Page 176 - Binder2
P. 176

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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