Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | LL001 | ||||||||
Effective Date | 11/01/2017 | ||||||||
Expiry Date | 11/30/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | David Mbewe | ||||||||
Policy Number | T/LL328 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Spain | ||||||||
Address | Escom | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
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Net Premium (Before Tax) | 59,795.25 | ||||||||
Service Fees | 0.00 | ||||||||
Total Premium (After Tax) | 69,657.97 | ||||||||
Signed by |