Agent | Continental Travel | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 010 | ||||||||
Effective Date | 04/20/2018 | ||||||||
Expiry Date | 05/01/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Chiletso Steven Chipanga | ||||||||
Policy Number | 090 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | Elmas Italy | ||||||||
Address | C/O CONTINENTAL TRAVEL AND TOURS | ||||||||
Number of Passengers | ONE | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 37,463.36 | ||||||||
Total Premium (After Tax) | 43,644.81 | ||||||||
Signed by |