# Certificate of Casualty Facultative Reinsurance

**NORTH AMERICAN REINSURANCE CORPORATION**

(herein called the Reinsurer)

HOME OFFICE NEW YORK, N.Y.

**RECEIVED** JUL 15 1977

**CERTIFICATE NO.** 0613976

**ATTN:** Mr. W. Erickson

**LEXINGTON INSURANCE COMPANY c/o MIDWESTERN RISK SPECIALISTS**

222 South Riverside Plaza Chicago, Illinois 60606

**NAME OF CEDING COMPANY:** INTERNATIONAL BUSINESS MACHINES CORPORATION

**ADDRESS:** Old Orchard Road Armonk, New York

**COMPANY'S POLICY NO.:** GC 550 18 52

**REINSURANCE PERIOD:** May 21, 1977 TO May 21, 1978

**DETAILS OF REINSURANCE AFFORDED:**

| TYPE OF INSURANCE ITEM 1. | POLICY LIMITS AND APPLICATION ITEM 2. | COMPANY RETENTION ITEM 3. | REINSURANCE ACCEPTED ITEM 4. | BASIS OF ACCEPTANCE ITEM 5. |
|---------------------------|--------------------------------------|----------------------------|-------------------------------|------------------------------|
| EXCESS UMBRELLA LIABILITY | $2,000,000 part of $21,000,000 each occurrence and in the aggregate excess of $19,000,000 limit of umbrella liability which in turn is excess of underlying limits of primary insurance or $10,000 Retention. | 50% | 50% | QUOTA SHARE |

**NET & TREATY**

**PREMIUM DUE DATE:** 5-21-77 **PREMIUM AMOUNT:** $2,500.00

**FIXED CHARGE PREMIUM**

**AUDIT PREMIUM**

**AUDIT FREQUENCY**

**COMPUTED AS FOLLOWS:**

| TOTAL PREMIUM | COMMISSION |
|---------------|------------|
| $2,500.00     | 25.0%      |

**MINIMUM PREMIUM:** For Reinsurance Period $2,500.00

**ISSUED AT:** Chicago, Illinois **DATE:** July 7, 1977

**FOR CERTIFICATE:** $______

**COUNTERSIGNED BY:** DGB

**COPY**