| Agent | BON VOYAGE TOURS | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL007 | ||||||||
| Effective Date | 11/15/2018 | ||||||||
| Expiry Date | 11/25/2018 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Baldwin Samuel Chiyamwaka | ||||||||
| Policy Number | T/BVT1047 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | Netherlands | ||||||||
| Address | BON VOYAGE TOURS | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | MK43,556.76 | ||||||||
| Service Fees | 15000 | ||||||||
| Total Premium (After Tax) | MK65,745.00 | ||||||||
| Signed by |
