| Agent | Rennies Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL016 | ||||||||
| Effective Date | 09/23/2017 | ||||||||
| Expiry Date | 10/08/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | SHARRA MAKAWA ELLEN LUTE | ||||||||
| Policy Number | T/RT296 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | UGANDA | ||||||||
| Address | RENNIE TRAVEL | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 28,710.00 | ||||||||
| Total Premium (After Tax) | 33,447.15 | ||||||||
| Signed by |
