| Agent | Libertas General Insurance Head Office | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT001 | ||||||||
| Effective Date | 09/25/2018 | ||||||||
| Expiry Date | 11/26/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | YASMEEN USMAN | ||||||||
| Policy Number | T/BT379 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | UK | ||||||||
| Address | Blockbuster Flats House No. 1, Limbe | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 77899.8 | ||||||||
| Total Premium (After Tax) | 90753.27 | ||||||||
| Signed by |
