| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT0001 |
|---|
| Effective Date | 12/09/2019 |
|---|
| Expiry Date | 01/04/2020 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | OSBELL ELYVIN MWALE |
|---|
| Policy Number | T/BT465 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | IRELAND, DUBLIN |
|---|
| Address | P. O. BOX 31492
BLANTYRE 3
|
|---|
| Number of Passengers | 2 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| OSBELL ELYVIN MWALE |
MB028037 |
63 |
84,041.25 |
| DAVID JEREMIAH MWALE |
MA613144 |
4 |
0 |
|
|---|
| Net Premium (Before Tax) | 84,041.25 |
|---|
| Total Premium (After Tax) | 102,403.06 |
|---|
| Signed by |  |
|---|
