Agent | Continental Travel | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 010 | ||||||||
Effective Date | 06/08/2018 | ||||||||
Expiry Date | 06/23/2018 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | Alexander Alexious Forster Nguwo | ||||||||
Policy Number | 091 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | Austria | ||||||||
Address | C/O Continental Travel and Tours | ||||||||
Number of Passengers | ONE | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 41,035.05 | ||||||||
Total Premium (After Tax) | 47,805.83 | ||||||||
Signed by |