| Agent | blueberrytravel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | MC | ||||||||
| Effective Date | 03/01/2020 | ||||||||
| Expiry Date | 03/07/2020 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Medical Only A-C | ||||||||
| Name of Policy Holder | DEUS DEDITT LUPENGA | ||||||||
| Policy Number | BB048 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | SWITZERLAND | ||||||||
| Address | BLUEBERRY TRAVEL LIMITED | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 37,769.60 | ||||||||
| Total Premium (After Tax) | 44,001.58 | ||||||||
| Signed by |
