Agent | Libertas General Insurance Head Office | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | BT001 | ||||||||
Effective Date | 10/12/2017 | ||||||||
Expiry Date | 10/30/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Maria Mendulo | ||||||||
Policy Number | T/BT257 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | China | ||||||||
Address | Amitofo Care Centre | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 38,953.60 | ||||||||
Total Premium (After Tax) | 46,380.94 | ||||||||
Signed by |