Bob Martin & Co
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Maximum number of pets reached.
PLEASE NOTE: you have the option to pay your premium annually. If you select this option, one of our friendly consultants will be in touch with you to set that up.
Total monthly premium: {monthly_premium}
Total annual premium: {annual_premium}
I request and authorise Renasa Insurance Co Ltd to draw against the above mentioned account, the amount necessary forpayment of the monthly premium, as and when, required. This amount will debit every month until this arrangement iscancelled in writing by either party.I accept that, if the debit date falls on a weekend, I will be debited on the subsequent working day. If no debit date is selectedP.UMA reserves the right to select the last working day of each month.
DECLARATIONI hereby confirm that all details supplied above are true and correct to the best of my knowledge. NB: Any false disclosure could result in the policy being made void. This policy will be renewed on 1 December each year. You will be informed of any changes 30 days prior to renewal.
By signing below, I hereby accept all terms and conditions (available by clicking here) related to this policy and authorise the premium to be debited off my account.
By completing this application form you consent to us obtaining any veterinary histories required from your treating vets in order for us to underwrite this risk. All your information will be treated in the strictest confidence at all times.
These are important documents & should be kept for reference purposes. A copy of the details entered will be sent to us for processing, and a reference copy will be emailed to you (at the email address you've entered) for your records.
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