| Agent | Rennies Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 01/10/2018 |
|---|
| Expiry Date | 02/17/2018 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | SOYAPI TIYENKHUKWALI LUNGU |
|---|
| Policy Number | T/RT393 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | JUBA |
|---|
| Address | Rennies Travel
P.o Box 31335
ADL House
LILONGWE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| SOYAPI TIYENKHUKWALI LUNGU |
MA061582 |
52 |
36,605.25 |
|
|---|
| Net Premium (Before Tax) | 36,605.25 |
|---|
| Service Fees | 9354.88 |
|---|
| Total Premium (After Tax) | 42,645.12 |
|---|
| Signed by |  |
|---|
