| Agent | blueberrytravel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | MC | ||||||||
| Effective Date | 03/07/2020 | ||||||||
| Expiry Date | 02/29/2020 | ||||||||
| Plan | Plan B (World Wide Including USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | MARTIN TAMANDA KANJADZA | ||||||||
| Policy Number | BB062 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | UNITED STATES OF AMERICA | ||||||||
| Address | BLUEBERRY TRAVEL LIMITED | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 115,991.30 | ||||||||
| Total Premium (After Tax) | 135,129.86 | ||||||||
| Signed by |
