**COLUMBIA CASUALTY CO.**

**PRODUCER NO.** 037982  
**BRANCH** 885  
**POLICY NUMBER** 513 69 62

**INSURED'S NAME & MAILING ADDRESS:**  
INTERNATIONAL BUSINESS MACHINES CORPORATION ETAL & IS MORE FULLY DESCRIBED ON A ATTACHED INSURED CLAUSE  
ARMONK, N.Y. 10504

**AMOUNT** $2,500,000  
**PROPERTY COVERED** OTHER

**INCEPTION (Mo. Day Yr.)** 1-1-80  
**EXPIRATION (Mo. Day Yr.)** 1-1-83  
**1 Years**

**STANDARD FIRE POLICY - POLICY FORM C-17005-A**

**Town Class**  
**Location Card By**  
**Date of Report**  
**Reinsurance**  
**APPROVED**

**DESCRIPTION AND LOCATION OF PROPERTY COVERED**  
Show address (No., Street, City, County, State, Zip Code, Construction, type of roof and occupancy of building(s) covered or containing property covered. If occupied as a dwelling state if building is a seasonal or farm dwelling. If commercial state exact nature of product (and whether manufacturer, wholesaler or retailer) or the service or activity involved.

**WRAP AROUND INSURANCE INCLUDING THIRD PARTY LIABILITY, FOREIGN D.I.C., DOMESTIC D.I.C., FOREIGN CONTINGENT BUSINESS INTERRUPTION AND DOMESTIC CONTINGENT BUSINESS INTERRUPTION.**

**Item No.**  
**PERIL(S) INSURED AGAINST AND COVERAGES PROVIDED (INSERT NAME OF EACH)**  
**Per Cent of Co-Insurance Applicable**  
**Deductible Amount**  
**Amount of Insurance**  
**Rate**  
**Prepaid or Installment Premium Due At Inception**  
**Installment Premium Due At Each Anniversary**

1. **FIRE AND LIGHTNING EXTENDED COVERAGE**  
   **N/A**  
   **N/A**  
   **$2,500,000. P/O $100,000,000 EACH OCCURRENCE AND IN THE AGGREGATE ANNUALLY WITH RESPECT TO ALL UNDERLYING COVERAGES COMBINED**

**TOTAL(S)** $23,712.28  
**TOTAL PREMIUM FOR POLICY TERM PAID IN INSTALLMENTS** $23,712.28  
**ANNUAL MINIMUM PREMIUM EARNED AT INCEPTION** $71,136.84

**Subject to Forms as attached hereto. MANUSCRIPT, ENDIT #1**

**Mortgage Clause: Subject to the provisions of the mortgage clause attached hereto, loss, if any, on building items, shall be payable to:**

**Countersignature Date**  
**OTHER RISKS OF THIS COMPANY**  
**BUREAU NAT'L**  
**DON REGIST**  
**HOOPER HOLMES**  
**RETAIL CREDIT**  
**TYPE**  
**DATE**

**C-17005-C Rev. 5-78**  
**COLUMBIA CASUALTY CO.**