| Agent | Kailash Pahlwani | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | MC | ||||||||
| Effective Date | 11/01/2019 | ||||||||
| Expiry Date | 11/10/2019 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | GREENE-LULILO MWAMONDWE | ||||||||
| Policy Number | BB018 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | NIGERIA | ||||||||
| Address | BLUEBERRY TRAVEL | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 62,770.50 | ||||||||
| Total Premium (After Tax) | 73,127.63 | ||||||||
| Signed by |
