Thank you for your payment!

Print this page and keep it as a receipt of your payment.

This information has also been emailed to you at (user email address)

Check your payment on your next credit card statement under (Company Name)

Moneris Store Merchant Name

(Street Number Address Suite)
(City),(Prov)
(Postal Code)
(Phone number)
(Website URL)

Payment Details

Type

(value)

Date

(value)

Order ID

(value)

Amount (CAD)

(value)

Cardholder

(value)

Card Num

(value)

Account

(value)

Ref Num

(value)

Auth Code

(value)

Item Details

Policy Number

(value)

Total (CAD)

(value)

Refund Policy

Please note online payments may take up to two (2) business days to be reflected on your account; over-payments may be subject to refund. Refunds will be issued by cheque to the named insured.