| Agent | Libertas Lilongwe | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 001 | ||||||||||||
| Effective Date | 11/19/2018 | ||||||||||||
| Expiry Date | 11/25/2018 | ||||||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||||||
| Cover | Full Package A-I | ||||||||||||
| Name of Policy Holder | Macdonald Moffat Madikhula | ||||||||||||
| Policy Number | T/LL444 | ||||||||||||
| Country of Origin | Malawi | ||||||||||||
| Destination Area | Ireland | ||||||||||||
| Address | P.O. Box 4, | ||||||||||||
| Number of Passengers | 2 | ||||||||||||
| List of persons insured |
| ||||||||||||
| Net Premium (Before Tax) | 106,449.00 | ||||||||||||
| Service Fees | 0 | ||||||||||||
| Total Premium (After Tax) | 125,013.08 | ||||||||||||
| Signed by |
