| Agent | Rennies Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL016 | ||||||||
| Effective Date | 10/02/2017 | ||||||||
| Expiry Date | 10/06/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | STORN BINTON KABULUZI | ||||||||
| Policy Number | T/RT337 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | EUROPE | ||||||||
| Address | Rennies Travel | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 26,556.75 | ||||||||
| Service Fees | 11061.39 | ||||||||
| Total Premium (After Tax) | 30,938.61 | ||||||||
| Signed by |
