| Agent | Marsh | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 3023 | ||||||||
| Effective Date | 11/26/2018 | ||||||||
| Expiry Date | 12/06/2018 | ||||||||
| Plan | Plan B (World Wide Including USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Chiwawa Nkhoma | ||||||||
| Policy Number | T/MarshLL451 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Washington DC | ||||||||
| Address | C/O PSI Malawi | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 96,251.80 | ||||||||
| Service Fees | 0 | ||||||||
| Total Premium (After Tax) | 112,133.35 | ||||||||
| Signed by |
