Example Member Agreement
A sample of an Actual NitroFill Tire Rewards “Benefits Page.”

Below is an example of a typical NitroFill Rewards “Benefits Page,” the page that ultimately appears, and customers are encouraged to print, upon their online registration. The language that appears on each Benefits Page is tailored to match the Rewards program you have chosen and provides the new member with all relevant program information including complete benefit details, program Terms and Conditions and provider contact information.
 
NitroFill Membership
Your Benefits are Effective Beginning Sunday 7/27/2014
Brought to you by Demo
Your registration is complete.
PRINT THIS PAGE FOR YOUR RECORDS.
To ensure you will continue to receive our email reminders, please add NO-REPLY@my.nitrofill.com to your email address book. Thank you for registering your NitroFill purchase. This page confirms your registration.
 
Customer Contact Information
Name: John  Doe
Address: 123 Main St
WashingtonDC  12345US
Phone: (000) 000-0000
Email: john.doe@email.com
Registration Date: 07/24/2014
 
Customer Vehicle Information:
Year: 14 Make: Ford
Model: F150 VIN: ABCXYZ12345678900
Mileage 0
Deal or RO Number:
Service Advisor: Jim Smith
 
Dedicate Your Tree:
Dedicated By: John Doe
Dedicated To: Jane Doe
Dedication Message: To my special wife.
Post on Site: No
 
Tire and Service Tracker:
 
Service Date: 7/24/2014
 
Tire Size: 145/10.5/10 Tire Brand: BFGoodrich
Tire Model: Grabber Other Info:
Tread Depth: New
DOT #1: 123456 DOT #2: 123456
DOT #3: 123456 DOT #4: 123456
DOT #5: DOT #6:
Register Tires with Manufacturer
Customer Type: New Car
 
Due for Oil Change in 3 month(s)
Due for Tire Rotation in 6 month(s)
Due for Wheel Alignment in 12 month(s)
Due for Tire Check in 12 month(s)
Due for Tire Replacement in 24 month(s)
Due for State Inspection in  
Due for in 0 month(s)
Due for in 0 month(s)
 
Notes: Preferred Customer
 
 
Roadside Assistance / Tire & Wheel Protection:
Claims Reimbursement & Customer Service: (800) 000-0000
24-hour Emergency Roadside Only: (800) 000-0000
Member/Tag #: 0000000 Plan ID: AKB9U-R5
Effective: 07/27/2014 Expiration: 07/27/2015

CLAIMS PROCEDURES
FOR 24 HOUR EMERGENCY ROADSIDE ASSISTANCE, PLEASE CALL: 1-866-887-2381
YOU MUST CONTACT THE CLAIMS CENTER AT 1-866-873-1429
PRIOR TO ANY TIRE REPAIR OR REPLACEMENT.

24-hour Towing Benefit: As a member of our Roadside Assistance Program, You will not be required to pay any additional fees when Your service is for a tow of up to 15 miles or other covered service that does not exceed the benefit limit of $100.00 per occurrence. 2. Your membership continues for a period of 12 months from the date of NitroFill purchase and registration. 3. This is not a vehicle liability insurance contract. 4. This is not a vehicle physical damage insurance contract. 5. Service obtained from any other source other than a properly licensed and insured roadside assistance provider is not covered and is not reimbursable. 6. 24-Hour Roadside Assistance: You will be given an 800 number for Your 24-hour emergency roadside benefits. IMPORTANT: Please be with Your vehicle when the service provider arrives, as they cannot service an unattended vehicle. a. Towing: Provided for up to 15 miles at no charge to member, not to exceed the benefit limit of $100.00 per occurrence. Additional mileage/cost is the responsibility of the member and will be negotiated prior to sending out service (extrication is included - 1 truck 1/2 hour).

Delivery Of Necessary Fluids: Including gasoline, water, oil, or any supplies necessary to send a member's vehicle on its way (member is responsible for actual cost of fluids or supplies requested).

24-hour Flat Tire Change: Includes changing a flat tire with Your good spare or repairing Your punctured tire.

24-hour Jump-start: Includes tightening or cleaning of cables, jump-starts, minor adjustments to alternator etc.

24-hour Lock Out Service: If You are accidentally locked out of Your vehicle, we will help You gain entry to Your locked vehicle.

All covered services are limited to one use per 72 hour period. Commercial vehicles and vehicles used for commercial purposes are not eligible for benefits/coverage.

Emergency Tire Repair/Emergency Tire Replacement Reimbursement Benefit:
ALL CLAIMS MUST BE PRE-AUTHORIZED. YOU MUST CONTACT THE CLAIMS CENTER AT 1-866-873-1429 PRIOR TO ANY TIRE REPAIR OR REPLACEMENT. Services secured prior to receiving authorization by US are NOT covered and will not be reimbursed. Pre-Existing Conditions are not covered under the terms of this contract. All tires must have a minimum of 3/32" tread depth to qualify for any benefits. The Warrantor has the right to inspect any tire prior to claim authorization. The Warrantor may, at the Warrantor's sole discretion, elect to pay the service facility directly, via credit card or electronic payment, for any covered tire repairs or replacements, or reimburse You for covered tire repairs or replacements. All parties agree to impartial arbitration in the event of any disputes. All parties agree to abide by arbitrators decision and to share equally in the cost of arbitration. This is not a vehicle physical damage insurance contract. Tire repair or replacement may be performed by any service facility after claim authorization.

In addition to free roadside assistance service, members are entitled to $200 total tire repair/replacement reimbursement benefits, as a result of the failure of our product to protect You from such hazards, during the term of this agreement. This agreement is between the Agreement Holder (You) and Vehicle Safety Solutions, LLC. (We/Us). It provides member reimbursement benefits for tire repair/replacement up to $200 if a covered tire becomes Unserviceable due to a Road Hazard covered under this limited Agreement. Unserviceable means that the tire has been punctured or otherwise damaged to the extent that it is unsafe. Tire damage that is cosmetic in nature and that does not render the tire Unserviceable is specifically excluded. In the event that Your covered tire is not repairable, We will reimburse for the reasonable cost of a new tire (up to $200). A Road Hazard is a condition on a public roadway which should not exist there, such as potholes, nails, glass, or other road debris. Coverage is limited to a total reimbursement of $200 only during the twelve (12) month coverage period. Motorcycle tires must have a minimum of 4/32" tread remaining to qualify for coverage and coverage on motorcycle tires is limited to a total reimbursement of $100 per registered motorcycle during the twelve (12) month coverage period.

If a reimbursement is requested, You must submit a copy of this enrollment form, a fully completed and executed Claim Form, a legible photograph of the damaged area of the damaged tire and the original payment receipt indicating the repair or replacement of the damaged tire and containing the selling business’s preprinted name, address, and telephone number, the date of the tire repair/replacement, the covered vehicle’s year, make, model, VIN number, odometer reading, tire brand and size and any other information that We reasonably request to: Vehicle Safety Solutions, Claims Department, 3750 Park Central Blvd North, Pompano Beach, FL 33064. Requests must be postmarked within 30 days of the date of disablement to qualify for reimbursement. For claim reimbursements call 1-866-873-1429, 24 hours a day, 7 days a week and follow the prompts/instructions to receive a Pre-Authorization Number and Claim Form.

Additional Tire Benefit Exclusions: Coverage does not apply for the following: Commercial vehicles and vehicles used for commercial purposes including but not limited to construction purposes, delivery purposes, commercial towing, commercial farm operation, volunteer public service(s), snow plowing, rental, livery, taxi, any type of emergency vehicle or competitive or on/off road racing. Any damage that occurs outside the United States or Canada; Any claim or benefit not listed; verbal and written promises made by anyone other than Us; Tires with less than 3/32 tread remaining; replacements due to defects or covered by a recall, manufacturer or other warranty; damage of tires which are over/under sized or otherwise not recommended by the vehicle manufacturer, damage caused by collision with another vehicle, curb or median impact, lack of proper maintenance, valve or rim leaks, improper inflation, misalignment, suspension problems, tire chains, racing, off-road-use, tires transferred from another vehicle, negligence, malicious mischief, abuse, misuse, vandalism, fire or theft; any loss where You or any person on Your behalf falsely swears or commits any fraudulent act with respect to any claim; any loss covered by primary physical damage insurance; any consequential damages.

Hotel and Rental Car Discounts: You are eligible to receive savings when renting vehicles from AVIS Rental Car Company by calling 1-800-331-1212 and using Discount I.D. Number G728200. You can also take advantage of savings when making reservations at the following hotels across the country. It's easy, simply call 800-364-6176 and use the Hotel Discount Number 1000012849 to make reservations at any of the following hotels: Baymont Inn & Suites - Days Inn - Hawthorne Suites - Howard Johnson - Knights Inn - Microtel Inns & Suites - Ramada Worldwide - Super 8 - Travelodge - Wingate by Wyndham - Wyndham Hotel Group. Discount codes for hotels and rental cars are subject to change. Please contact Customer Service for assistance.

Free Trip Routing and Concierge Service: Call 1-866-873-1429. The administrator will, upon request, furnish You with general information, trip and travel information, trip itineraries, maps and more. Please allow ten (10) business days advance notice for customized Trip Routing.

 
NitroFill Tire Rewards Program

Tire Rewards Benefit:
This benefit is offered for a period of one year after the purchase date of Your qualifying NitroFill service and Your registration and activation of participation in the program (the date of the registration and activation being the Effective Date). You may renew this benefit annually, as provided below, for a maximum term of five (5) years. This benefit requires, and is offered for, the continued, consistent rotation and maintenance of the covered tires on Your covered vehicle. In order to qualify for a tire replacement reward, You must adhere to the following program guidelines and maintenance requirements:

  1. Rotate all tires consistently at only one of the following two Tire Rotation Interval options: every 5,000 miles or every 7,500 miles, from the original odometer reading provided on the Effective Date (a +/- 1,000 mile grace period applies for meeting this tire rotation requirement). Note: All tire rotations must be performed at the same Tire Rotation Interval, either every 5,000 miles or every 7,500 miles from the original odometer reading provided on the Effective Date, +/- a 1,000 mile grace period, to qualify for benefits. Proper tire inflation, balancing and alignment is highly recommended. Failure to rotate as described herein will disqualify You from reimbursement consideration.
  2. Qualified Rotations must be completed at the new automobile dealership where You purchased Your qualifying NitroFill service, a member dealer of that dealership group or at another franchise new automobile dealership, in order to be a "Qualified Rotation."
  3. You must maintain Your covered tires' inflation, when necessary, with the NitroFill tire inflation product.
  4. If the manufacturer of Your vehicle does not recommend or prohibits the rotation of tires, You must have Your tires inspected consistently at only one of the following two Tire Inspection Interval options: every 5,000 miles or every 7,500 miles, from the original odometer reading provided on the Effective Date (a +/- 1,000 mile grace period applies for meeting this tire inspection requirement). Note: All tire inspections must be performed at the same Tire Inspection Interval, either every 5,000 miles or every 7,500 miles from the original odometer reading provided on the Effective Date, +/- a 1,000 mile grace period, to qualify for benefits. The inspection must document even tread wear by measurement of the tread at the right, left and center of each tire. Proper tire inflation, balancing and alignment is highly recommended. Failure to have a tire inspection as described herein will disqualify You from reimbursement consideration.
  5. You must renew Your participation in the NitroFill Tire Rewards Program on each 12 month anniversary of the original Effective Date (+/- 30 days) by returning to the original selling new automobile dealership, purchasing a comparable NitroFill service, draining and refilling Your tires with NitroFill as required and re-registering online.

Program Does Not Allow or Cover:

  • Claims submission by hand written receipts/history reports. At the time You make Your claim You must produce evidence of rotations or inspections. These must be repair orders generated by a nationally recognized automobile dealer management system such as Reynolds & Reynolds or ADP.
  • Non-OEM tires or tires exceeding manufacturer vehicle specifications.
  • First claim coverage by manufacturer or tire warranty.
  • Tire tread depth greater than 3/32nds (subject to respective State Law Safety Regulations).
  • Tire wear that is uneven or the result of misalignment, improper inflation, out of balance, abuse, misuse, vehicle collision, curb impact to side wall, rim pinches, tire chain use, racing, off-road use, vandalism, fire, theft, or any item other than "normal" wear & tear.
  • Commercial vehicles are excluded.

Tire Replacement: ALL CLAIMS MUST BE PRE-AUTHORIZED. YOU MUST CONTACT THE CLAIMS CENTER AT 1-866-873-1429 PRIOR TO ANY TIRE REPLACEMENT During the term of Your benefit participation, if Your covered tires are in need of replacement, reach a tread depth of 3/32nds or less, and have met the maintenance requirements shown above, You may be reimbursed, up to the total benefit amount shown in the below Tire Rewards Table towards the reasonable cost of replacing Your covered tires. (Total Benefit Amount = the aggregate reward amount You may qualify for towards the cost of replacing Your covered tires under this benefit.)

Tire Rewards Table
Number of Qualified Rotations Total Benefit Amount
3 Rotations = $25
4 Rotations = $50
5 Rotations = $100
6 Rotations = $150
7 Rotations = $250
8 Rotations = $350
9 Rotations = $450
10 Rotations = $600
11 Rotations = $800
12 Rotations = $1000

Tires must be replaced at the selling dealership where You purchased Your qualifying NitroFill service for the above listed benefits. You must call 1-866-873-1429 and receive a claim number in order to become eligible for a reimbursable tire replacement.

This benefit is being provided at no cost as a part of Your NitroFill tire conversion service and registration.

Provider Network:

Roadside benefits are administered by Auto Knight Motor Club, 43100 Cook Street, Suite 200, Palm Desert, CA 92211. Service providers own and operate their equipment. Auto Knight Motor Club is not responsible for their acts and omissions. All other benefits listed above including Emergency Tire Repair/Emergency Tire Replacement Reimbursement are offered or administered by Vehicle Safety Solutions, LLC., 3750 Park Central Blvd North, Pompano Beach, Florida 33064. Vehicle Safety Solutions, LLC. is not responsible for the acts or omissions of any independent service providers.

If you wish to update your registration information please visit our website www.nitrofill.com and click on "Already a Member." Enter your NitroFill tag number and log in, make the necessary changes and click update. If you need further assistance please send an email with the information to info@nitrofillnow.com.
Thank you for choosing NitroFill!
For more information please visit www.nitrofill.com.
 
 
 
To learn more about NitroFill Tire Rewards and our Tire Inflation Maintenance Customer Retention Program,
contact your NitroFill Distributor or us directly at 1-877-2GO-FILL.
 
© NitroFill, LLC.