**ZURICH INSURANCE COMPANY**

**AMERICAN GUARANTEE AND LIABILITY INSURANCE COMPANY**

**AUDIT ADJUSTMENT OF PREMIUM**

**POLICY NO:** 86 68 700

**AGENCY BROKER NO:** 50 515

**AGENCY NAME:** Johnson and Higgins

**AUDIT NO:** 19927

**PERIOD OF AUDIT:** 1/1/73 to 1/1/74

**DATE (IF CANCEL):** 9/4/74

**NAME AND ADDRESS OF INSURED:**
- International Business Machines Corp.
- Armonk, NY

**STATE:** NY
**CLASSIFICATION OF OPERATION:** VAR
**PERIOD OF AUDIT:** 1/1/73 to 1/1/74
**COMPOSITE RATE:** N/A
**ENDORSEMENT #:** 13

| CLASS 'N. NO | PAYROLL SALES OR OTHER | RATE | PREMIUM |
|---------------|------------------------|------|---------|
| Payroll       | 2,096,744,450          | Per 1,000. | 377,414. |
| Flat          |                        |      | 65,000. |

**TOTAL:** 442,41
**LESS DEPOSIT OR OTHER CREDIT:** 437,75
**ADDITIONAL PREMIUM:** 4,66

**FORM 800-1**
**100 DM**
**Z 007131**