Agent | Libertas General Insurance Head Office | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | BT001 | ||||||||
Effective Date | 04/04/2019 | ||||||||
Expiry Date | 04/11/2019 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Roy Khonyongwa | ||||||||
Policy Number | T/BT424 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Netherlands | ||||||||
Address | Box 51621, Limbe | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 43,674.80 | ||||||||
Total Premium (After Tax) | 50,881.14 | ||||||||
Signed by |