| Agent | Libertas Lilongwe | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | GUARDIAN INSURANCE | ||||||||
| Effective Date | 10/25/2017 | ||||||||
| Expiry Date | 11/19/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | SHAMISO NAJIRA | ||||||||
| Policy Number | T/GISLL318 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | GERMANY | ||||||||
| Address | P/BAG 394 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 50,756.60 | ||||||||
| Total Premium (After Tax) | 59,131.44 | ||||||||
| Signed by |
