Agent | Continental Travel | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 010 | ||||||||
Effective Date | 10/31/2017 | ||||||||
Expiry Date | 11/05/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Emma Chifundo Mabvumbe | ||||||||
Policy Number | 077 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | BERLIN | ||||||||
Address | C/O CONTINENTAL TRAVEL AND TOURS | ||||||||
Number of Passengers | ONE | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 39,665.36 | ||||||||
Total Premium (After Tax) | 56,210.14 | ||||||||
Signed by |