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Road Hazard Tire and Wheel Coverage
Step 1 - Select a Plan
Plan Duration
Plan Cost
1 Year with Unlimited Miles
$69
2 Years with Unlimited Miles
$99
3 Years with Unlimited Miles
$129
4 Years with Unlimited Miles
$159
5 Years with Unlimited Miles
$189
6 Years with Unlimited Miles
$219
7 Years with Unlimited Miles
$249
Step 2 - Customer Information
Title:
Mr.
Mrs.
Ms.
First Name:
Initial:
Last Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Step 3 - Vehicle Information
VIN:
In-Service Date:
Odometer Reading:
Mi
Km
Year:
All or 4-Wheel Drive:
Yes
No
Step 4 - Checkout
Disclosure Statement
By checking the box and submitting this form, you agree to the following: FleetPlans.com acts as a Buyer's Representative only - all contractual obligations are between the issuer of the contract and the purchaser. FleetPlans.com is not owned, operated, controlled or endorsed by any manufacturer or issuer of Service Contracts. This form is an Application for a Service Contract and does constitute a Service Contract until it is accepted by the issuer of the contract. FleetPlans.com will contact you when the Service Contract has been accepted or will issue a refund if the Application has been rejected. The following vehicles are ineligible for a Service Contract: Vehicles equipped with Right Hand Drive; Motor homes; vehicles placed in taxi or limousine service; vehicles used for emergency service, ambulance, towing and police service; vehicles used for postal, snow plow, dump truck service or severe off-road use; vehicles altered or converted from the original manufacturer's specifications; vehicles equipped with a diesel engine (except Chrysler LLC, Ford and General Motors vehicles); vehicles that operate on other than gasoline or diesel fuel systems; vehicles with a gross vehicle weight rating (GVWR) of over 14,000 pounds, vehicles not used in accordance with manufacturer's specifications for payload and/or towing capacity; any vehicle declared a total loss, or is issued a certificate of title indicating that it is designated as "salvage", "junk", "rebuilt" or words of similar impact; vehicles where the factory warranty has been voided or restricted by the manufacturer. All Service Contracts are eligible for full refund if cancelled within the first 60 days with no claims paid. Service Contracts cancelled after 60 days are subject to the cancellation provisions stated in the contract between the you and the issuer of the Service Contract. FleetPlans.com charges an Administration Fee ranging from $0 to $200 per contract. This Administration Fee is fully refundable if the Service Contract is cancelled within the first 60 days with no claims paid. The Administration Fee is not refundable for Service Contracts cancelled after 60 days from the issuance date. FleetPlans.com may receive monetary consideration from the Manufacturer, Dealer, Service Contract issuer or other parties for routing and processing of Service Contracts. FleetPlans.com makes every effort to ensure that the issuance of Service Contracts conforms to State and Local laws. Not all plans will be available in all States. FleetPlan.com is not responsible for remitting sales tax if it is required to be collected in your State - it is the obligation of the purchaser to determine if sales tax is required and to remit the sales tax to the proper agency. Information presented by FleetPlans.com is for general information only. All transactions relating to the Service Contract are solely governed by the Plan Provisions issued by the Service Contract Provider. Plan Provision will be mailed to the address you provided and arrive within 30 days of your Service Contract's acceptance. Service Contract Plan Provisions may also be available on the Internet. Contact FleetPlans.com if you have not received Service Contract Plan Provisions within 30 days of your Service Contract's acceptance. Carefully review your Service Contract Plan Provisions and contact FleetPlans.com immediately if there are any errors or omissions. FleetPlans.com will correct any errors or issue a complete refund for any issues directed to us within the first 60 days of the Service Contract's acceptance.
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