| Agent | Rennies Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 11/25/2017 |
|---|
| Expiry Date | 12/03/2017 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | CHIZAMSOKA MAYIBECK MANDA |
|---|
| Policy Number | T/RT355 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | GENEVA |
|---|
| Address | RENNIES TRAVEL
P.O.BOX 31335
LILONGWE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| CHIZAMSOKA MAYIBECK MANDA |
MS002973 |
52 |
29,510.00 |
|
|---|
| Net Premium (Before Tax) | 29,510.00 |
|---|
| Service Fees | 7320.85 |
|---|
| Total Premium (After Tax) | 34,379.15 |
|---|
| Signed by |  |
|---|
