| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT0001 |
|---|
| Effective Date | 09/15/2019 |
|---|
| Expiry Date | 09/30/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | TAONGA VIOLET CHIRWA |
|---|
| Policy Number | T/BT468 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | SPAIN |
|---|
| Address | P O BOX 2047
BLANTYRE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| TAONGA VIOLET CHIRWA |
MA336785 |
29 |
43,866.88 |
|
|---|
| Net Premium (Before Tax) | 43,866.88 |
|---|
| Total Premium (After Tax) | 52,107.25 |
|---|
| Signed by |  |
|---|
