| Agent | Libertas General Insurance Head Office | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT0001 | ||||||||
| Effective Date | 04/20/2020 | ||||||||
| Expiry Date | 05/01/2020 | ||||||||
| Plan | Plan B (World Wide Including USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | FRANCIS WILSON | ||||||||
| Policy Number | T/BT494 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | CANADA | ||||||||
| Address | P . O. BOX 48 | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 78,039.00 | ||||||||
| Total Premium (After Tax) | 91,915.44 | ||||||||
| Signed by |
