| Agent | Libertas General Insurance Head Office | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT001 | ||||||||
| Effective Date | 08/29/2019 | ||||||||
| Expiry Date | 09/12/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Sangwani Nyirenda | ||||||||
| Policy Number | T/BT462 | ||||||||
| Country of Origin | malawi | ||||||||
| Destination Area | Sweden-Norway | ||||||||
| Address | P.O Box 484 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,674.80 | ||||||||
| Total Premium (After Tax) | 51,881.14 | ||||||||
| Signed by |
