| Agent | Continental Travel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | 010 | ||||||||
| Effective Date | 09/14/2019 | ||||||||
| Expiry Date | 09/21/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | Leo Peter LOCKIE Masamba | ||||||||
| Policy Number | 140 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | Australia | ||||||||
| Address | C/O Continental Travel and Tours, | ||||||||
| Number of Passengers | One | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,733.82 | ||||||||
| Total Premium (After Tax) | 66,044.88 | ||||||||
| Signed by |
