| Agent | Libertas Lilongwe | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | LL003 | ||||||||
| Effective Date | 03/19/2019 | ||||||||
| Expiry Date | 03/24/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Rodwell Joseph Chizumila | ||||||||
| Policy Number | T/LL/474 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Swtzerland | ||||||||
| Address | Box 331, Lilongwe | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 37,769.60 | ||||||||
| Total Premium (After Tax) | 45,001.58 | ||||||||
| Signed by |
