| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT0001 |
|---|
| Effective Date | 11/19/2019 |
|---|
| Expiry Date | 11/25/2019 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | FELISTERS FRANCISCO |
|---|
| Policy Number | T/BT474 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | BERLIN, GERMANY |
|---|
| Address | P O BOX 3419
BLANTYRE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| FELISTERS FRANCISCO |
MA589031 |
26 |
43,017.00 |
|
|---|
| Net Premium (Before Tax) | 43,017.00 |
|---|
| Total Premium (After Tax) | 51,114.81 |
|---|
| Signed by |  |
|---|
