Agent | Libertas General Insurance Head Office | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | BT001 | ||||||||
Effective Date | 10/28/2017 | ||||||||
Expiry Date | 11/11/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Harvey Thom | ||||||||
Policy Number | T/BT259 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Ireland | ||||||||
Address | P.O Box 1546 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
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Net Premium (Before Tax) | 62,233.90 | ||||||||
Total Premium (After Tax) | 72,502.57 | ||||||||
Signed by |