| Agent | Rennies Travel |
|---|
| Agent Code | LL016 |
|---|
| Effective Date | 11/12/2018 |
|---|
| Expiry Date | 11/16/2018 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | EVINESS PEMPHERO NYALUGWE |
|---|
| Policy Number | T/RT681 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | ETHIOPIA |
|---|
| Address | MANICA TRAVEL
P.O.BOX 31335
LILONGWE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| EVINESS PEMPHERO NYALUGWE |
MS000182 |
44 |
43,674.80 |
|
|---|
| Net Premium (Before Tax) | 50,881.14 |
|---|
| Service Fees | 10000 |
|---|
| Total Premium (After Tax) | 60,881.00 |
|---|
| Signed by |  |
|---|
