| Agent | Libertas Lilongwe | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL001 | ||||||||
| Effective Date | 10/26/2017 | ||||||||
| Expiry Date | 11/01/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Medical Only A-C | ||||||||
| Name of Policy Holder | Callum Coombes | ||||||||
| Policy Number | T/LL317 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Brussels | ||||||||
| Address | P. O. Box 825 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 37,769.60 | ||||||||
| Service Fees | 0.00 | ||||||||
| Total Premium (After Tax) | 44,001.58 | ||||||||
| Signed by |
+265 111 832 844
+265 888 832 844
info@libertas.co.mw
Ground Floor, Unit House, Victoria Avenue, Blantyre
