| Agent | Satguru Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LLW004 | ||||||||
| Effective Date | 12/08/2017 | ||||||||
| Expiry Date | 12/14/2017 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Macfarlane Trench Kamanga | ||||||||
| Policy Number | T/STG213 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Lusaka, Zambia | ||||||||
| Address | Mantino Service Complex, Kenyatta Drive, PO Box 30185, Lilongwe 3 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 48,131.04 | ||||||||
| Service Fees | 10000 | ||||||||
| Total Premium (After Tax) | 58,131.04 | ||||||||
| Signed by |
