# Liability Policy Renewal Certificate

**Johnson & Higgins**
54-156 95 Wall St., New York, N.Y.

**LIABILITY POLICY RENEWAL CERTIFICATE**

**01 Coverage is provided by the Company designated by number, a stock insurance Company (hereina called the Company)**

**POLICY NUMBER** → XL-95789

**ITEM 1. INSURED'S NAME AND ADDRESS (NO STREET TOWN COUNTY STATE)**
- **INTERNATIONAL BUSINESS MACHINES CORP. (AS PER ORIGINAL POLICY)**
- **ARMONK, NEW YORK**

**5/21/70** **3 YEARS** **5/21/73**

**ITEM 2. INCEPTION (NO. DAY YR.)** **EXPIRATION (NO. DAY YR.)**

In consideration of the payment of the premium, it is agreed that the above policy is renewed by the designated Company for the policy period stated above, subject to all its terms except as otherwise stated herein.

**RENEWAL PREMIUM for this policy shall be $3750. subject to the following: PER END'T. ATTACHED**

**(a) The following percentages of the earned premiums paid under the policy of the primary insurer shall be used in computation of the final earned premium hereunder:**
- **Bodily Injury Liability:** Automobile FLAT %; Other than Automobile FLAT %
- **Property Damage Liability:** Automobile CHARGE %; Other than Automobile CHARGE %

**(b) This policy is subject to an ANNUAL MINIMUM PREMIUM OF $3750.**

**Schedule of Primary Insurance**

**NAME OF PRIMARY INSURER(S):** AS ON FILE WITH COMPANY
**POLICY NUMBER(S):**

In Witness Whereof, the company has caused this certificate to be executed and attested, but this certificate shall not be valid unless countersigned by a duly authorized representative of the company

**[Signatures]**

**SECRETARY** **PRESIDENT**

**COMPANY USE ONLY** **DATE OF ISSUE** **COUNTERSIGNED BY AUTHORIZED AGENT**

**175018-3.68**

**IMPORTANT: PLEASE ATTACH THIS CERTIFICATE TO YOUR POLICY**

**01 FIREMAN'S FUND INSURANCE COMPANY**
**18 THE AMERICAN INSURANCE COMPANY**
**07 NATIONAL SURETY CORPORATION**