| Agent | Rennies Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LLO16 | ||||||||
| Effective Date | 03/15/2018 | ||||||||
| Expiry Date | 04/17/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | LESTER CHITSULO | ||||||||
| Policy Number | T/RT428 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | EUROPE | ||||||||
| Address | Rennies Travel | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 59,862.80 | ||||||||
| Service Fees | 10000.00 | ||||||||
| Total Premium (After Tax) | 59,862.80 | ||||||||
| Signed by |
