Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | LL001 | ||||||||
Effective Date | 12/03/2017 | ||||||||
Expiry Date | 12/08/2017 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Charles Kumchenga | ||||||||
Policy Number | T/LL 342 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Brussels - Belgium | ||||||||
Address | P/Bag 11 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 50,881.14 | ||||||||
Service Fees | 0 | ||||||||
Total Premium (After Tax) | 50,881.14 | ||||||||
Signed by |