**Reinsurance Layoff Sheet**

**Assured:** IBM
**Type of Coverage:** Excess Umbrella
**Underlying Layer:** 40,000,000
**Policy Premium:** $25,407
**Effective Date of Reinsurance:** 5-21-79
**Policy Limit:** 5,000,000
**Policy Period:** From: 5-21-79 To: 5-21-80

**I Participating/Quota Share**

| Reinsurer | Reinsurance Broker/Direct | Percent of Participation | % of Change | Total Comm. to Company | Closing Cert. Number | Ceded Premium Annual | Pro-Rata |
|-----------|--------------------------|-------------------------|-------------|------------------------|----------------------|-----------------------|----------|
| Net Wt Unc | Direct | 20% | - | TBA | TBA | TBA | TBA |

**II Excess of Loss or Section II Casualty**

| Insurer | Reinsurance Broker/Direct | Percent of Participation | % of Change | Total Comm. to Company | Closing Cert. Number | Ceded Premium Annual | Pro-Rata |
|---------|----------------------------|--------------------------|-------------|------------------------|----------------------|-----------------------|----------|

**III Limits and Premium**

| Limits | Premium |
|--------|---------|

**Automatic Excess Treaty Reinsurance**

**Remarks:**
**Branch:**
**Underwriter:**
**Date:**

**Coding:** 24120 7/78