**Document Title:**

This document appears to be an insurance endorsement form, specifically related to Zurich Insurance Company and American Guarantee and Liability Insurance Company.

**Header Information:**

- **Policy No.:** 09-06-923
- **Eff. Date of Pol.:** 5-21-79
- **Eff. Date of End.:** 5-19-81
- **Agency No.:** 50-515-810
- **Add'l Premium:** $ (Not specified)
- **Return Premium:** $ (Not specified)

**Named Insured:**
- INTERNATIONAL BUSINESS MACHINES CORP.

**Endorsement Details:**

This endorsement is issued by the company named below, which is the insurer under the policy designated above, issued to the Named Insured and forms a part of said policy as of the effective date hereof, at the hour stated in the policy Declarations.

**Additional Insured:**
- DEPARTMENT OF THE AIR FORCE
- PMEC/RMES/PL-111
- HEADQUARTERS 2750 AIR BASE WING
- WRIGHT PATTERSON, AIR FORCE BASE
- OHIO 45433

**Agreement:**
- It is agreed that the following is added as an additional insured.
- It is further agreed that should the above policy be cancelled or materially changed before the expiration date thereof, the issuing company will mail 30 days written notice to the above-named certificate holder.

**Casualty Department:**
- JOHNSON & HIGGINS
- DRM/TRE/6-21-81

**Insurance Companies:**
- ZURICH INSURANCE COMPANY
- AMERICAN GUARANTEE AND LIABILITY INSURANCE COMPANY

**Counter-signature:**
- Authorized Agent
- U-GU 116-G REV. 11-76

**MM Number:**
- 009632

**Footer:**
- United States Manager (Zurich)
- President (American Guarantee)
- Secretary (American Guarantees)