| Agent | Libertas General Insurance Head Office |
|---|
| Agent Code | BT001 |
|---|
| Effective Date | 10/10/2020 |
|---|
| Expiry Date | 10/26/2020 |
|---|
| Plan | Plan A (World Wide Excluding USA & Canada) |
|---|
| Cover | Full Package A-I |
|---|
| Name of Policy Holder | WENDY HLUPEKILE HARAWA |
|---|
| Policy Number | T/TB503 |
|---|
| Country of Origin | MALAWI |
|---|
| Destination Area | SOUTH AFRICA |
|---|
| Address | PRIVATE BAG 13380
LILONGWE 3
|
|---|
| Number of Passengers | 1 |
|---|
| List of persons insured | | Name |
Passport Number |
Age |
Premium |
|---|
| WENDY HLUPEKILE HARAWA |
MA898105 |
37 |
43,352.10 |
|
|---|
| Net Premium (Before Tax) | 43,352.10 |
|---|
| Total Premium (After Tax) | 51,505.20 |
|---|
| Signed by |  |
|---|
