| Agent | Marsh Malawi Ltd | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | MMB01 | ||||||||
| Effective Date | 10/15/2017 | ||||||||
| Expiry Date | 10/25/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Jean Rene Ngando Moukala | ||||||||
| Policy Number | T/MM04 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Europe | ||||||||
| Address | C/O Marsh Malawi. | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 62,770.50 | ||||||||
| Total Premium (After Tax) | 74,127.63 | ||||||||
| Signed by |
