| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT001 |
|---|
| Effective Date | 07/23/2019 |
|---|
| Expiry Date | 09/23/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | Rashid Abdul Gaffar |
|---|
| Policy Number | T/BT458 |
|---|
| Country of Origin | Malawi |
|---|
| Destination Area | Germany |
|---|
| Address | Rashy Motors
P.O Box 241
Blantyre
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| Rashid Abdul Gaffar |
MD001855 |
56 |
94,424.00 |
|
|---|
| Net Premium (Before Tax) | 94,424.00 |
|---|
| Total Premium (After Tax) | 111,003.96 |
|---|
| Signed by |  |
|---|
