOU AND US MAY
BE SUBJECT TO ARBITRATION AS AN ALTERNATIVE TO COURT ACTION PURSUANT TO THE RULES OF THE AMERICAN ARBITRATION ASSOCIATION
A COPY OF WHICH IS AVAILABLE ON REQUEST FROM US. ANY DECISION REACHED BY ARBITRATION SHALL BE BINDING UPON BOTH YOU AND US.
THE ARBITRATION AWARD MAY INCLUDE ATTORNEY’S FEES IF ALLOWED BY STATE LAW AND MAY BE ENTERED AS A JUDGMENT IN ANY COURT OF
PROPER JURISDICTION. You and We will each pay 50% of the fee required to begin arbitration. Any arbitration will be held in the county in which
You maintain Your permanent residence.
WISCONSIN: The following disclosures are added to this Agreement:
THIS AGREEMENT IS SUBJECT TO LIMITED REGULATION BY THE OFFICE OF THE COMMISSIONER OF INSURANCE.
Section G., Cancellation Item 1., is deleted and replaced with the following.
1. CANCELLATION BY YOU: CANCELLATION BY YOU: You may cancel this Agreement at any time. To cancel, You must submit a written request
to the Producer or directly to Us. If You cancel this Agreement within the first 30 days of the Effective Date We will refund Your entire Agreement
Retail Price. The right to cancel this Agreement in the first 60 days and receive a full refund, less any paid or pending claims only applies to the
original purchaser and is non-transferable. If We do not provide Your refund within 45 days of the effective date of cancellation a 10% per month
penalty will be added to the refund. If You cancel this Agreement after the first 30 days We will refund the unearned Purchase Price calculated
on a pro-rata basis determined by the months remaining, less an administrative fee of $50 or 10% of the Purchase Price, whichever is less, and
less any paid or pending claims. If the Retail Price was paid by the Producer any refund will be issued to the Producer, You will not be entitled to
a refund.
Section G., Cancellation, item 2., is amended by adding the following:
END-VSA-F 5/19
Page 8 of 8
If We cancel this Agreement, We will mail written notice of cancellation to You at Your last known address at least 5 before the cancellation date
stating the cancellation date and reason for cancellation.
Section I., Arbitration, is amended by adding the following:
Arbitration cannot be an absolute dispute remedy and both parties must agree to arbitration.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

ENDVSAF Service Agreement Registration

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 2 December 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document