**HOME OFFICE COPY**

This endorsement modifies such insurance as is afforded by the provisions of the policy relating to the following designated insurance:

- ☐ COMPREHENSIVE GENERAL LIABILITY INSURANCE
- ☐ COMPREHENSIVE AUTOMOBILE LIABILITY INSURANCE

Johnson & Higgins
#030-000208

Return Premium
$4.18

CLASS CODE - 3172
SUBLINE - 81

In consideration of a return premium, it is agreed that the Estimated Premium is amended to read:

$4,363.11

It is further agreed that the Insured's address is amended to read:
Armonk, New York
NEW YORK BRANCH
030 N205
NOV 9 '87

This endorsement forms a part of and is for attachment to the following described policy issued by the CONTINENTAL NATIONAL AMERICAN GROUP company designated therein, takes effect on the effective date of said policy, unless another effective date is shown below, at the hour stated in said policy and expires concurrently with said policy.

Must Be Completed
ENDT. NO.
POLICY NO.
Complete Only When This Endorsement Is Not Prepared with the Policy
Or Is Not to be Effective with the Policy
ISSUED TO
International Business Machine Corp.
EFFECTIVE DATE OF
THIS ENDORSEMENT
7/1/67
7/1/70

CNA
CONTINENTAL NATIONAL AMERICAN GROUP
Blank Endorsement
G-31821-A
Countersigned by:
Licensed Resident Agent