Page 164 - Binder2
P. 164

Annual Premium


                   Insured Sections A - E

                   Payment of the premium as specified below will be deemed acceptance by the public authority
                   of the policy terms.

                     Minimum and Deposit                     GBP

                     Insurance Premium Tax at 12%            GBP

                     Total Payable                           GBP


























               Signed on behalf of the insurer
























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