| Agent | blueberrytravel | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | MC | ||||||||
| Effective Date | 03/01/2020 | ||||||||
| Expiry Date | 03/03/2020 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | BRIGHT BLAIMU MBEWE | ||||||||
| Policy Number | BB66 | ||||||||
| Country of Origin | Malawi | ||||||||
| Destination Area | South Africa | ||||||||
| Address | Blueberry Travel Limited | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,671.10 | ||||||||
| Total Premium (After Tax) | 50,876.83 | ||||||||
| Signed by |
