Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | T/LL001 | ||||||||
Effective Date | 04/21/2018 | ||||||||
Expiry Date | 04/27/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Simeon Msokera | ||||||||
Policy Number | T/LL387 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Spain | ||||||||
Address | Allied Freight Agencies | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 37,769.60 | ||||||||
Service Fees | 0.00 | ||||||||
Total Premium (After Tax) | 45,001.58 | ||||||||
Signed by |