Agent | Ultimate Travel-LL | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | UTLL006 | ||||||||
Effective Date | 06/01/2019 | ||||||||
Expiry Date | 07/01/2019 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Medical Only A-C | ||||||||
Name of Policy Holder | JACK NJANJI | ||||||||
Policy Number | U/UT015 | ||||||||
Country of Origin | MALAWI | ||||||||
Destination Area | PORTUGAL | ||||||||
Address | P.O. BOX 1041 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
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Net Premium (Before Tax) | 82,823.76 | ||||||||
Total Premium (After Tax) | 82,823.76 | ||||||||
Signed by |