Agent | Libertas General Insurance Head Office | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | BT001 | ||||||||
Effective Date | 03/03/2018 | ||||||||
Expiry Date | 03/05/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Memory Itimu | ||||||||
Policy Number | T/BT313 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Norway | ||||||||
Address | Queen Elizabeth Central Hosp. | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 41,314.20 | ||||||||
Total Premium (After Tax) | 49,131.04 | ||||||||
Signed by |