The image appears to be a form or document with various sections and fields filled out. Here is a transcription of the visible text:

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[FORM NAME: EXCESS STATISTICAL DATA FOR BRIM]
[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: International Business Machines Corp.]
[Date: 6-14-79]

[Stat Plan: 18107 (Avail)]
[Type: Commercial Umbrella]
[Major Class: 2013]
[Premium: $160,849]
[State: N.Y.]
[Location: