Certificate of Insurance 
This is your Certificate of Insurance. Please print it or write down the Certificate Number for future reference. to keep our prices as low as possible we will not post this certificate to you.

POLICY NUMBER: 65003964 ISSUE DATE: 17 Nov 2006 POLICY TYPE: Options Single Trip
PLAN: International AREA: Restricted Worldwide

This policy has been issued on the basis that you have received the Product Disclosure Statement and the Financial Services Guide and that the information contained on this certificate is true and correct. If this is not the case the policy may be invalid - Please contact the providing entity immediately.

Traveller's Details
Existing Medical Conditions Insured:
Adult Traveller/s: D.O.B. Tier 2 Tier 3
 
Accompanying Children/Infant/s:
 
Mr Joshua Marks 10 Apr 1989 No No
 
Address: 6 Vincent Street     Phone(AH): 02 9818 5618
Balmain NSW 2041     Phone (BH): 02 9931 9271
Email: joshmarks@gmail.com, bobm@agsm.edu.au

Travel Details
Area of Travel: Restricted Worldwide
Country Most Time Spent in: Germany
Travel Start Date: 19 Dec 2006
Travel End Date: 26 Jan 2007
Policy Duration: 38 Days

Options to Vary Cover
Excess Chosen: 250
 
Increase Luggage Item Limit:
Item Values Item Limit Increase
Apple iBook 12" March 2005 model$1000
 

Amount Payable
Base Premium: 171.50
Existing Medical/Pregnancy Cover: 0.00
Baggage Item Limit Increase: 42.00
Increased Rental Car Insurance Excess Cover: 0.00
TOTAL AMOUNT PAYABLE: 213.50
Total GST included: 0.00
Total Stamp Duty Included 0.88


Issuing Agent's Details
Agency: AUST HEALTH MNGT - MEMBERS
Branch: WOLLONGONG
Alpha Code: AAN0212
Consultant: XX
Phone: 134246
Agent reference no. b2c
Additional Information
In the last five years the person/s insured by this policy have
a)not made three or more travel insurance claims.
b)not had insurance declined or cancelled or had a renewal refused or claim rejected.
c)not been in prison or had a criminal conviction (other than driving offences).

The person/s insured by this policy does/do not have haemophilia, a heart condition, lung condition (other than asthma satisfying the criteria under the "Self Assessment" section), dementia, reduced immunity (e.g. as a result of medication or a medical condition), kidney failure, metastatic cancer, or a condition with a terminal prognosis.


Travelling in a Motor Vehicle
When items are left unattended in a motor vehicle this policy does not cover:
*Items unless they are stored in the boot.
*Valuable items e.g. jewellery, electronic equipment (even if a boot).
*Items left overnight (even if in the boot).
*More than $2,000 in total.
Please see section 4 of the policy wording for full details.

This certificate is a receipt for monies received on behalf of Vero Insurance Limited (ABN 48 005 297 807 AFSL#230859), the Underwriter. If you are registered for GST purposes your input tax credit entitlement is based on the GST amount shown above.
Please note that in accordance with the GST law relating to insurance premiums, the GST amount may be less than 1/11th of the total premium payable.

Thank you for choosing Cover-More Travel Insurance.
We would like to wish you a safe and enjoyable journey.