+265 111 832 844

+265 888 832 844

info@libertas.co.mw

Ground Floor, Unit House, Victoria Avenue, Blantyre

AgentRennies Travel
Agent CodeLL016
Effective Date07/13/2019
Expiry Date07/21/2019
PlanPlan A (World Wide Excluding USA & Canada)
CoverMedical Only A-C
Name of Policy HolderINNOCENT RAPHAEL HELEMA
Policy NumberT/RT804
Country of OriginMALAWI
Destination AreaTHAILAND
Address

MANICA TRAVEL
P.O.BOX 31335
LILONGWE

Number of Passengers1
List of persons insured
Name Passport Number Age Premium
INNOCENT RAPHAEL HELEMA MA527254 38 41314.20
Net Premium (Before Tax)48131.04
Service Fees20000.00
Total Premium (After Tax)68131.00
Signed by