First Name:       Last Name:      City:      State: 

Email Address:      

What are you interested in? Year:   2012 2011 2010 2009     Make:  Polaris Kawasaki Kymco Gas Gas       Model (be specific - Ex:  RZR S LE Red):          

Where did you get your quote?  Dealer Name:    Dealer City:    Dealer State: 

How much was your quote (out the door price including all fees)? $  Are you sure this includes all fees? Yes No Does it include Sales Tax? Yes No

If you received an extended warranty quote enter number of months: 12 N/A 24 36 48 60   Quoted cost in addition to price above:  $

Was this a true Polaristar, Goodtimes, or Kymco ESC?  Yes N/A No BEWARE! Some dealers sell independent warranty plans.  Insist on the manufacturer plan!

If the above quote included any accessories, Please specify:     

Accessory Description:    Part Number: 

Accessory Description:    Part Number: 

Accessory Description:    Part Number: 

Accessory Description:    Part Number: 

Accessory Description:    Part Number: 

Accessory Description:    Part Number: 

How did you receive your quote?  On Dealer Website Email Telephone Fax On-Site (verbal) On-Site (Written) Other   If other, please specify: 

If you would prefer to have a sales person contact you via phone, please provide a contact number:                                   

Additional comments: