| Agent | Continental Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 010 | ||||||||
| Effective Date | 03/13/2018 | ||||||||
| Expiry Date | 03/25/2018 | ||||||||
| Plan | Plan B (World Wide Including USA & Canada) | ||||||||
| Cover | Medical Only A-C | ||||||||
| Name of Policy Holder | McKnight Synos Kalanda | ||||||||
| Policy Number | 088 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | UNITED STATES OF AMERICA | ||||||||
| Address | C/O CONTINENTAL TRAVEL AND TOURS | ||||||||
| Number of Passengers | ONE | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 82,002.48 | ||||||||
| Total Premium (After Tax) | 95,532.00 | ||||||||
| Signed by |
