Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | LL001 | ||||||||
Effective Date | 04/09/2018 | ||||||||
Expiry Date | 04/15/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Victoria Munthali | ||||||||
Policy Number | T/LL388 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | France - Paris | ||||||||
Address | P.O. Box 512 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 45,001.58 | ||||||||
Service Fees | 0 | ||||||||
Total Premium (After Tax) | 45,001.58 | ||||||||
Signed by |