| Agent | Libertas lilongwe | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 001 | ||||||||
| Effective Date | 10/21/2018 | ||||||||
| Expiry Date | 10/31/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Medical Only A-C | ||||||||
| Name of Policy Holder | James Raphael Kandulu | ||||||||
| Policy Number | T/LL462 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Netherlands | ||||||||
| Address | C/O Ministry of Health & Population | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 40,130.20 | ||||||||
| Service Fees | 0 | ||||||||
| Total Premium (After Tax) | 47,751.68 | ||||||||
| Signed by |
+265 111 832 844
+265 888 832 844
info@libertas.co.mw
Ground Floor, Unit House, Victoria Avenue, Blantyre
