Agent | Libertas Lilongwe | ||||||||
---|---|---|---|---|---|---|---|---|---|
Agent Code | 001 | ||||||||
Effective Date | 10/30/2019 | ||||||||
Expiry Date | 11/09/2019 | ||||||||
Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
Cover | Full Package A-I | ||||||||
Name of Policy Holder | Reuben Jefred Maigwa | ||||||||
Policy Number | T/LL550 | ||||||||
Country of Origin | Malawi | ||||||||
Destination Area | Dominican Republic | ||||||||
Address | P.O. Box 30185 | ||||||||
Number of Passengers | 1 | ||||||||
List of persons insured |
| ||||||||
Net Premium (Before Tax) | 219,983.27 | ||||||||
Service Fees | 0 | ||||||||
Total Premium (After Tax) | 256,280.51 | ||||||||
Signed by |