Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | LL001 | ||||||||
Effective Date | 03/28/2018 | ||||||||
Expiry Date | 04/10/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Manaj Kumar Vats | ||||||||
Policy Number | T/LL382 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Israel | ||||||||
Address | P. O. Box 635 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 43,674.80 | ||||||||
Service Fees | 0.00 | ||||||||
Total Premium (After Tax) | 51,881.14 | ||||||||
Signed by |