| Agent | Libertas General Insurance Head Office | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Agent Code | BT001 | ||||||||
| Effective Date | 10/02/2020 | ||||||||
| Expiry Date | 10/10/2020 | ||||||||
| Plan | Plan A (World Wide Excluding USA & Canada) | ||||||||
| Cover | Full Package A-I | ||||||||
| Name of Policy Holder | SAMUEL FOSTER CHIWANDA | ||||||||
| Policy Number | T/BT501 | ||||||||
| Country of Origin | MALAWI | ||||||||
| Destination Area | SOUTH AFRICA | ||||||||
| Address | LLOYDS TRAVEL | ||||||||
| Number of Passengers | 1 | ||||||||
| List of persons insured |
| ||||||||
| Net Premium (Before Tax) | 43,264.38 | ||||||||
| Total Premium (After Tax) | 51403.00 | ||||||||
| Signed by |
