| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT001 |
|---|
| Effective Date | 10/27/2017 |
|---|
| Expiry Date | 11/13/2017 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | Sr Mercy Annie Kanyumbu |
|---|
| Policy Number | T/BT266 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | Paris-France |
|---|
| Address | Daughters of Wisdom
P.O Box 21
Lunzu
Blantyre.
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| Sr Mercy Annie Kanyumbu |
MA020613 |
61 |
65,186.60 |
|
|---|
| Net Premium (Before Tax) | 65,186.60 |
|---|
| Total Premium (After Tax) | 76,942.39 |
|---|
| Signed by |  |
|---|
