| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT0001 |
|---|
| Effective Date | 02/29/2020 |
|---|
| Expiry Date | 03/14/2020 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | JACQUELINE CHIMTENGO |
|---|
| Policy Number | MA176537 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | DUBLIN, IRELAND |
|---|
| Address | PRIVATE BAG 303
BLANTYRE
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| JACQUELINE CHIMTENGO |
MA176537 |
39 |
43,242.10 |
|
|---|
| Net Premium (Before Tax) | 43,242.10 |
|---|
| Total Premium (After Tax) | 52,542.04 |
|---|
| Signed by |  |
|---|
