# Certificate of Casualty Facultative Reinsurance

**North American Reinsurance Corporation**

**Home Office:** New York, N.Y.

**Certificate No.:** 0613976

**Prior Certificate No.:** NEW

**Attention:** Mr. W. Erickson

**Does hereby reinsure:**
- **Lexington Insurance Company c/o Midwestern Risk Specialists**
  - **Address:** 222 South Riverside Plaza, Chicago, Illinois 60606

**Name and Address of Ceding Company:**
- **Name of Insured:** 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 |

**Invoice Copy - Please forward to your accounting dept. Premium due and payable**

**Premium Due Date:** 5-21-77
**Premium Amount:** $2,500.00

**Fixed Charge Premium:** ☑️
**Audit Premium:** ☐
**Audit Frequency:** 
**Commission:** 25.0%

**Computed as follows:**
- **Total Premium:** $2,500.00
- **Minimum Premium:** For Reinsurance Period $2,500.00

**Issued At:** Chicago, Illinois
**Date:** July 7, 1977

**For Certificate:** [Signature]
**Counter-signed by:** DGB