| Agent | Rennies Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL016 | ||||||||
| Effective Date | 04/14/2018 | ||||||||
| Expiry Date | 04/21/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | IRENE TADALA MAMBALA | ||||||||
| Policy Number | T/RT420 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | BELGIUM | ||||||||
| Address | RENNIES TRAVEL | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 33,498.00 | ||||||||
| Service Fees | 15000 | ||||||||
| Total Premium (After Tax) | 39,025.17 | ||||||||
| Signed by |
